Gallstones (Cholelithiasis)
Description
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The gallbladder is a small organ located under the liver; it is responsible for storing the bile that is produced by the liver; bile is responsible for fats digestion. Bile normally exits the gall bladder and enters the small intestine. Bile that has been stored in the gallbladder hardens into a substance like a stone to develop gallstones. Gallstones can be caused by an excess of cholesterol, bile salts, or bilirubin (a bile pigment). Cholelithiasis affects around 6% of men and 9% of women, making it a very common condition. More than 80% of people have gallstones yet don't exhibit any symptoms. However, 1% to 2% of previously asymptomatic people will develop biliary pain each year. Major complications (gallbladder inflammation, gallstones in the bile duct, bile duct inflammation) might continue to affect people who have already begun to experience symptoms at a rate of 0.1% to 0.3% per year.
Symptoms
Most people who have gallstones don’t have symptoms. Most gallstones do not initially manifest any symptoms. However, symptoms or "attacks" start to happen as gallstones get bigger or when they start blocking bile ducts. Gallstone attacks typically happen at night and after a fatty meal. The most typical signs and symptoms of gallstones are listed below. However, each person may have distinct symptoms. Symptoms may include :
- Sudden, intense abdominal pain that usually lasts between 1 and 5 hours; this type of abdominal pain is known as biliary colic.
- Nausea
- Vomiting
- Fever
- Jaundice (yellowing of the skin or eyes)
- Abdominal bloating
- Intolerance of fatty foods
- Indigestion
If you experience sudden, intense abdominal pain that lasts more than 1 hour, seek emergency care.
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View MoreCauses
- Too much cholesterol in the bile : Normally, the chemicals in your bile are sufficient to break down the cholesterol your liver excretes. However, if your liver excretes more cholesterol than your bile can break down, it may crystallize and eventually turn into stones.
- Too much bilirubin in the bile : The chemical bilirubin is created when your body breaks red blood cells. Your liver produces too much bilirubin under some circumstances, such as liver cirrhosis, biliary tract infections, and certain blood diseases. Gallstone development is influenced by excess bilirubin.
- Incomplete emptying of the gallbladder : Bile can concentrate and turn into gallstones if the gallbladder does not empty properly.
Factors that may increase the risk of having gallstones are :
- Gallstones are more common in women
- People older than 40 years old
- Family history of gallstones
- Obesity
- Use of medicines that contain estrogen (such as birth control pills)
- Pregnancy
- Lack of physical activity
- Diabetes
- Liver cirrhosis
- Rapid weight loss by surgical intervention
Diagnostics
- Ultrasound : a diagnostic technique that uses high-frequency sound waves to create an image of the internal organs.
- Cholecystography : X-ray that shows the flow of contrast fluid through the intestines into the gallbladder.
- Blood tests : to detect infection, obstruction, jaundice, and/or pancreatitis.
- Computed tomography scan (also called a CT or CAT scan)
- Endoscopic retrograde cholangiopancreatography (ERCP) : a procedure that involves inserting an endoscope through the stomach and into the small intestine.
Treatment
- Surgery to remove the gallbladder (cholecystectomy)
- Dissolving the gallstones with medications (ursodeoxycholic acid or ursodiol)
