Gallstones – Causes, Symptoms & Treatment

gallstonesGallbladder is a small organ present in the liver that stores the bile juice secreted by the liver. Gallstones are not the real stones but small chunks of solid material that form in the gallbladder. You may not be aware of their presence in your body until these gallstones block a bile duct resulting in severe pain.

Gallstones Types

Mainly there are two kinds:

  1. Cholesterol Stones – 80% of the gallbladder stones are of this type and are usually yellow-green in color.
  2. Pigment Stones – These stones are formed by bilirubin and are small & dark. Bilirubin is a pigment present in bile juice.

Gallstones Causes

Diet, your weight & genes and problems with gallbladder are some of the several gallstones causes. This problem might even arise due to bile juice. Bile aids in the digestion process and hence the body requires it. But if it contains cholesterol, the chances of getting gallbladder stones are more likely.

If your gallbladder doesn’t empty properly then it may also lead to these stones. People with certain health conditions such as cirrhosis of the liver or sickle cell anemia are more likely to get pigment stones.

Risk Factors

Following are the risk factors:

    1. Estrogen – High estrogen levels increases cholesterol formation thus making it difficult for gallbladder to empty its contents. Increased estrogen levels may be due to birth control pills, pregnancy or the hormone replacement therapy taken for menopause.
    2. Obesity – It also increases the cholesterol in the body there by harder for the gallbladder to empty completely. It is one of the biggest risks.
    3. Weight – Losing weight too quickly makes the liver to produce extra cholesterol thus leading to gallbladder stones.
    4. Fasting – During fasting, your gallbladder will have problems emptying.
    5. Medicines – Some of the medicines you may take to lower your cholesterol may actually increase its levels in the bile. This is more likely to lead to cholesterol stones.
    6. Diabetes – Triglycerides, a type of blood fat is present in high levels in people with diabetes. It is a risk factor for gallbladder stones.

Symptoms of Gallbladder stones

 You may get this problem and you may not even know it unless told by a doctor. Some of the symptoms of gallbladder stones  are vomiting, nausea, pain in the abdomen and the back for several hours, indigestion, bloating, gas and heartburn.

Diagnosis

Doctor will do a physical exam of your body followed by one or two of the below tests.

Blood Tests

These tests are done to rule out any infection or blockage due to other reasons.

Ultrasound

It is a quick procedure and a doctor can perform it easily in his clinic. It takes images of inside of your body.

CT Scan

Your doctor uses specialized X-rays to see inside your body especially the gallbladder.

Magnetic resonance cholangiopancreatography(MRCP)

Photos of inside of your body mainly the liver and gallbladder are taken with the help of magnetic field and radio wave energy pulses in this test.

Endoscopic Ultrasound

To look for gallstones, both endoscopy and ultrasound are combined.

Cholescintigraphy (HIDA scan)

Your doctor can check whether you gallbladder squeezes properly by injecting a harmless radio isotope which reaches its target. The technician can then trace its movement.

Endoscopic retrograde cholangiopancreatography (ERCP)

With this test, your doctor can look for gallstones as well as remove them. After inserting an endoscope through your mouth down till the small intestine, the doctor will inject a dye. This dye colors the bile duct and makes it visible. With this he can also remove the gallbladder stones that have blocked the bile duct.

Treatment for Gallstones

Treatment for gallstones includes surgery for the removal of the stones. Two kinds of surgeries are usually done.

Laparoscopic cholecystectomy

It is the most common procedure for gallstones removal. Several small cuts are made in the belly. Through these small cuts, the surgeon passes a light, camera and instruments. A video monitor displays the views of inside of the body. After the surgery, you spend a night in the hospital.

Open cholecystectomy

Bigger cuts are made in the belly and the gallbladder is removed. After the operation, you have to stay for a few days in hospital.

If the gallbladder stones are blocking the bile ducts, the doctor uses the ERCP method to remove the gallstones either before or during the surgery.

Gallstones Treatment Without Surgery

Your doctor may recommend medications if you have a medical condition for which doing an operation would be risky. Doctor will prescribe medications like chenodiol (Chenix), ursodiol (Actigall), or both. These medications help to dissolve the cholesterol stones. The side effect may include mild diarrhea.

The problem with using medications is that to completely dissolve the stones, you have to take the medications for years. Sometimes, it may come back after discontinuing of the drug.

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