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Gallbladder stones

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Gallbladder stones or gallstones are solid calcium salt or cholesterol deposits that accumulate in the gallbladder or at nearby bile ducts. The crystals forming are combined with other elements and minerals and can vary in size from minute sand-like particles to marble-sized pieces. Most cases usually are asymptomatic with no treatment needed until further developments occur like intense pain. The gallbladder is a tiny sac located just under the surface of the liver near the right rib cage.

GALLBLADDER STONES SIGNS AND SYMPTOMS

Gallbladder stones are also medically termed choleliths which form inside the body through accretion or concretion of abnormal and normal bile components. The stones can manifest anywhere within the biliary tree such as the common bile duct and gallbladder. Symptoms may also vary depending on the location of the stones as they cause certain obstructions. Several thousand Americans are diagnosed with the condition appearing in different types every year. The condition is also observed to be more common among older females aging 40 years old and above.

Most people with gallbladder stones do not present any sign or symptom which explains delayed diagnosis. Usually, noticeable symptoms will appear later in life although the stones may already be present for several years prior to diagnosis. Approximately 10% of all affected patients will present a few symptoms in a span of 5 years. Once symptoms are noticed, these usually escalate and progress. The effects of gallstones including the silent ones are basically due to the obstruction they cause to various parts and organs.

GALLBLADDER STONES SYMPTOMS

The most common symptom of gallbladder stones is biliary colic which is defined as a specific type of pain. The pain may be accompanied by other symptoms or be the only symptom. Biliary colic is still due to obstruction of common bile duct, hepatic duct, extrahepatic ducts or cystic ducts. Fluid accumulates and distends the gallbladder and ducts continuously increasing pressure and causing pain. The pain is described as constant lasting anywhere between 15 minutes and 5 hours and located in the middle of the upper abdomen right below the sternum. Other associated symptoms of the condition include vomiting, jaundice, gassiness, indigestion, clay-colored stools, abdominal bloating and chills.

Gallbladder stones may be classified according to their relative location and obstructed area. If the common bile duct is obstructed, the condition is called choledocholithiasis. If the pancreatic exocrine system outlet is obstructed, the condition is called pancreatitis. If the gallbladder is obstructed, the condition is called cholelithiasis. “Chole” means bile, “lithia” means stone and “sis” means process.
Gallbladder stones
Image: Gallbladder stones


Gallstones may also be typified according to the stones’ composition. Cholesterol gallstones are made of cholesterol and are the most common type wherein cholesterol does not dissolve and begin to from solid particles. The rate of formation may also be too fast causing the fat to form stones quickly or the gallbladder is dysfunctional wherein it contracts then empties ineffectively. Pigment gallbladder stones are the second most common composed of black and brown pigment gallstones.

Black pigment gallbladder stones result due to excessive bilirubin present in bile thereby forming solid particles. The appearance of the stones is black and these are hard as well. Brown pigment gallbladder stones are caused by bacteria, bilirubin and calcium that form solid particles together. It is softer than black stones and softer. Other gallstones may result from consumption of the antibiotic ceftriaxone. When not dissolved properly, it combines with calcium then forms gallstones. Calcium carbonate may also cause another rare type of gallbladder stones.

GALLBLADDER STONES TREATMENT

Surgery may be indicated to directly remove the stones and remove the obstruction. Cholecystectomy is a common procedure involving the gallbladder. It can be performed through laparoscopic surgery which uses a laparoscope consisting of a thin tube with a built-in light and video camera. The device is inserted into the patient’s abdomen through a cannula. Other tiny instruments are inserted through tiny incisions made in the abdomen in order to remove the gallbladder. In some cases, the bile duct may also be removed surgically via ERCP or with the use of an endoscope. The entrance of the bile duct is increased in size to allow the stone to pass through. The same can be done to remove obstruction in the pancreatic duct.

Non-surgical options are also available. Bile salt tablets involve consuming the drug ursodiol which is known to dissolve cholesterol stones gradually. Patients may need to take the medication for years before improvements are observed. Half of cases also do not show improvements. Sound wave therapy or extracorporeal shock wave lithotripsy involves the use of high-frequency sounds to break gallbladder stones. This is done together with the consumption of ursodiol. This treatment is not as effective for those who have huge or several stones. Topical gallstone dissolution involves inserting a small catheter into the gallbladder then introducing a solution that dissolves the stones. Percutaneous electrohydraulic lithotripsy also uses a catheter inserted into the gallbladder wherein a tiny probe is introduced to send energy that breaks stones.

GALLBLADDER STONES PREVENTION

There are ways on how people can reduce their risk of developing gallbladder stones. Maintaining normal and healthy weight through a sound diet and exercise regimen will help keep gallstones at bay. Individuals should also choose the right types of food rich in fiber, calcium and whole grains. They should limit intake of fatty foods, alcohol and smoking. Early detection will also lessen the need for drastic treatment procedures so regular checkups will help patients find easy ways to stay healthy and keep their gallbladder in good functioning condition.

Pregnancy is also suggested to increase the risk for gallstone development. Women should be careful about taking antibiotics, birth control medications and hormone therapies since these can mimic pregnancy and increase their chances. Those with Crohn’s disease, above the age of 40 and with high blood triglyceride and cholesterol levels should be more careful about their diet and physical activity to stay safe. Some individuals may begin taking ursodiol early on to prevent complications.
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