What is Cholelithiasis ? (Gallbladder stones)

GALLBLADDER

Gallbladder is a small, pear-shaped organ on the right side of our abdomen, beneath the liver. The gallbladder holds a digestive fluid that’s released into our small intestine (bile).

What Are Gallstones

Gallstones are pieces of solid material that form in our gallbladder, a small organ under liver. 

Our gallbladder stores and releases bile, a fluid made in the liver, to help in digestion. Bile also carries wastes like cholesterol and bilirubin, which our body makes when it breaks down red blood cells. These things can form gallstones.

Gallstones can range from the size of a grain of sand to that of a golf ball. If they block a bile duct, causing pain that needs treatment right away.

Gallstone Types

The two main kinds of gallstones are:

Cholesterol stones. These are usually yellow-green. They’re the most common, making up 80% of gallstones.

Pigment stones. These are smaller and darker. They’re made of bilirubin.

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Signs and Symptoms of Gallstones
  • Pain in your upper abdomen , often on the right, just under your ribs
  • Pain in your right shoulder  or back
  • An upset stomach
  • Vomiting
  • Other digestive problems, including indigestion, heartburn, and gas 

Symptoms of serious inflammation

  • Belly pain that lasts several hours
  • Fever and chills
  • Yellow skin or eyes 
  • Dark urine and light-colored poop 
  • Concentrated.
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Gallstone Risk Factors

You’re more likely to get gallstones if you:

  • Have a family history of them
  • Are a woman
  • Are over age 40
  • Are obese
  • Have a diet high in fat and cholesterol but low in fiber
  • Don’t get much exercise 
  • Use  OCPs ( birth control pills )
  • Have diabetes 
  • Have an intestinal disease like Crohn’s
  • Have  cirrhosis of the liver
  • Take medicine to lower your cholesterol
  • Lose a lot of weight in a short time
Gallstone Diagnosis

Blood tests. These check for signs of infection or blockage, and rule out other conditions.

Ultrasound. This makes images of the inside of our body.

CT scan. Specialized X-rays let our doctor see inside your body, including your gallbladder.

Magnetic resonance cholangiopancreatography (MRCP). This test uses a magnetic field and pulses of radio wave energy to make pictures of the inside of your body, including our liver and gallbladder.

Cholescintigraphy (HIDA scan). This test can check whether your gallbladder squeezes correctly. Your doctor injects a harmless radioactive material that makes its way to the organ. A technician can then watch its movement.

Endoscopic retrograde cholangiopancreatography (ERCP). The doctor runs a tube called an endoscope through your mouth down to your small intestine. They inject a dye so they can see your bile ducts on a camera in the endoscope. They can often take out any gallstones that have moved into the ducts.

Endoscopic ultrasound. This test combines ultrasound and endoscopy to look for gallstones.

Gallstone Treatment

Gall stones are usually treated by surgery in which gall bladder is removed from the body (Cholecystectomy). You can still digest food without it. 

There are  two type of surgical procedures.

Laparoscopic cholecystectomy. This is the most common surgery for gallstones. We insert a narrow tube called a laparoscope into your belly through a small cut. It holds instruments, a light, and a camera. We will take out your gallbladder through another small cut. You’ll usually go home the same day. Nowadays ROBOTICS are also being used to carry Gallbladder removal . It has many advantages like less post operative pain and almost bloodless surgery.

Open cholecystectomy. Your doctor makes bigger cuts in your belly to remove your gallbladder . ( Now  days this is not common unless indicated because of anesthesia reasons)

If gallstones are in your bile ducts, your doctor may use ERCP to find and remove them before or during surgery.

Complications of Gallstones

Gallstones can cause serious problems, including:  

Gallbladder inflammation (acute cholecystitis).  This happens when a stone blocks your gallbladder so it can’t empty. It causes constant pain and fever. Your gallbladder might burst, or rupture, if you don’t get treatment right away.

Blocked bile ducts. This can cause fever, chills, and yellowing of your skin and eyes (jaundice). If a stone blocks the duct to your pancreas, that organ may become inflamed (pancreatitis).

Infected bile ducts (acute cholangitis). A blocked duct is more likely to get infected. If the bacteria spread to your bloodstream, they can cause a dangerous condition called sepsis.

Gallbladder cancer. It’s rare, but gallstones raise your risk of this kind of cancer.

Preventing Gallstones

Some lifestyle changes might lower your risk of gallstones.

Eat a healthy diet that’s high in fiber and good fats, like fish oil and olive oil. Avoid refined carbs, sugar, and unhealthy fats.

Get regular exercise. Aim for at least 30 minutes, 5 days a week.

Avoid diets that make you lose a lot of weight in a short time.

If you’re a woman at high risk of gallstones (for example, because of your family history or another health condition), talk to your doctor about whether you should avoid the use of hormonal birth control.