To help in digestion, the liver produces a fluid called bile which is stored in the gallbladder. The hardened deposits of the bile are called gallstones. Most of the gallstones are made up of cholesterol and bilirubin which are waste products carried away by bile. The condition of the presence of gallstones is called Cholelithiasis. Few people may develop many gallstones at a time and others may develop only one gallstone.
Types of gallstones
There are two types of gallstones and they are:
- Cholesterol gallstones: Most of the diagnosed gallstones are made up of cholesterol and makeup to 80%. They appear in yellowish-green color.
- Pigment gallstones: Pigment gallstones appear darker in color and small in size. These gallstones are made up of bilirubin.
Causes for gallstones
According to the studies conducted by research scientists and doctors, it came to light that there is no exact cause for gallstones formation. However, it is found that most of the gallstones are made of 80% cholesterol and 20% of bilirubin & calcium salts. However, the below theories may convey how gallstones are formed.
Excess cholesterol in bile:
Generally, bile dissolves cholesterol. So, if the liver starts producing excessive levels of cholesterol that bile cannot dissolve, then gallstones can form. These gallstones appear yellow in color.
More bilirubin in bile:
The liver destroys old red blood cells and produces a chemical-Bilirubin. Gallbladder usually breaks the excess bilirubin for better overall health. In a few conditions like liver damage and blood disorders, the liver may produce more amounts of bilirubin that the gallbladder can’t break down. Due to this, pigment gallstones may form that appear dark in color and harder.
Emptying of the gallbladder keeps the overall health of an individual in the best condition. So, if the gallbladder doesn’t empty properly or fails to empty, then the bile becomes extremely concentrated which can cause it to form gallstones.
Usually, gallstones don’t cause any symptoms and don’t require any treatment. However, patients who experience any symptoms of gallstones should undergo surgery. If symptoms become severe, then gallstones may block the duct. The following are a few of those symptoms:
- Severe and intense pain in the center and the upper region of the abdomen
- Pain in the back of the shoulders
- Persistent pain that lasts from minutes to hours
- Nausea and vomiting
Gastroenterologists, general surgeons, and abdominal surgeons can evaluate and diagnose gallstones [Cholelithiasis]. Primary a physical examination will be performed and then any of the following tests may be recommended.
- Ultrasound: This test helps to check the inside of the body by producing images.
- Blood tests: Blood tests help the healthcare providers to rule out other medical conditions and to check the signs of any infection and blockages in the blood vessels.
- HIDA scan [Cholescintigraphy]: During this test, radioactive material will be injected into the organ and checks whether the gallbladder is functioning properly or not.
- ERCP [Endoscopic retrograde cholangiopancreatography]: In this test, an endoscope is inserted into the mouth of a patient till the small intestine. Then, a dye will be passed down to check the presence of gallstones. If the doctor finds out any presence of gallstones, then they can be removed.
- MRCP [Magnetic resonance cholangiopancreatography]: Magnetic pulses and radio wave energy are used in this test to picture the internal organs of the body like the liver and gallbladder. So, doctors can check the presence of gallstones.
- CT scan: In this test, specialized X-rays are being used to visualize and see the body parts. This also helps to check the gallbladder for the diagnosis of gallstones.
Every disease can cause complications if left untreated. So, the following are a few of the major complications associated with gallstones.
- Severe pain and fever due to inflammation of the gallbladder [cholecystitis]
- Inflammation of the pancreas [pancreatitis] due to blockage of the pancreatic duct
- Blockage of the gallbladder
- Infection of the bile duct
- Intense and sharp abdominal pain
- Rare chances of developing gallbladder cancer
Management of gallstones: Gallstone treatment & prevention
If the gallstones are small in size and do not require any surgical intervention, then the doctor may prescribe a few medications. These medications can help in dissolving the gallstones. However, in severe cases, the removal of the gallbladder may be suggested by the doctor to provide a good quality of life.
Open gallstone removal [Open cholecystectomy]:
- The patient will be sedated using general anesthesia.
- Then, large cuts are made on the belly or abdomen to examine and to remove the whole gallbladder.
- Once the surgery is performed, the cuts will be stitched together which can result in the formation of scars.
- Either local or general anesthesia will be used to sedate the patient.
- Once the patient is sedated, small incisions or cuts are made on the bully to pass the laparoscope into the abdomen.
- Once the surgeon finds out the presence of gallstones, depending on severity, the whole gallbladder may be removed.
Out of these 2 surgeries, laparoscopic cholecystectomy is preferred over open surgery. This is because laparoscopic removal of gallstones involves less risk of infection, few incisions compared to the large incision, quick recovery, safe and effective, and same-day discharge of the patient.
Few of the lifestyle modifications and preventive measures should be followed by an individual to avoid or to manage the occurrence of gallstones and they are:
- Don’t skip meals as it can increase the risk of developing gallstones
- Should eat fiber-rich food items
- Should lose weight slowly as rapid weight loss may increase the risk of gallstones
- Do regular exercises for about 30 minutes