GALLSTONES

The gallbladder is a small pear-shaped organ on the right side of your abdomen that releases digestive fluid, called the bile, and aids in digestion.  Sometimes the bile can be concentrated in the gallbladder and form stones known as gallsrones or cholelithiasis.

These gallstones do not cause symptoms, and may only be detected when the gallbladder is already inflamed or cholecystitis.

Here are several factors that may increase the risk of having gallstones:

  • Female
  • Obesity (Fat)
  • Above the age 40
  • Pregnant
  • Oral hormonal therapy
  • Rapid weight loss
  • Eating high cholesterol and high fat diet
  • Having a family history of Gallstones

The two main types of gallstones are:

  • Cholesterol stones: Usually yellow-green in color, approximately 80% of gallstones are cholesterol stones. This is the most common type of gallstones.
  • Pigment stones: These stones are smaller and darker and are made up of bilirubin.

What Are the Symptoms of Gallstones?

Gallstones often don’t cause symptoms. Those that don’t are called “silent stones.” A person usually learns he or she has gallstones while being examined for another illness.

When symptoms do appear, they may include:

  • Pain in the upper abdomen and upper back; the pain may last for several hours.
  • Sudden and rapidly intensifying pain in the upper right portion of your abdomen
  • Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
  • Back pain between your shoulder blades
  • Pain in your right shoulder
  • Nausea
  • Vomiting
  • Other gastrointestinal problems, including bloating, indigestion and heartburn, and gas

DIAGNOSIS

If your doctor suspects you have gallstones, he or she will do a physical exam and may perform various other tests, including the following:

  • Blood tests: Blood tests may be given to check for signs of infection or obstruction and/or to rule out other conditions.
  • Ultrasound: This procedure produces images of various parts of the body and can be used to identify gallstones.
  • CAT scan: This test uses specialized X-rays to create cross-section images of organs and body tissues.
  • Magnetic resonance cholangiopancreatography (MRCP): This test uses a magnetic field and pulses of radio wave energy to get pictures of structures inside the body, including the liver and the gallbladder.
  • Cholescintigraphy (HIDA scan): This test can determine whether the gallbladder is contracting correctly. A radioactive material is injected into the patient and makes its way to the gallbladder. The technician can then observe the movement of the gallbladder.
  • Endoscopic ultrasound: This test combines ultrasound and endoscopy to look for gallstones.
  • Endoscopic retrograde cholangiopancreatography (ERCP): The doctor inserts an endoscope through the patient’s mouth down to the small intestine and injects a dye to allow the bile ducts to be seen. The doctor can often then remove any gallstones that have moved into the ducts.

 

RECOMMENDED MEDICATIONS

Gallstones that don’t cause signs and symptoms, such as those detected during an ultrasound or CT scan done for some other condition, typically don’t require treatment.

Your doctor may recommend you be alert for symptoms of gallstone complications, such as intensifying pain in your upper right abdomen. If gallstone signs and symptoms occur in the future, you can have treatment. But most people with gallstones that don’t cause symptoms will never need treatment.

Medicine choices

Bile acids can be used to dissolve gallstones. They usually are reserved for people who have symptoms of gallstones and for whom surgery would be risky.

Surgery to remove the gallbladder (cholecystectomy).

Your doctor may recommend surgery to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder.

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