Gallbladder is a small, pear-shaped sac on the right side of the abdomen. It is found just beneath the liver. It stores bile (a digestive fluid) made by the liver which helps in fat digestion. Bile is released into the small intestine through two ducts (tubes) – the cystic duct and common bile duct. Gallstones are hard, calcified structures inside the gall bladder formed due to crystallization of bile. They may also form when the gallbladder fails to empty normally.
Cholelithiasis is a term to describe stones in the gallbladder. Gallstones may pass into the cystic duct, common bile duct or pancreatic duct and are called choledocholithiasis.
Gallstones vary in size from being as small as a grain or as big as a golf ball. There may be a single large stone or many smaller stones.
Cholesterol gallstones -- are the most common type consisting of more than 80% cholesterol by weight.
Pigment gallstones -- are made of bilirubin, a product of red blood cells destruction (haemolysis).
Women and people over age 40 are more prone to develop gallstones. Losing weight quickly may increase the chances of getting gallstones. A lack of melatonin that boosts the conversion of cholesterol to bile has been thought to contribute to gallbladder stones. Prolonged intravenous feedings (receiving nutrition through a vein) may cause gallstones due to disuse of gastrointestinal tract and reduced flow of bile.
In addition to this, there are few factors that increase your risk of gallstones -
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Gallstones may be asymptomatic, i.e. a person may not have any symptoms and may be found during a routine examination or medical procedure. Such stones may not require treatment. If a stone is large in size or it blocks either the cystic duct or common bile duct, symptoms may begin to appear. There may be sharp, cramping pain in the upper right side of abdomen which may spread to the back. There may be fever, nausea, vomiting and jaundice. Read about 9 causes of belching or burping you didn’t know about.
Gallstones in the gallbladder may cause inflammation (acute cholecystitis) causing bile retention. They may also lead to secondary infection by intestinal microorganisms. Gallstones in the biliary tract ducts can cause obstruction leading to life-threatening conditions (ascending cholangitis or pancreatitis) which need immediate medical attention.
Some of the tests that may be used to confirm diagnosis of gallstones are -
- Abdominal ultrasound -- An abdominal ultrasound involves using a probe, to detect the presence of stones. This is done by passing the probe over the abdomen.
- CT scan -- A CT scan or Computerized tomography is also called a CAT (computerized axial tomography). It is essentially an X-ray procedure that combines a large number of X-ray images taken in succession. Here are top 10 facts you should know about CT scans.
- ERCP (endoscopic retrograde cholangiopancreatography) -- In this, the inside of the stomach and duodenum is seen through an endoscope and radiographic contrast which can be seen on X-rays is injected into the ducts and pancreas.
- Blood tests -- may include bilirubin test, liver function tests, test for pancreatic enzymes, etc.
Read about 6 tests to check your liver function.
Asymptomatic gallstones do not need treatment. In some cases, oral medicines (ursodeoxycholic acid) may be given to dissolve cholesterol gallstones. Surgery is indicated if symptoms arise. Less commonly, open cholecystectomy
(gallbladder removal) may be done for uncomplicated cases. Read about general anaesthesia and surgery – all your queries answered.
(also known ascholecystectomy) -- is the most commonly used procedure. After administering general anaesthesia, the gall bladder is removed through several small cuts made in the abdomen. The surgeon inserts a scope with a small light and a video camera (laparoscope) into one incision near the belly button. He will then use a video monitor as a guide, and will insert a surgical instrument into another incision to remove the gall bladder. The surgery lasts for about 2 hours or less. After the gall bladder has been removed, the bile flows directly from the liver into the small intestine through the common bile duct. Smaller cuts allow for a faster recovery and reduced hospitalization. Read in detail about what is laparoscopic surgery?
ERCP with sphincterotomy
-- may be done to relieve obstruction of the bile duct with gallstones. The gallstones are removed by enlarging the opening of the duct with a sphincterotome (electrified wire).
Extracorporeal shock wave lithotripsy (ESWL)
-- uses ultrasonic shock waves to break the gallbladder into tiny pieces which later pass safely in the faeces. This treatment is not used very often because of chances of recurrence.
Bile helps digest fats but our body may have no negative consequences without a gallbladder after cholecystectomy. Bile flows straight from the liver to the intestine.
Although, very few people develop a condition called
which may cause stomach upset, persistent pain in the upper right abdomen and diarrhoea. There may be small changes in fat absorption.
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Here are a few herbal remedies that can help to prevent or deal with gallstones.
Here is detailed information on herbal remedies to treat gall stones.