Written By: Mita Majumdar | Published : February 24, 2016 4:04 PM IST
All you need to know about gallstones, kidney stones and other stones in GI tract
The first time it was a sort of stabbing pain in the upper abdomen. Gas! I didn t pay much attention to it. The next episode was about a fortnight later, about half-an-hour after a sumptuous fatty meal with friends I met after a year. This time the pain was stronger and lasted for an hour or so. Gradually the pain level and frequency increased and I noticed that the pain was radiating towards the back, right below the shoulder blades. I felt a little relief after vomiting. After enduring the pain for a couple more months, I decided it was time to visit the doctor. I was asked to get an ultrasound scan done. The scan revealed a gallstone, more than a centimetre thick, stuck to the gallbladder wall and partially blocking the bile duct. Doctors recommended the gall bladder be removed surgically.
Why do gallstones form?
The liver produces bile, a fluid which consists of cholesterol, bile salts, and bilirubin. Bile helps the body digest fats and fat-soluble vitamins such as A, D, E, and K. Gallstones may form when there is too much cholesterol, too much bilirubin, or not enough bile salts in the bile, that is, gallstones are formed when there is an imbalance of these substances in the bile.
Gallstones can be yellow-green stones in case of too much cholesterol which has hardened, or it can be a dark coloured pigment stone because of bilirubin imbalance.
Symptoms
In many cases you may not even know that you have gallstones since they do not produce any symptoms and you need not even go for treatment. However, when the gallstones are too large or block the bile ducts, you may experience symptoms of pain which
You may also have the urge to walk around when you are having the pain. Norway researchers found that 71 percent of subjects they studied had the urge of walking. They also found that symptoms of functional indigestion (gastroesophageal reflux, dyspepsia or irritable bowel symptoms) occurred in the vast majority in association with attacks. [1]
Preventive measures
It is difficult to prevent gallstones but you can reduce the risk by
Surgical options
The most common surgical procedure for removal of gallbladder is called laparoscopic cholecystectomy. It is performed under anaesthesia. The surgeon will make three or four incisions of 5 mm to 10 mm length, remove the gallbladder along with gallstone, and suture the incisions. The whole procedure will take less than an hour. You may be allowed to go home the morning after surgery if not on the same day. You can resume working within one to two weeks of surgery.
Kidney stones
Kidney stones, just like gallstones, happen because of an unwanted phase in which the dissolved salts in the kidney solidify into crystals.
Why do kidney stones form?
Kidney stone or stones in the lower urinary tract may occur because the patient has low urinary output, is excreting too much salt, or has very acid urine.
Approximately 80% of stones are composed of calcium oxalate and calcium phosphate; 10% of struvite (magnesium ammonium phosphate produced during infection with bacteria that possess the enzyme urease), 9% of uric acid; and the remaining 1% are composed of cystine or ammonium acid urate or are diagnosed as drug-related stones. [2]
Symptoms
Kidney stones can pass on their own without causing any symptoms or needing any treatment. Stones less than 5 mm in diameter have a high chance of passage; those of 5 7 mm have a half chance of passage, and those greater than 7 mm will always require medical intervention. [2]
You may experience symptoms when the kidney stone gets stuck somewhere during the passage in the kidney itself or in the urinary tract (ureter, bladder, or urethra). Symptoms include
Preventive measures
Diet, medical conditions such as obesity, gout, and diabetes, family history of kidney stones, and certain medications are the main risk factors for kidney stone.
Keep a tab on these factors (except of course if it runs in your family) to avoid getting kidney stones. Reduce weight if you are overweight or obese. Take control of your medical conditions. Well, certain medications too can cause kidney stones. Some examples [3]are
Diet is actually the most important factor for preventing kidney stones. Here s what experts [4] recommend
Surgical options
There are a number of surgical options for kidney stone removal.
Shock wave lithotripsy (SWL) is a safe and minimally invasive procedure that uses high frequency sound waves to break a kidney stone into small pieces, and allow it to pass through the urinary tract.You will be instructed not to drink or eat anything for at least 12 hours before the procedure.
The procedure takes about an hour. You will be given local anaesthesia or, if required, general anaesthesia. The following methods are used
The Intracorporeal Shock Wave Lithotripsy, also called Laser Lithotripsy technique is used in case of stones in the lower part of the urinary tract, such as ureter or bladder. An endoscope or cystoscopeis used to get close to the stone inside your urinary tract and laser waves are applied to fragment the stone into small particles. The fragments are extracted out or they are passed out naturally during urination.
Percutaneous Nephrolithotomy(PCNL) is a procedure for removing medium sized or large kidney stones, ones which cannot be removed through SWL. Here a nephroscope is passed into the kidney through a track created through the skin at the back. The stone is then crushed to fine particles and passed out through urinary tract.
You ll need to stay in the hospital for 3-4 days.
Open surgery is the most invasive form of treatment for removing kidney stones and is not usually preferred unless
The stone is very large or extremely hard
Salivary gland stones
Saliva made by the salivary glands contains enzymes that breakdown starch and fat from the food you ingest. Three pairs of salivary glands are involved in the making of saliva
The main chemicals in the saliva are the calcium salts, especially calcium carbonates and phosphates. The size of the stones range from 0.1 to 30 mm, but commonly the submandibular stones are 1.5 to 9 mm in size, and the number of stones range from 1 to 5.
Why do salivary gland stones form?
More than 80 percent of cases are stones in the submandibular glands. This is because it produces a particularly viscous, mucous and more alkaline saliva, with a relatively high concentration of hydroxyapatites and phosphates. This causes saturation of salts, especially when water intake is low and subsequent formation of stones. Moreover, the opening of the main salivary duct of the submandibular gland (Wharton s duct) is narrower than the diameter of the whole duct, so when the saliva ascends towards its opening it tends to get stuck at the opening and calcifies. [5]
Other possible causes are
Symptoms
The stone blocks the mouth of the duct and the most common symptom is pain and swelling of the affected gland at mealtimes or soon after the meals. The pain is sudden and intense right after you begin eating followed by swelling. The pain and swelling persist for about one to two hours after the meal.
Sometimes, the stone is just lodged in the gland and may not (or maybe, partially) block the duct. Then you experience a dull pain from time to time over the affected gland.
Preventive measures
Drink plenty of fluids, keep your mouth hydrated.
Surgical options
Sialendoscopyis the most used surgical option. Your doctor will first inject a local anaesthesia into the affected duct, then push an endoscope into the affected duct and pull out the stone.
Shock wave lithotripsy is done in cases of large stones. The ultrasound waves break up the stone and the fragments are allowed to pass into the duct. However, it is not very common. Doctors now do the SWL just to break up the large stone and then use sialendoscopy to remove the fragments.
Herbal remedies for gallstones
10 simple ways to prevent kidney stones
6 foods to avoid if you are suffering from kidney stones
5 early symptoms of kidney stones you should know
References
Image source: Shutterstock
