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Gallstones
The gallbladder stores and releases bile to assist digest fats. Gallstones, stone-like objects often made from cholesterol or bilirubin, can develop within the gallbladder or bile ducts. These stones can cause pain and other complications. Treatment options often involve minimally invasive surgery to get rid of the gallstones, and sometimes the gallbladder.
What are gallstones?
Gallstones are stone-like objects that develop within the gallbladder or bile ducts (the pipe-like system within the liver). Gallstones can range dramatically in size, from tiny grains of sand to golf ball-sized objects. Interestingly, small stones can often cause the foremost trouble. These are stones which will leave the gallbladder and get stuck. Larger stones tend to stay quietly within the gallbladder. It is important to understand that a lot of folks that have gallstones are never bothered by them and do not know the stones are even there. In these cases, no treatment is needed.
What are gallstones made of?
Gallstones are made from hardened materials in your body. Typically, there are two types:
Cholesterol: Made from fatty substances within the blood, cholesterol is found throughout the body. These are the most common types of gallstones.
Pigment Stones (mainly made from bilirubin): This substance is made when red blood cells break down within the liver. Too much bilirubin can actually leak into the bloodstream and cause the skin and eyes to show yellow (jaundice).
Gallstones that are made from cholesterol tend to be greenish in color. It is more common to possess gallstones made from cholesterol than other sorts of stone.
Where do gallstones develop?
Gallstones are most ordinarily found within the gallbladder, as cholesterol stones.
Gallstones can even travel from the gallbladder to the common bile duct, which is the largest of the ducts (pipes) within the liver.
Common bile duct stones are much less common than gallstones. Stones that find their way into the common channel can create more serious medical situations than simply gallstones that remain within the gallbladder. common bile duct stones can block the common bile duct, leading to a heavy infection called cholangitis. These stones may also cause pancreatitis, a painful condition caused by inflammation of the pancreas. Stones within the common bile duct are often removed without surgery by employing a scope. Removal of the gallbladder requires surgery, which is usually done laparoscopically (a minimally invasive surgical procedure).
Illustration showing the gallstones and organs around the gallbladder.
The gallbladder may be a small organ tucked up under the liver, on the proper side of your body. It is shaped like a swollen pea pod. The gallbladder’s job is to store and dispense bile—a fluid that helps digest fats within the food you eat. Similarly to a peasecod, the gallbladder is green. This is due to the bile inside the gallbladder. Bile may be a mixture of cholesterol, bilirubin, bile salts and lecithin.
The gallbladder is connected to other parts of the gastrointestinal system through a series of ducts, or tunnels. These ducts help to hold bile and aid within the entire process of breaking down food. Ultimately, the bile finds its way into the common bile duct, where it passes through a special sphincter (a valve made from muscle), into the tiny intestine. Once there, the bile can mix directly with food that’s waiting to be digested. The common bile duct then empties bile into the duodenum, the primary portion of the very lengthy intestine .
Not all bile travels directly from the liver into the duodenum. Another portion of bile moves from the liver into the gallbladder through a special duct called the cystic duct. The gallbladder stores bile, which is out there to be used for digestion on very short notice. If a fatty meal is eaten, then the gallbladder is signaled to contract and to squeeze some stored bile into the common bile duct where it’s passed into the small intestine to mix with food. All bile finishes up within the intestine, where it helps digest food.
What are the symptoms of gallstones?
The symptoms of gallstones can vary supporting the dimensions of the gallstone. Most gallstones don't cause any symptoms in the least . These gallstones are referred to as silent stones and need no treatment. When the gallstones cause symptoms, they'll include:
What are the symptoms of gallstones?
- Pain within the upper mid abdomen or upper right abdomen.
- Associated pain in the right shoulder.
- Chest pain.
- Nausea and vomiting.
- Repeated similar episodes
- Jaundice (a yellow tint to the skin and eyes).
Why do gallstones develop?
- Forming when there's a critical concentration of cholesterol or bilirubin within the bile.
- Developing if the gallbladder is lazy and doesn’t completely empty itself of bile.
- Occurring in people with other conditions, like: 1) Cirrhosis of the liver. & 2) Blood disorders.
- During pregnancy.
- When you rapidly lose weight.
Pain is the main symptom most of the people experience with gallstones. This pain is steady and may last from around a quarter-hour to many hours. The episodes, which may be severe, generally subside after one to three hours approximately. People who have these painful attacks, while uncomfortable, aren’t in any medical jeopardy. Gallstones can cause acute cholecystitis, which may be a more serious condition when the gallbladder is really inflamed. This happens if a stone blocks off the cystic duct, which increases the pressure within the gallbladder. This condition may require antibiotics, hospitalization and even urgent surgery. Stones that pass out of the gallbladder and into the common bile duct can cause an entire blockage of the duct with jaundice, infection and pancreatitis.You may feel pain in several places, including:
- Upper part of the abdomen, on the proper side.
- Between the shoulder blades.
- des.
When people experience pain with gallstones, it's sometimes mentioned as a gallbladder attack or biliary colic. There are two special conditions that would mimic gallstone symptoms. First, some gallbladders contain a thick sludge, which has not formed into actual stones. Sometimes sludge is felt to cause symptoms almost like actual gallstone pain. Secondly, there’s an uncommon condition called acalculous cholecystitis, when the gallbladder becomes inflamed, but no stones are present. This is generally treated by surgical removal of the gallbladder.
Can children get gallstones?
Gallstones can happen to both children and adults. It is commonest to ascertain gallstones in middle-aged adults. However, adults aren't the sole ones who experience gallstones. One challenge with gallstones in children is identifying symptoms. Young children may have difficulty expressing where the pain is found. If your child has any unusual symptoms or abdominal pain, call your doctor.
How are gallstones diagnosed?
The most commonly used test to detect gallstones is an ultrasound. Ultrasound may be a painless and accurate procedure that transmits high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photographic images of the interior structures of the body. While no test is 100%, this is often a really accurate test for diagnosing gallstones. There are other radiology tests that are sometimes used, but ultrasound is the main tool for diagnosing gallbladder disease.
In general, ultrasound doesn’t visualize the common bile duct well. Though stones during this duct aren’t as common, they will happen. If they're suspected, the subsequent tests could also be done:
- Endoscopic retrograde cholangiopancreatography (ERCP): This is both a test and a possible treatment for common bile duct stones. When used as a test, an endoscope—a flexible tube with a light and a camera attached—is inserted into the patient's mouth, down the throat, and into the stomach and small intestine. A dye is injected to allow the bile ducts to stand out. If there are gallstones in the bile duct, they can be removed by the endoscope. This scope cannot remove stones contained within the gallbladder.
- Magnetic resonance cholangiopancreatography (MRCP): In MRCP, the bile ducts are examined with magnetic resonance imaging (MRI), a test that uses a large magnet, radio waves, and a computer to produce very clear images of parts of the body. Unlike ERCP, MRCP can only diagnose common bile duct stones. It cannot remove them. However, MRCP’s advantage over ERCP is that it’s the safer alternative, so often physicians will choose for MRCP initially.
- Endoscopic ultrasound (EUS): This procedure combines endoscopy with ultrasound (there’s a probe at the tip of the scope). Like ERCP, this scope is skilled at the mouth and advanced to the common bile duct and gallbladder region. It visualizes the common bile duct well. Similarly to MRCP, all stones are identified but not removed during this procedure. If common bile duct stones are demonstrated by EUS (or MRCP), then an ERCP will generally follow to urge obviate them.
How are gallstones treated?
Silent stones are not treated and should be left alone. Most people who have gallstones are in this category.If you have symptoms, such as pain, you will probably need to be treated. The most common treatment for gallstones is to get rid of the gallbladder surgically. Removal of the gallbladder is called a Cholecystectomy. In the majority of cases (90%), this surgery is often performed laparoscopically, a minimally invasive technique that leads to less post-operative pain and a faster recovery than conventional cholecystectomy. Gallstones that are found within the bile ducts may have to be removed albeit there are not any symptoms. This procedure is commonly done with the endoscopic retrograde cholangiopancreatography (ERCP) procedure.
What is a laparoscopic cholecystectomy?
Laparoscopic cholecystectomy is known as a minimally invasive procedure because it uses several small incisions instead of one large one. A laparoscope could be a narrow tube with a camera. This surgical tool is inserted through one incision. The camera allows your doctor to examine your gallbladder on a TV screen. Your gallbladder is then removed through another small incision.
What happens if a laparoscopic cholecystectomy does not work or if there are complications during surgery?
If the patient has certain complications related to gallstones, the surgeon may have to get rid of the gallbladder with an open cholecystectomy. This surgery involves an incision in the abdomen and requires a longer hospital stay (three to five days). Medical issues that would cause open cholecystectomy include:
- Having severe inflammation of the gallbladder.
- Experiencing difficulties during an attempted laparoscopic surgery.
- Having severe cardiac and respiratory issues.
- Having a late term pregnancy.
- Experiencing major scarring from a previous surgery.
- Having a bleeding disorder or liver disease.
- Having suspected gallbladder cancer, a very rare condition.
What is an endoscopic retrograde cholangiopancreatography (ERCP) procedure?
An endoscopic retrograde cholangiopancreatography (ERCP) procedure is another minimally invasive option for removing gallstones. The endoscope is a tube-like tool. Your doctor will have to move it throughout your gastrointestinal system during the treatment. The path the endoscope travels is:.
- In the mouth.
- Down the throat.
- Through the stomach.
- Into the duodenum (beginning of the small intestine) where the common bile duct empties its bile.
Once there, the endoscope is employed to get rid of any blockages within the common bile duct
Can I digest food without a gallbladder?
You don't need a gallbladder so as to digest food properly. If your gallbladder is removed, bile will flow directly from your liver through the duct and therefore the common bile duct to the tiny intestine. After the surgery, you'll experience some softer stools, which generally resolve over time.
Can gallstones be prevented?
Gallstones cannot be prevented. However, you'll decrease your risk factors by following healthy lifestyle tips. It is important to take care of a healthy weight through exercise and a diet. Talking to your doctor about weight loss and cholesterol management is additionally an enormous part of preventing gallstones.
Are there any non-surgical treatments for gallstones?
In most cases where gallstones need treatment, your healthcare provider will use a minimally invasive technique to get rid of the stone. There are medications that can be used to dissolve the stones. However, as minimally invasive methods have advanced, these drugs haven’t been used as often. Dissolving medications can take months—or possibly even years to get rid of the gallstones. By contrast, a procedure resolves the issue quickly. Using these medications to treat gallstones might be an option if you're unable to possess surgery due to another condition. Talk to your doctor about all treatment options and which one is the best fit for you.
What are the complications of gallstones?
There are several complications of a gallstone attack, including:
- Bloating.
- Nausea and vomiting.
- Abdominal pain.
- Shoulder pain.
- Back pain.
- Chest pain.
Gallstones can also cause the gallbladder or bile ducts to become infected. A blockage within the common bile duct can cause jaundice (yellowing of your skin or eyes) or can irritate the pancreas.
What foods should I avoid if I even have had gallstones within the past?
Many gallstones are formed from cholesterol. Though you can't prevent gallstones, you'll attempt to limit the quantity of fatty foods in your diet. Several tips for limiting cholesterol in your diet include:
- Eating less meat.
- Adding fish.
- Limiting the amount of fried foods.
- Adding more whole grains.
- Choosing low-fat dairy products (cheese, milk).
- Adding fresh vegetables and fruit.
Can I have gallstones more than once?
Yes. If you have experienced a gallstone attack once, it is more likely that you will have them again. The multiple attack nature of gallstones is why your doctor may suggest removing the gallbladder.
When can I return to my normal activities after having gallstones?
If you've got a gallstone that doesn't require treatment (silent stone) you'll continue on together with your normal activities directly . If you have a minimally-invasive procedure, you will need a short amount of time to recover before starting your activities again. Two major advantages of minimally-invasive procedures include a much faster recovery time and less pain. Larger, open surgeries traditionally mean more time in the hospital and a longer recovery at home. Speak together with your doctor a few realistic plans for your recovery.
When should I call my doctor?
If you're experiencing pain in your abdomen, call your doctor, especially if the pain increases over time and is related to fever, nausea or vomiting. Abdominal pain has many causes and your doctor will evaluate your symptoms carefully in order to make the correct diagnosis. If your symptoms are severe, then you may be directed to an emergency department for immediate evaluation.Are gallstones fatal?Gallstones themselves are not fatal. However, they will cause many complications that would be fatal. Fortunately, this is a rare event. If a large stone blocks your bile ducts after leaving the gallbladder, there could be a build-up of bile in the gallbladder and ducts, causing severe pain and an infection within the ducts. This is an urgent medical situation that needs prompt treatment, like an emergency endoscopic retrograde cholangiopancreatography (ERCP). Of course, all medical procedures—such as ERCP and cholecystectomy—have risks.
How quickly will I recover from gallstones?
If gallstones cause symptoms, then you'll need surgery. If you have a laparoscopic cholecystectomy (minimally invasive procedure to remove the gallbladder) without any complications, you may be home within 24 hours. If there are complicating factors—swelling of the gallbladder, infection, a blocked duct or other medical conditions may need to have an open surgery. If that happens, your hospital stay could be about three to five days.
If you are seeing the above mentioned symptoms, visit an Endoscopist/ Gastroenterologist near you immediately and get the proper treatment for Gallstones. Dr. Chirayu Chokshi & team is an expert Endoscopist in Vadodara, Gujarat. For more information, visit our website www.gastrovadodara.com or call us on 9081333897 / 9825795257 to book an appointment.
