Prevention from Gallstones

Gallstones are hardened lumps or deposits containing supersaturated collections of fat or bile inside the gall bladder. They may appear like pebbles. They occur in various sizes ranging from a tiny grain of sand to a significantly larger size of a golf ball. Gallstones can manifest themselves as single stones or assume the form of clusters or groups.

 

There are two types of gallstones:

1. Cholesterol gallstones are masses of fat (cholesterol) and account for the majority of gallstones.
2. Pigment gallstones are lumps of the chemical bilirubin which is a constituent of bile. These stones are lesser in number compared to the other type.

The primary cause of gallstones may be explained as follows. The liver produces bile and stores it in the gallbladder intermediately until it is transported to the small intestine. Bile plays a crucial role in the digestion of fats and related fat-soluble vitamins like Vitamin A, D, E and K. Gallstones are formed as a result of an imbalance in the bile transportation process due to abnormal accumulation of cholesterol in the bile or incomplete emptying of bile into the bile duct.

Gallstones Symptoms and Diagnosis
Symptoms of gallstones occurrence include:

• Sudden episodes of severe pain in the upper right portion of the abdomen or central abdomen right below the breastbone.
• Occurrence of back pain between the two shoulders
• Ache in the right shoulder
• Vomiting or feeling of nausea
• Jaundice wherein there may be yellowing of the eyes and skin.
• Unexplained fever and chills
• Unusual light-coloured stools and dark coloured urine

Many gallstones are asymptomatic. They are usually diagnosed through routine X-rays, ultrasound scans, Computerized Tomography (CT) scans or during abdominal surgeries and clinical procedures. Specialized techniques for the detection of gallstones include:

• Hepatobiliary Iminodiacetic Acid (HIDA) scan
• Magnetic Resonance Cholangio-Pancreatography (MRCP)
• Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
• Oral Cholecystogram(OCG)
• Intravenous Cholangiogram(IVC)
• Endoscopic Ultrasonography
• Blood tests for liver and pancreas functioning
• Duodenal drainage

Gallstones Treatment

• Observation - Silent gallstones that do not display evident symptoms (like pain and discomfort) are simply watched and actively monitored under close observation. No special treatment is administered in this case.
• Medication - Small gallstones that do not contain calcium may be treated with medication. The common medicine used for this purpose is ursodeoxycholic acid tablets which need to be taken for a long duration to dissolve the stones. The risk involved here is that the gallstones may recur after the treatment is stopped.
• ERCP for removal of gallstones - ERCP may be used for the removal of gallstones from the bile duct. In this procedure, an endoscope is inserted through the mouth and the opening of the bile duct is widened by making a small cut or by using an electrically heated wire. The stones may be removed or left to pass into the intestine and subsequently out of the body through excretion.
• Gall bladder removal surgery - The complete gall bladder along with the gallstones may be surgically removed through a procedure called cholecystectomy. This intervention may be done in multiple ways:

• Laparoscopic cholecystectomy - Here three or four small cuts are made in the abdomen of the patient under anaesthesia and a laparoscope is inserted through one of them to view the organs. The gall bladder is removed through special surgical instruments. Later the cuts are closed with dissolvable stitches and covered with dressings. Recovery is quick after this surgery.
• Single-incision keyhole surgery - This is one of the latest forms of laparoscopic cholecystectomy wherein a single hole is made in the abdomen for removal of the gall bladder. This approach is however not used often due to some uncertainties about the procedure itself and also because it calls for an experienced surgeon with specialized training.
• Open surgery - A wide incision (4 to 6 inches) is made in the abdomen under anaesthesia for removal of the gall bladder in this surgery. Recovery takes longer here and there is more prominent visible scarring.

For more information on gallstones treatment and gallstones surgery consultation, please contact us.