Gallstones or gall bladder stones are the stones in the gall bladder, a gland which is located right behind an organ located in the right upper quadrant of the abdomen called liver. It is also called as cholelithiasis; “Chole” – bile and “lithiasis” – stones forming. Gallbladder stores bile and this is what helps in digestion and emulsification of fat, absorption of fat and fat soluble vitamins, excretion of bilirubin, decrease the acidity in duodenum.
What are these gallstones?
Gallstones can be of 3 types
1. Cholesterol stone.
2. Calcium salts of bilirubin stone (Pigment stones).
3. Mixed stone.
Image source: https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214
A little detail about gallbladder
Even though the liver produce about 500 ml of bile only 30 ml is stored in the gallbladder the rest will be continuously processing the fat that we eat in the duodenum, helping it digest. Gallstones are formed as result of bile sediment collection and crystallisation.
Gallstones – triggering factors
- People who intake excess amount of high fat foods.
- Sedentary lifestyle
- Common in 3 Fs woman: Fat, Fertile, Forty year woman or 3 F along with intake of oral contraceptive pills.
- Pregnancy
- Rapid weight loss.
- Family history
- Excess alcohol intake
- Decreased physical activity
- Liver diseases like cirrhosis.
Signs and symptoms
- Asymptomatic in most of the time and discovered incidentally.
- Pain in the right upper quadrant of abdomen within 15 min to 4 hrs after intake of foods containing fats.
- Pain upon touching or pressing at that region.
- Pain can also radiate to shoulders.
- Sudden severe pain in the right upper quadrant abdomen – gallbladder attack
- Nausea and vomiting.
- Dark coloured urine.
- Light coloured stools.
- Fever (infection)
Complications
- If the stones block the duct then it causes jaundice.
- Peritonitis.
- Infection and inflammation of gallbladder – cholecystitis.
- Inflammation of bile duct called as cholangitis.
- Pancreatitis.
- Septicemia
- Gallbladder cancer
Treatment
SURGERY – CHOLECYSTECTOMY
- This is done when the patient is having continuous symptoms like stomach pain, infection in gallbladder, pancreatitis. Surgery is the best option because it decreases the chances of having life threatening conditions like peritonitis, gallbladder cancer or its inflammation.
- The patient might have problem to digest fat but still they can be saved from such life threatening conditions and is only done when there is a surety for the development of or have already caused such complications.
- Eat low fat foods. If you are planning to intake fat rich foods take it intermittently. For example take it in small quantity and then consume another small quantity after 2 hours.
- Eat fibre rich foods.
- Drink plenty of water.
NON SURGICAL TREATMENT
- Weight reduction, noted that it must be decreased overtime and not rapid reduction within 2 months or so. Say loosing 4kg in 6 months is a healthy way of decreasing weight but by consuming low fat diet, physical activity and not by going on prolonged fasting or any other unhealthy methods.
- Medication: Ursodeoxycholic acid administration can reduce cholesterol stones but has no effect in mixed or pigmented stones.
- Lithotripsy, the shock wave dissolution of gallstones is another option. It involves the use of a highly focused sound wave to break the stone to tinier particles such that it pass via cystic and then the common duct and finally to the intestine. This is rarely done in some patients especially in pigmented or cholesterol stones.
- ERCP (Endoscopic retrograde cholangiopancreatography – removes the gallstones) can be done but it often has a risk of serious complications (pancreatitis, cholecystitis…)
Prevention
- Eat fibre rich foods.
- Drink plenty of water.
- Exercise regularly or at least 150 min per week.
- Maintain a healthy weight.
- Control and follow up regularly if you are diabetic or have cholesterol.
Written by Gayathri Gopinadh