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Gallstones (cholelithiasis) : Symptoms, Causes, Diagnosis and Treatment

What is Gallstones?

The gallbladder stores and release bile to help digest fats. Gallstones, stone-like objects often made of cholesterol or bilirubin, can develop in the gallbladder or bile ducts. These stones can cause pain and other complications. Treatment options often involve minimally invasive surgery to remove the gallstones, and sometimes the gallbladder.

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that's released into your small intestine.

Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time.

People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don't cause any signs and symptoms typically don't need treatment.

Types of Gallstones

There are two types of gallstones:

  • Cholesterol stones: These are yellow-green stones, predominately found in women and obese people. Cholesterol stones account for 80 percent of gallstones. This is the most common type in the United States.
  • Pigment stones: These may be black or brown and tend to develop in patients who have other liver conditions, such as cirrhosis or biliary tract infections.
Gallstones is also known as cholelithiasis. Cholesterol stones, Pigment stones are some common types of Gallstones. Generally Male, Female are the victim of the Gallstones. Seriousness of this disease is Low.

Symptoms of Gallstones are :

  • Pale stool
  • digestive difficulty
  • Dark color urine
  • stomach pain
  • diarrhea
  • Diarrhea is characterized by loose, watery stools or a frequent need to have a bowel movement. It usually lasts a few days and often disappears without any treatment. Diarrhea can be acute or chronic.

    Acute diarrhea occurs when the condition lasts for one to two days. You might experience diarrhea as a result of a viral or bacterial infection. Other times, it could be due to food poisoning.

    There?s even a condition known as traveler?s diarrhea, which happens when you have diarrhea after being exposed to bacteria or parasites while on vacation in a developing nation. Acute diarrhea is fairly common.

    Chronic diarrhea refers to diarrhea that lasts for at least four weeks. It?s usually the result of an intestinal disease or disorder, such as celiac disease or Crohn?s disease.

  • Vomiting
  • Vomiting, or throwing up, is a forceful discharge of stomach contents. It can be a one-time event linked to something that doesn?t settle right in the stomach. Recurrent vomiting may be caused by underlying medical conditions.

    Frequent vomiting may also lead to dehydration, which can be life-threatening if left untreated.

  • Nausea
  • Nausea and vomiting are common signs and symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis ? often mistakenly called stomach flu ? or the morning sickness of early pregnancy.

    Many medications can cause nausea and vomiting, as can general anesthesia for surgery. Rarely, nausea and vomiting may indicate a serious or even life-threatening problem.

    Causes

    Gallstones can be caused due to:

    It's not clear what causes gallstones to form. Doctors think gallstones may result when:

    • Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.
    • Your bile contains too much bilirubin. Bilirubin is a chemical that's produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation.
    • Your gallbladder doesn't empty correctly. If your gallbladder doesn't empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones.

    What kind of precaution should be taken in Gallstones?

    You can reduce your risk of gallstones if you:

    • Don't skip meals. Try to stick to your usual mealtimes each day. Skipping meals or fasting can increase the risk of gallstones.
    • Lose weight slowly. If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds (about 0.5 to 1 kilogram) a week.
    • Eat more high-fiber foods. Include more fiber-rich foods in your diet, such as fruits, vegetables and whole grains.
    • Maintain a healthy weight. Obesity and being overweight increase the risk of gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get. Once you achieve a healthy weight, work to maintain that weight by continuing your healthy diet and continuing to exercise.

    How it can be spread?

    Gallbladder cancer can spread from the inner walls of the gallbladder to the outer layers and then on to the liver, lymph nodes, and other organs. The symptoms of gallbladder cancer may be similar to those of acute cholecystitis, but there may also be no symptoms at all.

    Treatment for the Gallstones

    Diagnosis:

    A diagnosis of gallstone disease begins with a comprehensive physical exam during which you describe your symptoms and medical history. Often, the physical exam will be completely normal. Sometimes, your doctor can feel the gallbladder, and there may be some abdominal tenderness. Other diagnostic procedures include:

    • Laboratory tests
    • Imaging scans
    • Endoscopic diagnosis

    Laboratory Tests

    Blood tests will check your liver function. If there are complications from gallstones, the tests will be abnormal.

    Imaging Scans

    Gallstones, especially those that are asymptomatic, are often discovered accidentally during an imaging scan for another problem. If you need an imaging scan based on your history and physical exam, there are a number of procedures available. Imaging scans use different technologies to determine the presence and location of gallstones.

    • Ultrasound: An abdominal ultrasound is the best noninvasive test for detecting gallstones in the gallbladder. An ultrasound uses sound waves to create images of your organs. It is a simple, safe and painless procedure that provides accurate information about the presence of gallstones.
    • CT scan: A CT scan is a powerful X-ray. It can detect complications of gallstone disease, such as excess fluid, gas in the gallbladder wall, gallbladder perforations and abscesses (collections of pus in the body). A CT scan may help determine if you need urgent surgical intervention.
    • MRI and magnetic resonance cholangiopancreatography (MRCP): An MRI uses strong magnetic waves to create a detailed picture. An MRCP uses MRI imaging with special software to help detect gallstones and bile duct stones and evaluate the gallbladder for presence of cholecystitis (inflammation).
    • Cholecystingraphy: You receive an intravenous radioactive substance, which your liver absorbs and then is secreted into the gallbladder and bile ducts. Scans are then taken that can accurately detect acute inflammation of the gallbladder.

    Endoscopic Diagnosis

    An endoscope is a thin, flexible, lighted tube inserted into your mouth. It reaches your esophagus, stomach and small intestine. Using the endoscope, you doctor can visualize your biliary system.

    Endoscopic Retrograde Cholangiopancreatography

    Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred method for detecting gallstones in the common bile duct. Because the endoscope is in position, stones can be removed during an ERCP. During this procedure:

    • A special side-viewing endoscope called a duodenoscope is used.
    • This scope is specially designed to allow the placement of necessary accessories into the bile and pancreatic duct and remove bile duct stones.
    • A catheter is used to inject dye into the ducts.
    • An X-ray is taken to obtain images of your pancreatic and biliary ducts.

    Endoscopic Ultrasound

    Endoscopic ultrasound (EUS) uses both an endoscopy and an ultrasound to evaluate and diagnose digestive tract disorders, and together they produce detailed images of your bile duct and gallbladder. Unlike an ERCP, an EUS cannot be used to remove gallstones. However, it is an accurate diagnostic tool and presents a lower risk of complications than ERCP.

    Treatment:

    Most people with gallstones that don't cause symptoms will never need treatment. Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing.

    Your doctor may recommend that you be alert for symptoms of gallstone complications, such as intensifying pain in your upper right abdomen. If gallstone signs and symptoms occur in the future, you can have treatment.

    Treatment options for gallstones include:

    • Surgery to remove the gallbladder (cholecystectomy). Your doctor may recommend surgery to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder.

      You don't need your gallbladder to live, and gallbladder removal doesn't affect your ability to digest food, but it can cause diarrhea, which is usually temporary.

    • Medications to dissolve gallstones. Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way, and gallstones will likely form again if treatment is stopped.

      Sometimes medications don't work. Medications for gallstones aren't commonly used and are reserved for people who can't undergo surgery.

    Possible complication with Gallstones

    The gallbladder may form an abnormal passageway, or fistula, between the gallbladder and the intestine to help process the liver?s bile. This is most often a complication of chronic inflammation related to gallstones.

    Other complications can include:

    References:

    1 https://www.pristyncare.com/gp/pune-gallstones-cholecystectomy 2 https://www.hopkinsmedicine.org/health/conditions-and-diseases/gallstone-disease 3 https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214 4 https://www.webmd.com/digestive-disorders/gallstones 5 https://www.healthline.com/health/gallstones 6 https://my.clevelandclinic.org/health/diseases/7313-gallstones 7 https://www.healthline.com/health/gallbladder-disease 8 https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/symptoms-causes 9 https://www.nhs.uk/conditions/gallstones/ 10 https://www.medicalnewstoday.com/articles/153981

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