So, what are gallstones? Gallstones are solid,
pebble-like material that form inside the gallbladder. The gallbladder is a
sac-like organ located under the liver. The gallstones
can be the size of a grain or even as large as a golf ball.
Imagine this is sitting in your gallbladder, you can imagine the PAIN.
Luckily, the majority of gallstones are smaller than one inch which is about
two and a half centimeters in size; eighty percent of gallstones or
cholesterol gallstones the other 20 percent are pigment stones.
So what causes gallstones? The liver makes
and releases bile. Bile is stored in the gallbladder and bile is a greenish
brown fluid and the gallbladder not only
stores it but it also concentrates the bile.So
when we eat a meal, let's say we're having a good hearty fatty meal
like a good old cheeseburger dripping with cheese on the side the
gallbladder says heh! I need to do something about this and
gets active and contracts and bile flows
from the gallbladder to the small intestine to help with digestion.
In between meals the gallbladder is relaxing,
allowing the bile to flow into the gallbladder.
Now, if there's too much cholesterol or too much of another substance
called bilirubin or not enough bile salts
gall stones may form. Also, if the gallbladder does not
empty completely or not often enough gall stones can also form. So how many
people are affected especially here in the US by gallstones
On a yearly basis more than a million Americans are
diagnosed with gallstones. Your physician might use the term
cholelithiasis. And if you're wondering what happens if
you're on too MANY medications click on the link above.So are you at
risk for gallbladder stones? So these are the
risk factors having a family history, especially if
you're a woman, over the age of 40, you're obese,
if your diet is high in fat but low in fiber,
if you're frequently fasting, a rapid weight loss
or for that matter lack of exercise, use of birth control pills or hormone
replacement therapy, if you're pregnant, diabetes, hemolytic
anemia such as sickle cell disease, cirrhosis of the liver.
So if you're finding value in this video don't forget to like,
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that notification bell. So what are gall bladder stone symptoms?
the classical symptoms are your pain after eating
a fatty meal. You have abdominal pain located classically in your right
side of your belly with radiation to your right shoulder
or to your back. You might be vomiting or feeling nauseous some people present
without having eaten anything with pain and usually
they have symptoms around midnight. Having said that many
people have silent gallstones meaning they are
found incidentally during a CT scan or an ultrasound
and if the stones are not symptomatic they do not need treatment &
can can be monitored by your provider. So, how to diagnose gallstones? The most
important initial test would be a physical examination by a
provider coupled with specific blood tests to rule out signs
of infection as well as blockage. The next test
would be an ultrasound which is a non-invasive test
looking at your gallbladder which can pick up stones.
Most of the time a diagnosis can be established
by these tests, however, if the diagnosis is not conclusive
your doctor might order a CT scan to get a more detailed view of the
gallbladder liver and bile ducts. Your doctor might
also order another test called the HIDA can especially if the
gallbladder is acutely infected coupled with a blockage of the
gallbladder outlet. It is also used to look at gallbladder
disease without any stones known as a acalculous
cholecystitis. Then there are two other specialized tests one is called
MRCP and the other ERCP especially to look at
gallbladder stones blocking the bile ducts. During an
ERCP the added advantage is not only diagnosing a gallbladder stone
in the bile duct but also removing it. So the reason you want to avoid
symptomatic gallbladder stones is to avoid gall bladder stone complications!
If the gallbladder becomes blocked by a stone
or several stones it can cause the inflammation of the gallbladder.
This presents as pain which is constant especially
in the right upper side of your belly and fever
is common. Older adults can present atypically without a fever and sometimes
even without pain. If not treated this can lead to a rupture of the
gallbladder which is an acute medical emergency.
If stones leave the gallbladder and cause a blockage
of the bile ducts it's called choledocholithiasis.
Typical symptoms are fever, abdominal pain
chills as well as jaundice this is a yellowish discoloration of the skin
and the white of your eyes. It can also cause an
inflammation of the pancreas. This is another medical emergency
requiring immediate treatment to remove
the bloodstones or the blocked stone and this can be done by means of an ERCP.
So, how do we treat gallbladder stones? If you don't have any symptoms you do
not have to be treated. Your doctor would monitor you and give
you advice about diet, hydration and lifestyle changes.
Some small stones can pass through your body
on their own. If the stones continue to be symptomatic
and cause problems your doctor might offer one of two options. The first thing
could be a laparoscopic cholecystectomy which is the most
common surgery for gallstones. Through a small cut in your belly
your doctor passes a narrow tube called a laparoscope.
It holds a camera and light and during this procedure your gallbladder is taken
out through another small cut. Usually, you can be discharged the very
same day. The other surgical procedure requires
you to stay at the hospital for a couple of days.
During this procedure called an open cholecystectomy
gallbladder is removed using a bigger cut in your belly. As I
mentioned earlier if gallstones are in your bile ducts
your doctor might use a procedure called ERCP to find and remove the
gallbladder stones before or even during surgery.
Non-surgical treatments are usually offered if the risks of surgery
are too high. This was offered to one of my patients recently
as she had multiple cardiovascular risk factors.
The disadvantage with this option is that the stones
can reoccur after some time. Your Doctor might use a bile acid pill to dissolve
cholesterol stones called Ursodiol, a side effect of the medication is
diarrhea. You will have to be on this medication
for several years as it takes years to dissolve the stones. And if
you're interested in the side effects of other medications
click right here! My patient was offered a per
cutaneous removal of stones. During the procedure
a small plastic tube is inserted into the gallbladder to drain the bile
caused by the obstruction of stones. So the most important thing how can you
prevent a recurrence of gallbladder stones and
its problems? So, your diet should include
low fat dairy foods, whole grains such as brown rice, oats, bran cereals
whole wheat bread and whole wheat pasta, lean meats and poultry, fish
fresh fruits and vegetables. You should avoid
the following foods such as fried foods, highly processed foods such as cookies
and pies, whole milk dairy products such as cheese
butter or an ice cream, fatty red meat and exercise regularly I would recommend
about 30 minutes five times a week. Question of the day
Are you suffering from gallbladder stones?
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