A brief understanding of gallstones
Gallstones are pebble-like supersaturated deposits of bile in the gallbladder. They range from the small sizes of sand to the large ones the size golf balls. Further still, they can occur as a collection or as a single stone. Gallstones get divided into two categories with cholesterol stones contributing around 80% of the known cases and pigment stones contributing to the rest. The pigment stones contain bilirubin, which is a chemical found in bile.
There are no visible signs for someone suffering from gallstones. However, if a gallstone gets stuck in one of the ducts, a blockage gets caused as a result, and several signs and symptoms may get observed. First, there will be abrupt and rapidly worsening pains in the upper right portion of the abdomen. The pain may also get felt in the center of the abdomen below the breastbone. Back pain between the shoulder blades follows, and it may worsen in the right shoulder. All of these pains last for several minutes or a few hours. While most of the pains may not cause discomfort to the point of seeing a doctor, visit the hospital if the pains get so intense you are unable to sit or find a comfortable position and if there is yellowing of the skin and eye whites.
Gallstones mainly occur when there is an imbalance in bile transportation. Since bile is made in the liver, it has to get transported to the small intestines as it helps in digestion of fat-soluble vitamins K, E, A and D. During this transportation process, if there is too much of cholesterol in the bile, there is risk of cholesterol stones getting formed. The same case happens if there is excess bilirubin or inadequacy in bile salts.
Gallstones also get formed when the gallbladder does not empty into the bile duct frequently. At this point, women are at a greater risk since excess estrogen, especially during pregnancy, from birth control pills and hormone replacement therapy increases cholesterol levels. As a result, this decreases gallbladder movements, and this could lead to the formation of gallstones.
Other stones such as the black pigment ones contain little or no cholesterol. They occur due to liver damage, old age, alcoholic liver disease, or hemolytic anemia. There are also some brown pigment stones, which contain little amounts of cholesterol but mainly fatty acids and calcium bilirubinate. Most of the times the brown pigment stones get found in the bile duct and mostly get associated with bile infections, parasitic infections of the liver as well as inflammations. It is also possible to get gallstones from fluctuations in weight with such variations getting caused by pregnancies, after-surgery effects among other factors.
Diagnosis and testing
Before treatment takes place, there has to be assurance that a patient is suffering from gallstones. Some of the symptoms could be because of other diseases hence the tests are imperative in terms of confirming a patient is indeed suffering from gallstones. In terms of diagnosis, it can be hard at times for most people exhibit no or unnoticeable symptoms. As such, most gallstones get discovered during routine X-ray, minor surgeries or other medical procedures.
Most of the times, doctors request for an ultrasound scan for a better look at the gallstones. Where the situation is more severe, a CT scan can get conducted as opposed to the normal ultrasound. Perhaps because of its ability to detect advanced complications such as infected or ruptured gallbladder or bile duct. Other imaging techniques that can get used include magnetic resonance imaging (MRI), hepatobiliary iminodiaetic acid (HIDA) scan, and endoscopic retrograde cholangiopancreatography (ERCP) test. The ERCP is special in that the doctor can remove the gallstones by passing an endoscope down the mouth, esophagus, through the stomach to the small intestine.
Gallstones treatment and medication
For people with little or no symptoms, it means they have small stones treatable through medication. A pill containing a substance called ursodiol works quite well. The substance gets naturally produced within the body, and the pill works in conjunction with what the body produces. Its effect is dissolving the cholesterol in the gall bladder. Nonetheless, it can take a long time of up to around six months for the pill to work. Again, only around half of the cases have reported a full recovery with the rest often citing gallstone reoccurrence.
The next treatment option is surgery. However, for surgery to take place there has to be indisputable symptoms. The surgery involves removing the gallbladder entirely. It can be performed with the help of a laparoscope and a miniature camera, meaning minimal incisions. Thus, the operation can get conducted, and the patient gets discharged the same day. Once the gallbladder gets removed, bile is still made in the liver from where it gets transported directly into the intestine through the bile duct. Since gallstones can lead to more severe conditions such as pancreatitis or cholangitis, the recommendation after treatment is usually removing the gallbladder.