Dr. Iwamura Hospital is organizing
Gallbladder stone camp from
Jestha
1 to 32, 2076
Contact
: Jiwan – 9861937345
Gallstones:
Causes, Treatment and Prevention
Gallstones are supersaturated, pebble-like
deposits of bile inside the gallbladder. They can be as small as a grain of
sand or as big as a golf ball and can occur as a single stone or as a
collection of stones in a combination of sizes. There are two types of
gallstones — cholesterol stones, which account for 80 percent of gallstones,
and pigment stones, which are composed of bilirubin, a chemical found in bile,
according to the National Institutes of Health.
Causes
Bile is made in the liver and it is stored in
the gallbladder until
it is transported to the small intestine, where it helps with digestion of fats
and fat-soluble vitamins.
Gallstones occur when there's an imbalance in
the bile transportation process. Cholesterol stones can form when bile contains
too much cholesterol,
too much bilirubin or not enough bile salts.
"Cholesterol is a naturally occurring
substance within our bile, When you have an abnormal accumulation, you can wind
up with cholesterol crystals precipitating out, and growing over time into what
we call stones."
Gallstones can also occur when the gallbladder
does not empty into the common bile duct completely or often enough. Women are
twice as likely as men to develop gallstones because excess estrogen from
pregnancy, hormone replacement therapy, and birth control
pills may increase cholesterol levels and decrease gallbladder
movement, which can facilitate gallstones.
Black pigment stones usually consist of
bilirubin polymers and calcium carbonate, and they rarely contain cholesterol.
These stones are mostly found in the gallbladder, and can develop as a result
of liver damage, alcoholic liver disease, hemolytic anemia and old age.
Brown pigment stones usually consist of calcium
bilirubinate, fatty acids and small amounts of cholesterol. These are usually
found in the bile duct and they are almost always associated with bile
infections, inflammations and occasionally, parasitic infestations in the
liver.
People who have significant fluctuations in
weight, such as from a pregnancy or operation, are also at risk of developing
gallstones.
Diagnosis & tests
The majority of people with gallstones are
asymptomatic. Therefore, gallstones are often discovered during routine X-ray,
abdominal surgery or other medical procedures.
Occasionally, gallstones can cause prolonged
discomfort and cramps as the stones wind down the bile duct, creating a
blockage and increasing the pressure in the gallbladder. These sudden
occurrences are known as gallbladder "attacks" and they often happen
during the night or after a fatty meal.
Symptoms include pain in the center or upper right of the upper
abdomen, or pain around the back or right shoulder blade.
When pain occurs, the doctor will order an ultrasound exam to
look for gallstones. Although ultrasound is the most sensitive and specific
test for gallstones, the doctor may also order a CT scan if the symptoms are
more serious, since the CT scan can also detect complications such as a
ruptured or infected gallbladder or bile duct.
Gallstones can sometimes lead to pancreatitis.
They can also lead to cholangitis, an infection that happens when a gallstone
becomes trapped in the bile duct.
"It’s a potentially life threatening
infection of the bile ducts and liver," Bencsath said. "It requires
rapid and prompt attention with antibiotics with ERCP procedure. Once the
patient has recovered, then the recommendation can be to remove the
gallbladder, so that the risk of that happening again is eliminated."
Treatment & medication
If a person has minimal or no symptoms, and if
they have few or small stones, then they can take medication for gallstones.
Surgery may not be needed unless there are
symptoms, according to the NIH. However, people with frequent gallbladder
attacks may opt to have their gallbladder surgically removed. The procedure is
known as cholecystectomy and it can be performed using a laparoscope and a
miniature video camera. The process is minimally invasive, and patients can
typically go home following the operation.
Prevention
Gallstones occur more frequently in people at
two opposite ends of the weight spectrum — those who are overweight or obese,
and those who fast or lose a lot of weight quickly. In addition, research
published in the journal Gut in
2005 suggests that high intake of carbohydrate, a fluctuating glycaemic load
and glycaemic index increase the risk of symptomatic gall stone disease in men.
Therefore, it is important to adopt a healthy diet and stick to regular meal
times.
For More information, please contact
Jiwan - 9861937345
