Gallstones: Treatment, symptoms, advice and help
Gallstones are solid deposits that may form inside the gall bladder. These hard deposits may vary in size ranging from small pebble-sized to large golf ball-sized stones. The gall bladder is a small abdominal organ located just below the liver, in the right abdominal region. The gall bladder is responsible for storage of digestive juices which are produced by liver.
Gallstones: Incidence, age and sex
Gallstones are commonly occurring problems in recent times. Although, it can occur in any age but individuals above the age of 40 years are most susceptible to this disorder. The incidence of gallstones is more in females as compared with males.
Signs and symptoms of gallstones: Diagnosis
The gallstones do not exhibit any clinical features in almost 80% of individuals. Such gallstones which remain asymptomatic are termed as ‘silent stones’. These gallstones may be accidentally diagnosed on routine imaging investigations like ultrasonography. Some individuals may exhibit symptomatic episodes which occur due to passage of gall stones from gall bladder to cystic or common bile duct. The pain usually starts shortly after a meal and is usually excruciating in intensity. The pain may be cramping and is felt in upper right region of abdomen. Such pain is characteristically called ‘biliary colic’. It may be associated with nausea and vomiting. Sometimes the individual may also experience fever, abdominal fullness or even jaundice.
The investigation of choice for detecting gallstones is ultrasonography. However other imaging tests like CT scan or Endoscopic retrograde cholangio-pancreatography (ERCP) may also be done if diagnosis is in doubt. Certain blood tests like serum bilirubin and liver function tests are also recommended to aid the diagnosis.
Causes and prevention of gallstones
Gallstones are usually found in women who are more than forty years of age. Genetic susceptibility may also play a role in causation of gallstones. Other risk factors include obesity, diabetes and haemolytic anaemia. Gall stones can be of two types namely cholesterol stones which are most common and pigment stones which are formed due to excessive production of bilirubin pigment by liver.
Complications arising from gallstones are rarely seen in present times. However in rare cases, persistent or repeated blockage of cystic duct or common bile duct by gallstone can damage the wall of gall bladder and ducts. Such conditions are called cholecystitis and cholangitis respectively. Pancreatitis or perforation of gall bladder is a very seldom occurrence.
Gallstones require treatment only if they are symptomatic and result in repeated episodes of abdominal cramps. The choice of treatment is surgical removal of gall bladder which is generally done laparoscopically in recent times. This procedure is called laparoscopic cholecystectomy wherein the surgery involves small incisions which leads to fast recovery. However, other treatment modalities may be considered in individuals who are unable to get operated upon. These treatment modalities include lithotripsy followed by medications. Lithotripsy is a procedure wherein shock sound waves are given to break the gallstones. Thereafter medications which supplement bile acids are prescribed to dissolve the small stones. But such therapies are not very effective and recurrences are usually observed in these individuals. It is always better to get the gall bladder surgically removed unless it is contraindicated.