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Your Ultimate Guide for Gallstones (Cholelithiasis)

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Your Ultimate Guide for Gallstones (Cholelithiasis)

Gastro Science | Posted on 02/24/2023 by Dr. B D Soni



Do you feel intermittent pain in the upper right part of your abdomen?? Does it last for more than one to five hours? Can you feel the pain in your back and shoulder? If yes, then it could indicate gallstones (Cholelithiasis) in your gallbladder. Well, one of the most common digestive problems around the world is gallbladder stones. As per one study, it is found that in most developed countries, an estimated 10%-15% of people have gallbladder stones. The gallbladder is located under the liver on the right side of the abdomen and resembles the shape of a small pear.

Gallbladder stones or Choleliathiasis are stone-like objects that form in the gallbladder as bile ducts. Bile is a fluid that is produced by the liver and is made up of several substances. These substances are bilirubin and cholesterol which are stored or released by the gallbladder and help in digesting fats.

Gallstones can cause pain depending on the number and size. It may vary from the size of a tiny grain of sand or maybe as large as a golf ball. Although no combination of number and size can predict whether symptoms will occur or not and the severity of the symptoms. Usually, the treatment option for gallbladder stones is surgery, but it is recommended depending on the severity of the symptoms the patient is experiencing.

In this blog, we are going to discuss everything related to Cholelithiasis.

What are gallstones (Cholelithiasis)?

Gallstones also known as Cholelithiasis are hard deposits of cholesterol and other substances which look like pebbles. These occur in various sizes. The size varies as small as a tiny grain of sand and is not so harmful if in the initial stages. Sometimes, it can occur in large sizes like golf balls.

These stones can be composed of one or a mixture of substances. The normal pieces are a mix of calcium bilirubin, cholesterol, and calcium carbonate. They regularly fall under one of three characterizations. Blended stones are composed of a cholesterol substance of 20-80% of the mass of the stone.

Pigment stones are under 20% cholesterol. They are composed of calcium salts and bilirubin. They have dark shade and are normally small. Cholesterol stones have a body weight of at least 80% cholesterol. They commonly have a dark focal spot and are brownish, dull green or yellow.

What are the types of gallstones?

There are two types of gallstones (Cholelithiasis) which include:

  • Pigment stones: These are made up of bilirubin and occur in people who have certain conditions, such as cirrhosis of the liver or blood disorders.
  • Cholesterol stones: These are made up of cholesterol and occur when there is too much cholesterol or bilirubin in the bile. Most gallstones tend to be cholesterol stones.

What causes gallstones?

Some of the Choleliathiasis causes are listed below:

  • Disorder in bile composition
  • Fluctuations in the proportion of bile salts and cholesterol
  • Inflammation or irritation of the gall bladder lining
  • Narrow bile ducts
  • A diet high in cholesterol or calcium
  • Obesity
  • Ageing
  • Ailments like diabetes
  • Pregnancy
  • Intake of birth control pills
  • Hormone replacement therapy

What are Choleliathiasis symptoms?

If you have any of the following symptoms, you must consult a medical professional immediately.

  • Recurring pain in Upper Right Abdomen, Back or Shoulder
  • Nausea and Vomiting
  • Indigestion, Bloating and Belching
  • Intolerance of Fatty Foods
  • Fever
  • Jaundice
  • Pancreatitis
  • Discolouration of Urine and Stool

What are the risk factors for gallstones?

The risk factors for gallstones are:

  • Hereditary problem of gallstones/family history
  • Regular intake of cholesterol-controlling pills and medications
  • Diabetes
  • Weight loss and loss of appetite rapidly
  • Treatment for hormone replacement therapy or intake of birth control pills
  • Pregnancy
  • Obesity
  • A diet without including proper fibre and maximum level of fats and cholesterol

How are gallstones (Cholelithiasis) diagnosed?

Your doctor will order the following tests for gallstones diagnosis:

  • Endoscopic Ultrasound

This device uses a special scope with an ultrasound probe on the end. The scope is passed down into the small intestines where internal bile ducts, gallbladder and pancreas ultrasound images can be taken. It helps locate bile duct stones that may be missed by ordinary ultrasound. The test also assists in diagnosing cancers within the pancreas and bile ducts.

  • ERCP

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a special type of endoscope, which allows access to the bile ducts and pancreas. It is performed by removing stones from the bile ducts or pancreas.

  • MRCP

Magnetic Resonance Cholangiopancreatography (MRCP) is a test which involves using a machine called MRI (Magnetic Resonance Imaging). A non-invasive test, it employs special computer software for producing images of the bile and pancreatic ducts similar to the images gathered by ERCP and doesn’t need an endoscopy. Anomalies found on MRCP can be further evaluated or treated by ERCP or surgery.

How are gallstones (Cholelithiasis) treated?

In most cases, there is no need for gallstones treatment unless they are causing pain. Sometimes, you can pass gallstones through urine even without noticing. The doctor will consider surgery if you are in severe pain otherwise, a medication treatment option is considered.

If a doctor suspects that you are at higher risk for surgical complications, then there are various non-surgical methods for gallstone treatment.

Here are surgical options that might be considered:

  • Laparoscopic cholecystectomy- It is a normal surgery performed with general anaesthesia. Three to four incisions are made by the surgeon in the abdomen and with a small, lighted device, the doctor looks for the stones and cautiously removes the gallbladder.
  • Open cholecystectomy- This surgery is done when there is inflammation, infection or scarring in the gallbladder. It is also considered if issues occur during laparoscopic cholecystectomy.

Non-surgical treatment

If surgery cannot be considered due to any specific reason, then here are other non-surgical treatment options the doctor will consider:

  • Oral dissolution therapy- Involves the use of medications to rupture gallstones. It is a suitable option for cholesterol stones which might take months or years to work
  • Shock wave lithotripsy- A machine named lithotripter is used for breaking gallstones through shock waves into small pieces. A Lithotripter is a machine that generates shock waves.
  • Percutaneous drainage of the gallbladder- Involves the placement of a sterile needle into the gallbladder for drawing out bile. This treatment option is for people who aren’t seeing any improvement with other options.

Conclusion

Gallstones or Cholelithiasis are common these days and usually, they are never a cause of concern. You will probably never know that the stones are there if they stay put in the gallbladder. They become dangerous, once they start to move. It is important to know that these tiny, pebble-like pieces can harm and can enter into the tight spaces of the delicate biliary system.

A gallbladder attack can be severe and dangerous at the same time, primarily if you didn’t know that you have gallstones. In such cases, the recommended treatment option is surgery. It is crucial to understand the symptoms of gallstones and obtain information. Speak to your doctor about your options and know what’s suitable for you.

FAQs

Are gallstones dangerous?

Usually, gallstones or Cholelithiasis is not dangerous, but if they enter the bile duct and the treatment is ignored, then it can cause blockage in the pancreatic duct leading to pancreatitis. It can cause severe, continuous abdominal pain, and needs hospitalization. People having a history of gallstones are at higher risk of gallbladder cancer.

Can gallstones be dissolved?

Yes, doctors generally recommend Ursodiol for dissolving gallstones to people who don’t want to go through a surgical procedure. This medication helps in preventing gallstone formation.

How to prevent gallstones?

It is very simple to reduce the risk of developing gallstones. All you need to do is make some below changes in your life:

  • Restrict the consumption of fast foods and gallstones
  • Replace red meat with fish
  • Eat a diet which includes high-fibre fruits, vegetables, and whole grains
  • Lose weight if you are overweight