Treatment for Gallstones

Gallstones are like tiny rocks that form in the gallbladder. They are made of cholesterol or bile particles that clump into a solid mass. A stone can grow as liver bile passes through the gallbladder. Most gallstones are small enough to pass out of the body through the intestines without our noticing. However, some do get caught in the narrow outlet of the gallbladder or in the intestines. This can lead to pain, a buildup of bile, pancreatitis and/or infection. Gallstones are common, especially in women, the elderly and overweight individuals.

Diagnosis

Patients having a gallstone attack report pain in the upper abdomen, usually on the right side, along with belching, gas, nausea and/or loss of appetite. In more serious cases, the patient may show signs of jaundice and have a fever.

Regular X-rays will not help the doctor find gallstones, but ultrasound and CT scans can. For example, if a stone is blocking the flow of liver bile, an ultrasound or CT scan will show swollen bile ducts. Blood tests might then be ordered to see if there is damage to the liver or pancreas.

Causes

High levels of estrogen, usually from multiple pregnancies or birth control pills (or both), are thought to be one cause of gallstones in women. People who are overweight, Native American or Hispanic and those with sickle cell anemia are at high risk for gallstones. In addition, obese individuals who go on crash diets are also prime candidates for troublesome gallstones.

Screening and Prevention

There is no way to screen for the disease. But since obesity is so closely linked, maintaining a normal weight is an important, especially for women. Avoiding high-fat meals and "yo-yo" weight loss diets are also good ideas. If your background places you at high risk, avoid taking birth control pills or estrogen.

Treatment Options

  Gallstones are treated only when they cause a great deal of discomfort. In those cases, removing gallbladder is recommended. This may be done with traditional surgery (open cholecystectomy) or with less invasive laparoscopy.

Due to the smaller incisions of the laparoscopic surgery, patients usually recover faster than with traditional surgery. However, surgery does provide a direct view and more room to move around inside. Surgery is usually done on patients who have had surgery before in this area, have a lot of inflammation or are very obese. Occasionally, a laparoscopic procedure may end up as a traditional surgery. When gallstones are found in the common bile duct, laparoscopy is used to remove the gallbladder.

Overall, gallbladder surgery has generally proven to be highly effective. Most people do not miss the organ since, like the appendix, it is no longer essential. In rare cases, there may be diarrhea and abdominal pain afterward. This is easily addressed with time, healing and sometimes diet. People who cannot tolerate surgery are sometimes given a drug that dissolves the stones slowly over six or more months. Unfortunately, it is not always effective. New stones can form after the patient stops taking the medicine.

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