Gallstones – Overview
Gallstones are hardened deposits of digestive fluid that can form in the gallbladder are called gallstones. The gallbladder is a shaped as small, pear-shaped organ on the right side of the abdomen, just beneath the liver. A digestive fluid is held by the gallbladder called bile that’s released into the small intestine.
Size of Gallstones ranges from as small as a grain of sand to as large as a golf ball. Some people produce just one gallstone, while others develop several gallstones at the same time.
Gallbladder removal surgery is required usually for people who are experiencing symptoms from the gallstones. If not signs or symptoms are caused then no treatment is required usually.
Gallstones – Symptoms
No signs or symptoms may be caused by gallstones. If gallstone is lodged in a duct and causes a blockage, the signs and symptoms may include:
- Pain is sudden and intensifying rapidly in the upper right portion of the abdomen
- Pain is sudden and intensifying rapidly in the center of the abdomen, just under the breastbone
- Pain in the back between the shoulder blades
- Right shoulder pain
- Nausea or vomiting
The pain from gallstone may last several minutes to a few hours.
If the signs and symptoms are worrisome, an appointment with the doctor should be made
Immediate care should be sought if developing signs and symptoms of a serious gallstone complication, which can be:
- Intense Abdominal pain that can’t make difficult to sit still or find a comfortable position
- Yellowing of the skin and the whites of the eyes (jaundice)
- High fever with chills
What causes gallstones to form is still unclear. Gallstones may result when:
- Normally, the bile holds enough chemicals for dissolving the cholesterol excreted by the liver. But if the liver is excreting more cholesterol than the bile can dissolve, crystals may be formed and eventually forms into stones due to the excess cholesterol.
- A chemical that’s produced when the body breaks down red blood cells is known as bilirubin. Certain conditions cause too much bilirubin can be made by the liver, including liver cirrhosis, biliary tract infections and certain blood disorders. Contribution to gallstone formation can be the excess bilirubin.
- Bile may become very concentrated if the gallbladder not emptying fully or enough, contributing to the formation of gallstones.
Types of gallstones
Types of gallstones that can be formed in the gallbladder may include:
- Cholesterol gallstone is the most common type of gallstone, often appears yellow in color. They are composed mainly of undissolved cholesterol, but may carry other components.
- Pigment gallstones are in the form dark brown or black stones when the bile contains too much bilirubin.
Gallstone – Risk factors
Risk of gallstones may be increased by some factor that may include:
- Aged 40 or older
- Native American
- Mexican American
- Overweight or obese
- Being pregnant
- Consuming a high-fat diet
- Consuming a high-cholesterol diet
- Consuming a low-fiber diet
- Family history of gallstones
- Certain blood disorders, such as sickle cell anemia or leukemia
- Weight loss very quickly
- Consuming medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
- Liver disease
Gallstones – Complications
Gallstones complications may include:
- Inflammation of the gallbladder can be caused when a gallstone that becomes lodged in the neck of the gallbladder which is known as cholecystitis. Cholecystitis can cause pain which is severe and fever.
- Blockage of the common bile duct in gallstones through which bile flows from the gallbladder or liver to the small intestine. Infections that can result in severe pain, jaundice and bile duct
- A tube that runs from the pancreas and connects to the common bile duct just before entering the duodenum is known as the pancreatic duct. Aiding in digestion by the pancreatic juices which flow through the pancreatic duct.
A blockage can be caused by the gallstone in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Intense, constant abdominal pain can be caused by pancreatitis and usually requires hospitalization.
- Risk of gallbladder cancer can be increase if having a history of gallstones. Even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very rare.
Gallstones – Prevention
Risk of getting gallstones can be reduced if:
- Try and follow to the regular mealtimes each day. The risk of gallstones may increase if meals are skipped or doing fasting
- If wanting to reduce weight do it slowly. Rapidly increasing weight loss can increase the risk of gallstones. Make a goal to lose 1 or 2 pounds (about 0.5 to 1 kilogram) a week.
- More fiber-rich foods should be included in diet, such as fruits, vegetables and whole grains.
- A healthy weight should be maintained as obesity and being overweight increase the risk of gallstones. Try to achieve a healthy weight by decreasing the number of calories being eaten and increasing the amount of physical activity. Once a healthy weight is achieved, try in maintaining that weight by continuing the healthy diet and exercise.
Gall stones – Diagnosis
To diagnose gallstones and complications of gallstones tests and procedures may include:
- Abdominal ultrasound is a test that is most commonly used to look for signs of gallstones. Moving a device (transducer) is moved back and forth across the stomach area is involved in the abdominal ultrasound. Signals are sent to a computer by the transducer, which creates images that show the structures in the abdomen.
- Endoscopic ultrasound (EUS) is a procedure that can help to identify stones which are smaller which may be missed on an abdominal ultrasound. During EUS the doctor passes a thin, flexible tube known as endoscope through the mouth and through the digestive tract. A small ultrasound device (transducer) in the tube produces sound waves and a precise image of surrounding tissue is created.
- Additional imaging tests may include oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones which are discovered using ERCP test can be removed during the procedure.
- Infection, jaundice, pancreatitis or other complications caused by gallstones can be revealed through blood tests.
Gallstones – Treatment
Treatment will not be required for most people having gallstones but symptoms are not caused. It will determined by the doctor if treatment for gallstones is indicated based on the symptoms and the outcomes of diagnostic testing.
The doctor may suggest being alert for symptoms of gallstone complications, such as intensifying pain in the upper right abdomen. Treatment can be done if the signs and symptoms occur in the future.
Treatment options for gallstones include:
- Surgery to remove the gallbladder may be recommended by the doctor, since gallstones frequently recur. Bile will flow directly from the liver into the small intestine once the gallbladder is removed, rather than being stored in the gallbladder.
Gallbladder is not needed for living, and gallbladder removal doesn’t affect the ability to digest food, but it can cause diarrhea, which is generally temporary.
- To help dissolve gallstones, medications may be given to consume by mouth. In this way, it might take months or years of treatment to dissolve the gallstones, and gallstones will likely form again if treatment is not continued.
Medications don’t work sometimes. Medications for gallstones aren’t consumed commonly and are kept for people who can’t undergo surgery.
Preparing for appointment
Family doctor or a general practitioner should be consulted first if having any signs or symptoms that are worrisome. If it is suspected by the doctor of having gallstones, a specialized doctor may be referred who specializes in the digestive system (gastroenterologist) or to an abdominal surgeon.
There’s often a lot of information has to be covered as the appointments can be brief, it’s a good idea to be well prepared. Below are some information to help in getting ready, and what to expect can be expected from the doctor.
- At the time of scheduling the appointment, make sure to ask if there’s anything that needs to be done in advance, such as restricting diet.
- Any symptoms which are experienced should be written down, including any that may seem unrelated to the reason for which the appointment is scheduled
- Key personal information should be noted, including any major stresses or recent life changes.
- A list of all medications should be made, vitamins or supplements that are being taken.
- Family member or a friend should come along as it can be difficult to grasp all the information provided during an appointment. Someone who is accompanying may remember something that was missed or forgot.
- Questions to ask the doctor should also be written
Time with doctor is limited, so a list of questions if prepared will help in making the most of the appointment. For gallstones, some basic questions to ask the doctor may include:
- Gallstones being the likely cause of abdominal pain?
- A chance that the symptoms are because of something other than gallstones?
- Kinds of tests to be needed?
- A chance that gallstones may be cured without treatment?
- Gallbladder removal surgery needed or not?
- The risks of surgery?
- Recovery from gallbladder surgery?
- Other treatment options for gallstones?
- A specialist should be referred? Cost, insurance cover?
- Managing with other health conditions together?
- Brochures or other printed material available? What websites recommended?
What to expect from the doctor
Your doctor may ask questions like:
- Beginning of experiencing symptoms?
- Symptoms connected to eating?
- Symptoms ever included a fever?
- Symptoms been continuous or occasional?
- Severity the symptoms?
- How long does the symptoms last?
- Anything that seems to improve the symptoms?
- Anything that appears to worsen the symptoms?