Gallstones -causes, Symptoms and Treatment

Gallstones are solid lumps or stones that form in the gallbladder or bile duct. They are formed when some of the chemicals stored in the gallbladder harden into a mass.

About one in three women and one in five men have gallstones by the age of 75. Some people get just one large stone; others may have lots of tiny ones.

What causes gallstones?

Scientists believe cholesterol stones form when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason these imbalances occur is not known.

The cause of pigment stones is not fully understood. The stones tend to develop in people who have liver cirrhosis, biliary tract infections, or hereditary blood disorders—such as sickle cell anemia—in which the liver makes too much bilirubin.

Complete or partial blockage can also cause your gallbladder to get irritated and inflamed. If this happens, you will usually have pain for more than 3 hours. You may also get a fever. Your skin may turn a yellowish color, known as jaundice (say “john-diss”).

Gallstones Symptoms

Gall stones usually remain asymptomatic initially.[4] They start developing symptoms once the stones reach a certain size (>8mm).[5] A main symptom of gallstones is commonly referred to as a gallstone “attack”, also known as biliary colic, in which a person will experience intense pain in the upper abdominal region that steadily increases for approximately thirty minutes to several hours.

When gallstones keep blocking a bile duct, you may have pain with fever and chills, or your skin or the whites of your eyes may turn yellow. Call your doctor right away. Having stones in your bile duct increases your chance of having a swollen pancreas (pancreatitis). These symptoms may also be a sign of an infected gallbladder.

How are gallstones diagnosed?

Gallstones are diagnosed in one of two situations. The first is when there are symptoms or signs that suggest gallstones, and the diagnosis of gallstones is being pursued. The second is coincidentally while a non-gallstone-related medical problem is being evaluated. Ultrasonography is the most important means of diagnosing gallstones. Standard computerized tomography (CT or CAT scan) and magnetic resonance imaging (MRI) may occasionally demonstrate gallstones, however, they are poor for doing so compared with ultrasonography.

Treatments and drugs

Laparoscopic surgery. Most often gallbladder surgery is performed using a laparoscope, a pencil-thin tube with its own lighting system and miniature video camera. A surgeon inserts the laparoscope into your abdomen through a hollow instrument (cannula). Only small incisions are required. The video camera then produces a magnified view on a television monitor of the inside of your abdomen. This allows the surgeon to see the surgery in detail.

Laparoscopic cholecystectomy is a recent technique which was introduced in the United States in 1988. The surgeon makes several incisions in the abdomen through which a tiny video camera and surgical instruments are passed. The video picture is viewed in the operating room on a TV screen, and the gallbladder can be removed by manipulating the surgical instruments. Because the abdominal muscles are not cut there is less postoperative pain, quicker healing, and better cosmetic results. The patient can usually go home from the hospital within a day and resume normal activities within a few days.

Medication

In people with a functioning gallbladder, bile salts taken by mouth may dissolve gallstones. However, the process may take 2 years or longer, and stones may return after treatment ends.

Medicines called chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UDCA, ursodiol) may be given to dissolve the stones. Both CDCA and UDCA are useful only for gallstones formed from cholesterol.

Laparoscopic surgery. Most often gallbladder surgery is performed using a laparoscope, a pencil-thin tube with its own lighting system and miniature video camera. A surgeon inserts the laparoscope into your abdomen through a hollow instrument (cannula). Only small incisions are required. The video camera then produces a magnified view on a television monitor of the inside of your abdomen. This allows the surgeon to see the surgery in detail.