Gallstones



Gallstones

(Biliary Colic; Cholecystitis; Cholangitis)

by Diane Savitsky

Definition

Gallstones are pieces of stone-like material that form in the gallbladder. About 80% of gallstones are made up of cholesterol. The rest are made up of bilirubin. Bilirubin is a breakdown pigment of the blood product hemoglobin.

Biliary colic is the pain caused by a gallstone stuck in the bile duct, a tube that carries bile to the small intestine. Sometimes, a stone caught in the bile duct causes cholecystitis, which causes inflammation of the gallbladder. Cholangitis is inflammation of the bile duct caused by a gallstone or a bacterial infection.

Gallstones

[pic]

Copyright © 2005 Nucleus Communications, Inc. All rights reserved.

Causes

The gallbladder stores bile, which is produced in the liver and used in the small intestine to digest fat. Bile contains cholesterol, water, bilirubin, and bile salts. The bile salts break up fats.

Gallstones can form under the following conditions:

• Too much absorption of bile salts from the bile

• Too much absorption of water from the bile

• Too much cholesterol in the bile

• Inflammation of the lining of the gallbladder

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for gallstones include:

• Age: older than 60 years old

• Sex: women between 20 and 60 and women with high estrogen levels due to pregnancy, oral contraceptive use, or hormone replacement therapy

• Obesity

• Race: Native American and Mexican American

• Use of cholesterol-lowering drugs

• Diabetes

• Rapid weight loss and fasting

• Previous gallstones

• Diseases of the gallbladder and ducts

• Blood diseases, including sickle-cell anemia

• Cirrhosis of the liver

• Crohn's disease

• Infection with liver flukes

• Cysts of the great bile duct

Symptoms

Many people have gallstones without symptoms. These are called "silent gallstones" and do not require treatment.

Gallstones may cause pain in the upper abdomen that is sometimes called an attack because it begins suddenly, often after a fatty meal. The pain is severe and may last for 30 minutes or up to several hours.

Other symptoms include:

• Pain between the shoulder blades or under the right shoulder

• Bloating, nausea, and vomiting

• Belching, gas, and indigestion

If you have the following symptoms, you should see a doctor right away:

• Sweating

• Chills

• Low-grade fever

• Jaundice (yellowish color of the skin or whites of the eyes)

• Clay-colored stools

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include:

Ultrasound - a test that uses sound waves to find gallstones

Endoscopic Retrograde Cholangiopancreatography (ERCP) – a type of x-ray that shows the pancreas after dye has been sent through a tube down the throat and into the gallbladder

Cholecystogram or Cholescintigraphy – x-rays that show movement of the gallbladder and any blockage of the cystic duct that carries bile to the bile duct

Blood Tests – may be used to find an infection, jaundice, pancreatitis, or an obstruction

Treatment

Surgical Treatments

Laparoscopic Cholecystectomy – removal of the gallbladder through several small incisions in the abdomen. A small, lighted tube with a camera is inserted into one of the incisions to view the gallbladder area and display it on a television screen. Surgical instruments are used to remove the gallbladder through one of the other incisions.

Open Cholecystectomy – removal of the gallbladder through a large incision in the abdomen. This is necessary if there is an infection in the abdomen or a great deal of scar tissue.

Nonsurgical Treatments

Oral Dissolution Therapy – medications taken by mouth to dissolve stones. These drugs are most effective for treating small stones and may take months or years to be effective.

Extracorporeal Shock Wave Lithotripsy (ESWL) – shock waves used to break the stones into pieces small enough to pass through the ducts. This treatment does not have a high success rate and may cause severe pain.

Prevention

To reduce your chance of getting gallstones:

• Maintain a healthy weight.

• Avoid rapid weight loss diets.

• Exercise regularly.

• Eat a diet low in saturated fat.

• Eat plenty of fruits, vegetables, and whole grain foods.

RESOURCES:

American Liver Foundation



National Digestive Diseases Information Clearinghouse, NIH



Sources:

National Institute of Diabetes & Digestive & Kidney Diseases

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download