Understanding and treating gallstones

Understanding and treating gallstones

GALLSTONES (scientifi­cally known as cholelithi­asis) are hardened de­posits of the digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen just beneath your liver. The gallbladder holds a digestive fluid called bile that’s released into your small intestine.

Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time. Types of gall­stones that can form in the gall­bladder include cholesterol gall­stones. The most common type of gallstone often appears yellow in colour and is often composed of undissolved cholesterol.

Pigment gallstones are dark brown and black stones that form when your bile contains too much bilirubin. It is, however, not clear what causes gallstones to form. Doctors think gallstones may re­sult when your bile contains too much cholesterol or bilirubin. If your gallbladder doesn’t empty completely or often enough, the bile becomes highly concentrat­ed, thus contributing to the for­mation of gallstones.

There are several risk factors that may increase your risk of de­veloping gallstones. Females are at an increased risk compared to their male counterparts. Individ­uals older than 40 years have an increased risk factor, and being overweight or obese puts you at greater risk. A sedentary lifestyle and eating high-fat diet may con­tribute to the onset of gallstones.

Individuals with liver disease and a family history of gallstones may also be at risk.

Gallstones may cause no signs or symptoms. If a gallstones lodg­es in a duct and causes a blockage, the resulting signs and symptoms may include sudden and rapidly intensifying pain in the upper right portion of your abdomen, just below your breastbone. This may manifest as back pain be­tween your shoulder blades and/ or pain in your right shoulder, as well as nausea and/or vomiting.

Complications of gallstones may include inflammation of the gallbladder (cholecystitis), jaun­dice and bile duct infection, as well as pancreatic duct blockage, resulting in inflammation of the pancreas (pancreatitis).

People with a history of gall­stones have an increase risk of gallbladder cancer.

You may reduce the risk of gall­stones if you try to stick to your usual meals each day. Skipping meals increases the risk of gall­stones. If you need to lose weight, go slowly because rapid weight loss can increase the risk of gall­stones. Work to achieve a healthy weight by reducing the number of calories you eat and increase the amount of physical activity you get.

Make an appointment with your doctor if you have any signs or symptoms that worry you. Seek immediate care if you de­velop abdominal pain so intense that you can’t sit still or find a comfortable position, or if you experience yellowing of your skin and the whites of your eyes and high fever with chills.

The test and procedures used to diagnose gallstones include ab­dominal ultrasound or comput­erised tomography (CT) as well as endoscopic retrograde chol­angiopancreatography (ERCP). Blood tests may reveal infection or other gallstone-related com­plications.

The gold standard in treating gallstones is surgery to remove the gallbladder (cholecystecto­my), 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.

You don’t need your gallblad­der to live and gallbladder re­moval doesn’t affect your ability to digest food, but it can cause diarrhea, which is usually tempo­rary. In case an individual devel­ops cholecystitis (inflammation of the gallbladder) antibiotics can be administered concurrently to mitigate the infection.

Dr. Makemba Shayela Nel­son holds an MBChB from the University of Kwazulu-Natal in Durban, South Africa and can be contacted at Nesha Medical Practice.