Dorothy FarrarGallstones
Gallstones or gallbladder stones (cholelithiasis) are solidified, crystalline components of bile that can form both in the bile duct (choledocholithiasis) and in the gallbladder itself (cholecystolithiasis). In most cases, gallstones do not cause any symptoms. However, gallstones can also cause severe pain in the upper abdomen ( biliary colic ).
What are gallstones (cholelithiasis)?
Gallstones (gallbladder stones), known in technical terms as cholelithiasis, are endogenous, solidified bile. The gallbladder and bile duct should actually only contain liquid substances. Therefore, the gallstones can create an obstacle to the flow of bile.
Gallstones can vary in size. The finest stones, which are often overlooked in ultrasound, are referred to as “grit” in technical jargon.
If gallstones remain in the gallbladder for a long time, it can cause irritation or inflammation of the gallbladder wall. This inflammation of the gallbladder is then referred to as cholecystitis. A gallbladder with a thickened and calcified bladder wall (porcelain gallbladder) is visible on X-ray .
causes
Gallstones usually form when the proportions of the various components in the bile are no longer optimal. As a result, components that are difficult to dissolve, such as cholesterol , can possibly clump together.Bile is 80 percent water. Most of the other components are soluble (for example: proteins , bilirubin, bile acids). If there are too few of these soluble substances or too many of the insoluble cholesterol, these cholesterol parts can clump together.
Cholesterol stones make up 80 percent of gallstones. Often they arise in the gallbladder; sometimes they migrate into the bile duct. Pigment stones consist largely of bilirubin. Mixed forms of the stones can also occur.
Gallstones are usually not visible on X-rays. When the gallstones are calcified, they can be seen on the x-rays. Women are affected more often. Gallstones affect about one in five women over the age of 40, but only one in ten men.
When to the doctor?
If pain in the upper right abdomen is noticed again and again, a disease of the gallbladder may be the cause. Gallstones are also manifested by a frequent feeling of fullness and flatulence, which is associated with nausea and vomiting. Other warning signs: Loss of appetite and intolerance to certain foods – such as flatulent foods, fried foods or coffee. If you have these symptoms, you should consult a doctor as soon as possible. The medical professional can use clinical diagnostic methods to quickly diagnose the gallstones and determine if treatment is needed.
As soon as symptoms appear, therapy is necessary in most cases. Therefore, the following applies: consult a doctor at the first sign of gallstones or another disease of the gallbladder. Early therapy not only prevents complications, but also reduces the risk of bile duct cancer or gallbladder cancer. In the event of complications, the emergency doctor must be alerted. If, for example, gallbladder inflammation or calcification of the gallbladder wall occurs, immediate treatment is necessary. Otherwise, other symptoms such as peritonitis can occur, which must be treated in the hospital.
symptoms and course
Possible symptoms of gallstones:
The symptoms of gallstones in the bile duct often cause typical biliary colic, which can last between 15 minutes and five hours and is felt as upper abdominal pain.
This pain can then radiate to the back and right shoulder. This pain is often accompanied by vomiting and nausea.
By impeding the flow of bile, liver enzymes accumulate in the blood in the bile duct. As a result, the urine turns dark and the stool remains light.
The bile may even be returned to the liver. As a result, the bile pigment increases in the bloodstream and the skin turns yellow. Jaundice or icterus can result. At the same time, the backlog of bile can inflame the bile ducts and lead to gallbladder inflammation.
Diagnose
People suffering from gallstones have symptoms. They complain of abdominal pain and often cannot tolerate fatty foods. Some have had biliary spasms in the past. The doctor first examines the patient physically. When palpating the right upper abdomen, they complain of pain. If the doctor suspects that it could be a gallstone blocking the bile ducts, he will first arrange for a blood test to be carried out in the laboratory. If the liver enzymes are elevated and bile secretions can be detected, this indicates gallstones.
Gallstones can be detected relatively quickly using sonography. During the ultrasound examination, the doctor can also see if the gallbladder is enlarged or if the gallbladder wall has already thickened. Sonography also offers the doctor the opportunity to determine whether, instead of gallstones, malignant changes in the gallbladder are causing the patient’s symptoms.
Sonography is not always sufficient to diagnose gallstones with certainty. If there are any doubts, the doctor can also use magnetic resonance imaging ( MRI ), computed tomography ( CT ) or endoscopy . During the endoscopic examination, the doctor inserts an endoscope equipped with a camera into the bile ducts via the mouth, stomach and small intestine. If he finds gallstones, there is an option to remove them during the examination.
complications
Gallstones usually cause severe pain in those affected. This pain is stabbing and burning and has a very negative effect on the patient’s quality of life. In most cases, there is also abdominal pain and a feeling of fullness. Those affected also continue to suffer from flatulence or congestion. Nausea also occurs and the affected person often vomits. As the disease progresses, gallstones can also lead to jaundice. Those affected generally feel very unwell and ill and may suffer from fatigue and/or reduced resilience. Sweating is also not uncommon with this disease and significantly reduces the quality of life.
As a rule, the gallstones do not have to be removed until the patient is in pain. However, there are no complications during the treatment itself. With the help of medication or shock waves, the gallstones can be removed relatively well and easily. The patient’s life expectancy is also not reduced or restricted if the gallstones are treated successfully.
treatment and therapy
Gallstones need to be treated when they cause problems for the person affected. Ultrasound or endoscopy allows the doctor to diagnose the location, size, and composition of the stones.
Gallstones with a diameter of up to five millimeters can be dissolved with tablets. The drugs are taken over several months or years. Individual stones of up to two centimeters can be shattered externally with ultrasound (extracorporeal shock wave lithotripsy). The resulting stone splinters can then be dissolved with medication.Larger or more gallstones are treated surgically by the doctor. The gallbladder is surgically removed (cholecystectomy), which prevents new stones from reappearing.
The low-risk endoscopic variant is used in 98 percent of treatments. The surgeon guides an endoscope through the esophagus and stomach into the duodenum. The papollotome opens the bile duct sphincter there. As a result, most of the stones that are fished out of the bile duct by the Dormia baskets fall out on their own.
If stones are stubborn, they can be crushed mechanically by ultrasound or laser beforehand. After the gallbladder has been removed, liver cells take over the production of bile and subsequently enable the patient to lead a normal life.
prevention
Gallstones cannot be prevented directly. Obesity and a diet high in cholesterol and low in fiber are risk factors that promote the formation of gallstones. A balanced, healthy diet is also recommended if gallstones have already occurred. This significantly reduces the risk of new growth.
Sufficient daily exercise should also be ensured. Regular checking of blood lipid levels can also help prevent gallstones early on. In the case of diabetics , there is also the fact that the blood sugar level is well adjusted.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.