Gall Bladder Stones:
Causes, Symptoms and Management
Gallstones are small deposits made of cholesterol, calcium salts, and bile pigments that form in the gallbladder.
They can cause symptoms such as abdominal pain, nausea, vomiting or fever.
Gallstones are common in people with a family history of gallstones or those who have high cholesterol levels.
In most cases, gallstones are asymptomatic. However, sometimes surgery is necessary to remove the stones because they may block the exit of the gall bladder which leads to inflammation of gallbladder or may block the common bile duct and leads to jaundice or inflammation of pancreas.
Overview
Gallstones are small, hard deposits of cholesterol and other substances made by the gallbladder. The gallbladder is a small organ that helps store and release bile to help break down food. Gallstones can range in size from tiny grains of sand to large marbles.
Gallstones are quite common. According to a survey done by the International Foundation for Functional Gastrointestinal Disorders (IFFGD) in 2006, 44% of people in North America have them at some point in their lives.
Some symptoms include:
• Abdominal pain or discomfort (usually on the upper part) that occurs suddenly and often comes with an urge to vomit or pass stool
• Nausea or vomiting
• Pain after eating fatty foods
Cause & Risk Factors:
• Family history of gallstones.
• Age: Gallstones are most common in people over the age of 40.
• Obesity and diabetes: People with obesity have a higher risk of developing gallstones, as do those with diabetes, especially if they have had it for a long time or if their condition is not well controlled by their treatment plan.
• High cholesterol levels in the blood can increase your risk of developing gallstones, especially if you also have one or more other risk factors (such as being overweight).
• Gender: Women have a higher risk of developing gallstones than men. This may be due to the fact that women have a lower concentration of bile acids in their bodies and smaller diameter bile ducts, which are the tubes that carry bile from your liver to your small intestine.
• Certain medications: Some medications can increase your risk of developing gallstones, including those used to treat cancer and HIV/AIDS, as well as antibiotics that are not needed for a current infection. Medications that can contribute to gallstone formation include thiazide diuretics (which lower blood pressure), steroids (such as prednisone), nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, and antacids containing aluminum hydroxide.
• Race: African Americans have a higher risk of developing gallstones than people from other racial backgrounds. Diet and Lifestyle Risk Factors Eating lots of fatty foods, especially those high in cholesterol, can increase your risk of developing gallstones.
Types of Gallstones:
There are several types of gallstones.
The most common type is the cholesterol stone, accounting for 80-85% of all gallstones. These stones are usually yellow in color and can be as small as a grain of sand or large enough to cause abdominal pain.
Another type of gallstone is made up of calcium bilirubinate stones, which are usually green or brown in colour and measure about 1 cm to 3 cm (0.4 inches to 1 inch).
Cholesterol stones and calcium bilirubinate stones may form separately or together. People who have high cholesterol levels are more likely to develop these types of gallstones than those with normal cholesterol levels.
Combination stones contain both calcium bile salts and cholesterol together. Combination stones can also be composed entirely of substances other than cholesterol or calcium; this rare type accounts for around 5% of total cases but causes 80% mortality rate due to complications such as obstruction and bleeding.
Symptoms:
You may feel pain in your upper part of the abdomen. It starts as a dull ache, but as it becomes more severe and lasts longer, you may notice that it is a sharp pain. You might also experience pain in the middle of your back or under your ribs on either side of your body. The pain in this area could be felt when taking deep breaths or coughing.
It can also radiate to other parts of the body including:
• The upper right shoulder region
• The middle section of chest
• Upper right side of your back
In addition to pain, there are other symptoms that can occur along with a gallstone attack.
These include:
Nausea
Vomiting
Abdominal fullness or bloating
Yellowing of the skin and eyes (jaundice)
Fever
Complications:
Gallstones may cause complications.
Complications of gallstones include:
• Gallbladder infections (cholecystitis). You may develop a gallbladder infection if you have gallstones and your gallbladder becomes inflamed.
• Gallbladder cancer. There is a possibility of gall bladder cancer if stone is more than 2 cm in size for a long term. If you have large numbers of stones or a condition called choledochal cyst, you are at risk for developing cancer in the bile ducts or the wall of your liver. This risk is higher in women than men and increases with age, but it can happen at any age.
• Inflammation of your bile ducts (cholangitis) and pancreatitis (inflammation of your pancreas). These conditions occur when stones block one or more bile ducts, preventing normal drainage of bile from the liver into the intestine. If this backup occurs in the duct joining the liver to the intestine, cholangitis can result; if it affects the area where the duct from pancreas join the intestine, then pancreatitis can occur because that organ doesn't receive sufficient drainage either.
If left untreated, these conditions can be life-threatening because they interfere with digestion and absorption of food nutrients into your system.
Diagnosis & Tests:
If you are suspected of having gallstones, your doctor will likely perform a variety of tests and exams to confirm the diagnosis. These methods may include physical examination, blood tests, imaging studies like ultrasound of abdomen, CT scan of Abdomen or MRI (MRCP).
If you have severe pain in your upper abdomen that does not go away with rest or medicine, an endoscopic ultrasound may be used to take pictures inside your body and guide doctors toward areas of concern.
An ERCP is often performed when doctors suspect that biliary stones are present but cannot find them with traditional methods like X-rays or CT scans because they are too small (less than 2 millimeters wide) or located in another part of the digestive tract besides the bile ducts such as duodenum (the first part of small intestine).
Management & Treatment:
The main treatment for gallstones is surgery.
Gallbladder removal, or cholecystectomy, is the most common surgical procedure for this condition.
Here are some other ways to manage gallbladder stones:
• Eat a healthy diet low in fat and cholesterol; avoid fatty foods such as red meat, butter and cheese; and drink plenty of fluids (unless it causes nausea).
• Reduce stress by exercising regularly and taking time for relaxation through meditation or yoga. Meditation can also help you take control over your emotions so that they do not lead to anxiety attacks that could increase symptoms of gallstones like pain or vomiting.
Gallbladder surgery is the most common treatment for people with gallstones.
Gallbladder surgery is the most common treatment for people with gallstones.
Laparoscopic Cholecystectomy is the gold standard surgical treatment for gall stones worldwide.
During the procedure, your surgeon will remove your gallbladder through an keyhole incision in your belly button. Surgery is usually performed under general anaesthesia and can be performed using a laparoscope, which is a thin tube with a camera attached to it. The laparoscope helps the surgeon see inside you so they can perform the procedure while minimizing any pain or discomfort you may experience during recovery.
Surgery takes less than an hour to complete and requires few days of recovery time in a hospital bed before you're released home again.
In conclusion, gallstones are serious condition and can be managed with the help of your doctor.
If you need immediate medical attention or have any of the symptoms mentioned above, consult your physician immediately.