Gallstones

Description

Gallstones are hardened deposits of digestive fluid that can form in the gallbladder. The 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 is released into the 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 surgical removal of the gallbladder. Gallstones that don't cause signs and symptoms usually do not need treatment.

Symptoms

Gallstones may cause no signs or symptoms. If a stone lodges in a duct and causes a blockage, the resulting signs and symptoms may include:

  • Sudden and rapidly intensifying pain in the upper right portion of your abdomen
  • Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
  • Pa backbetween the shoulder blades
  • Pain in the right shoulder
  • Nausea or vomiting

Gallstone pain may last several minutes to several hours.

When to see a doctor

Make an appointment with your doctor if you have any of the signs or symptoms that worry you.

Search immediate care if they develop signs and symptoms of a severe complication of gallstones, such as:

  • Abdominal pain so severe that you can't sit still or find a comfortable position
  • Yellowing of the skin and the whites of the eyes (jaundice)
  • High fever with chills

Causa

It is not clear what causes gallstones to form. Doctors believe that gallstones may be the result when:

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

Types of gallstones

The types of stones that can form in the gallbladder include:

  • Cholesterol gallstones. The most common type of gillringtone of cholesterol gallstones, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but it can contain other components.
  • Bile pigments. These dark brown or black stones form when bile contains too much bilirubin.

Risk factors

Factors that may increase the risk of gallstones include:

  • The fact of being a woman
  • Being the age of 40 years or more
  • Be a Native American
  • Be a Hispanic of Mexican origin
  • To be orverweight or obesity
  • Being sedentary
  • The fact of being pregnant
  • Eating a diet high in fat
  • Eating a diet rich in cholesterol
  • Eating a diet low in fiber
  • Having a family history of gallstones
  • Have diabetes
  • Have certain blood disorders, such as sickle cell anemia or leukemia
  • Theing of weight very quickly
  • Taking estrogen-containing drugs, such as oral contraceptives or hormone therapy drugs
  • Have liver disease

Complications

Complications of gallstones may include:

  • Inflammation of the gallbladder. A stone that is embedded in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.
  • The obstruction of the common bile duct. Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to the small intestine. The severe pain, jaundice and bile duct infection can result.
  • Obstruction of the pancreatic duct.The pancreatic duct is a tube that extends from the pancreas and connects to the common bile duct just before entering the duodenum. Pancreatic juices that aid in digestion, the flow through the pancreatic duct. A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.
  • The gallbladder cancer. People with a history of gallstones have a higher risk of gallbladder cancer. But the cancer of the gallbladder is very rare, so even though the risk of cancer is high, the likelihood of gallbladder cancer is still very small.

Obstruction of the pancreatic duct. The pancreatic duct is a tube that extends from the pancreas and connects to the common bile duct before entering the duodenum. Pancreatic juices that aid in digestion, the flow through the pancreatic duct.

A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.

Prevention

You can reduce your risk of gallstones if you:

  • Do not skip meals. Try to follow with your usual lunchtime 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 foods rich in fiber. Include more fiber-rich foods in your diet, such as fruits, vegetables, and whole grains.
  • Maintain a healthy weight. Obesity and 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 reach a healthy weight, work to maintain that weight by following a healthy diet and continuing to exercise.

Gallstones

Diagnosis

Tests and procedures used to diagnose gallstones and complications of gallstones include:

  • Abdominal Ultrasound. This test is most often used to look for signs of gallstones. Abdominal ultrasound involves the displacement of a device (transducer) back and forth across your stomach area. The transducer sends signals to a computer, which creates images that show the structures in his abdomen.
  • Endoscopic ultrasound (EUS). This procedure can help to identify the smaller stones that can be lost in an abdominal ultrasound. During the USE your doctor passes a thin, flexible tube (endoscope) through your mouth and through your digestive tract. A small ultrasound device (transducer) into the tube produces sound waves that create an accurate image of the surrounding tissue.
  • Other imaging tests. Additional tests may include oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, scand computed tomography (CT) scans, magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered the use of ERCP may be removed during the procedure.
  • Blood tests. Blood tests may reveal the infection, jaundice, pancreatitis or other complications caused by the presence of gallstones.

Treatment

The majority of people with gallstones that do not cause symptoms do not need treatment. Your doctor will determine if treatment for gallstones is indicated based on symptoms and the results of diagnostic tests.

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

Treatment options for gallstones include:

  • The surgery to remove the gallbladder (cholecystectomy).Your doctor may recommend surgery to remove the gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver to your small intestine, instead of being stored in the gallbladder. You don't need your gallbladder in vivo, and the removal of the gallbladder does not affect your ability to digest food, but it can cause diarrhea, which is usually temporary.
  • Medications to dissolve gallstones.The medications that you take by mouth may help dissolve gallstones. But this can take months or years of treatment to dissolve gallstones in this way, and gallstones is likely to form again if you stop the treatment. Sometimes the drugs don't work. Medications for the gallstones are not in common use, and are reserved for people who can't undergo surgery.

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

You don't need your gallbladder in vivo, and the removal of the gallbladder does not affect your ability to digest food, but it can cause diarrhea, which is usually temporary.

Medications to dissolve gallstones. The medications that you take by mouth may help dissolve gallstones. But this can take months or years of treatment to dissolve gallstones in this way, and gallstones is likely that the form of the again if treatment is stopped.

Sometimes the drugs don't work. Medicine for gallstones are not in common use, and are reserved for people who can't undergo surgery.

Preparing for your appointment

Start by seeing your family doctor or a general practitioner if you have signs or symptoms that worry you. If your doctor suspects that you may have gallstones, you may be referred to a doctor who specializes in the digestive system (gastroenterologist) or a surgeon in the abdomen.

Because appointments can be brief, and because there is often a large amount of information to cover, it is a good idea to be well prepared. Here's some information to help you prepare, and what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time of makand the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking.
  • Have a family member or friend. Sometimes it can be difficult to understand all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their doctor.

Your time with your doctor is limited, s, or prepare a list of questions will help you get the most out of your appointment. For gallstones, some basic questions to ask your doctor include:

  • Are gallstones probably the cause of my abdominal pain?
  • There is a possibility that my symptoms are due to something other than gallstones?
  • What kinds of tests do I need?
  • There is a possibility that my gallstones will go away without treatment?
  • Do I need surgery for removal of the gallbladder?
  • What are the risks of the surgery?
  • How much time does it take to recover from gallbladder surgery?
  • Are there other treatment options for gallstones?
  • You should see a specialist? What will that cost, and will my insurance cover it?
  • I have these other health conditions. How can I best manage them together?
  • Are there brochures or other printed material that I can bring with me? What sites do you recommend?

What to expect from your doctor

Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • Are your symptoms related to food?
  • The symptoms that included a fever?
  • The symptoms been continuous or casual?
  • How severe are the symptoms?
  • How long do your symptoms last?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
The symptoms and treatment of Gallstones