What are gallstones?
Gallstones are stones that can form in your gallbladder, a small sac-like organ that is attached to your liver. Gallstones are created because the fluid, or bile, which is formed in the liver, and then stored and released by the gallbladder for food digestion, can become hardened and form stones. These stones are found in about 10-20% of the adult population less than 50 of age, with rates increasing with age.
The majority of people who have gallstones do not have any symptoms. Sometimes stones can leave the gallbladder and block small tubes, or ducts, causing symptoms such as pain on the right side of your belly and back, nausea and vomiting. These attacks usually occur after meals. The pain can peak over several hrs and then disappear completely, or can last up to several days.
Blockage of ducts can also damage or cause infections in your gallbladder, liver, or pancreas.
You may experience symptoms such as fever, jaundice or yellowing of the skin, and persistent pain. If you have any of these symptoms, see your doctor immediately.
Other symptoms include: belching, gas, intolerance to fatty foods, clay-colored stools.
Types of stones:
1. cholesterol stones-these are made primarily of hardened cholesterol; this is the most common type of stone (approx 80% of stones are cholesterol stones)
2. pigment stones-these are made of bilirubin, found in the blood.
What are the risk factors for gallstones?
1. Increasing age (>60 yo)
2. Females are twice as likely to have gallstones than males
3. Being of Native American heritage
4. Obesity
5. Rapid weight loss
6. Certain types of anemia
7. Inflammatory bowel disease
8. Pregnancy
9. Oral contraceptives or hormone replacement
10. High fat levels in the blood, known as hypertriglyceridemia
11. Diabetes Mellitus
12. cholesterol lowering medications
13. Childhood cancer
How do I know if I have gallstones?
You may have symptoms such as right upper abdominal pain related to meals that may lead you r doctor to order an imaging study to check for gallstones. Gallstones are usually found on a CT scan, ultrasound, HIDA scan, or other imaging studies. Oftentimes, gallstones are found when an ultrasound or CT is ordered for other reasons unrelated to gallstones or gallstone symptoms. Blood tests can also be done to determine if organs such as the liver or pancreas have been affected.
When do you treat for gallstones?
As mentioned above, the majority of people (over 50%) have gallstones but are not treated because they have no symptoms. You should not worry about your gallstones if your doctor feels they do not need to be treated.
Your doctor may recommend treatment if you have an episode of pain, since most people will have recurrent pain attacks in the future. You will also need treatment if the pain is persistent or you have symptoms of jaundice, fever, nausea, vomiting, or have inflammation of the gallbladder. Please see your doctor immediately if you have any of the above symptoms.
What are the treatments?
In order to stop symptoms, the gallstones need to be removed or dissolved. The best way to do this is to have surgery to remove the gallbladder. This can usually done by making small openings into the abdomen and looking into the inside of your abdominal cavity with a camera. This type of surgery, called laparoscopic surgery, allows the surgeon to remove your gallbladder without making large openings in your abdomen in most cases (for most people). Patients often leave the hospital the same day after this procedure, or maybe one day later.
If a stone is trapped in one of your tubes or ducts, you may require another procedure called an ERCP, in which a camera attached to a long tube is placed into your food passageway to remove the trapped stone, or put in a stent, which is a tube to keep your duct open.
There are other treatments to dissolve gallstones, such as taking a pill, or having sound wave therapy. Not every one can have these treatments, however, and they are not nearly as effective as surgery. Please ask your doctor if you have further questions about the possible treatments for gallstones.
http://digestive.niddk.nih.gov/ddiseases/pubs/gallstones/index.htm
Copyright 2007, MD Kiosk
