Gallstones are clusters of cholesterol or calcium salts that are deposited in gallbladder or bile ducts. Often they do not cause any difficulties and therefore do not need any treatment. Some people, however, have a “flashes” of pain accompanied by nausea and vomiting after ingestion of certain foods or even on empty stomach.
Gallstones are more common in women, people over 45 years of age and obese people (4Fs: fat, fertile, forty, female).
An interesting fact is that very low calorie diets and rapid weight loss can encourage the formation of gallstones.
Symptoms
1) Long-term indigestion. Nausea, swelling, flatulence accompanied by discomfort in the abdomen that occur after the consumption of foods high in fats. But other diseases and conditions can cause chronic digestive disorders: gastritis, ulcer in stomach/on duodenum, irritable bowel.
2) Pain in the upper abdomen. The pain usually occurs abruptly, is of very high intensity, appearing approximately an hour or two after eating or even at night and lasts between half an hour to several hours, can spread (referred pain) to the right shoulder or to the back. Mild pain may be persist for a few days. If you had one seizure chances are high that it will be repeated.
3) Nausea / vomiting.
4) Temperature. Sometimes a stone is moved and stuck in the bile duct that leads to the strengthening of the intensity of pain that does not subside even after several hours. When the main bile duct is shut by a stone, inflammation may be caused that manifests itself by high temperature and deterioration of general condition, jaundice and clay-colored stools.
Causes of gallstones
It produces bile (greenish-brown liquid consisting of bile salts, cholesterol, fat and enzymes) that accumulates in the bile duct and accelerates the degradation of fatty foods in the small intestine.
After eating, the gall bladder contracts and releases bile into the main bile duct and into the small intestine. In the event of a chemical imbalance of bile gallstones begin to appear They can be like a grain of sand and can grow to the size of table tennis balls. There are several types of stones:
1) Cholesterol stones. 80% of all stones are of this type, yellowish in color and have within them calcium and bilirubin. The level of cholesterol in the blood is not related to the concentration of cholesterol in bile and cholesterol-lowering drugs do not dissolve nor prevent gallstones.
2) Pigment stones. These dark brown, black stones occur in people who have high bilirubin values and are more common in patients with cirrhosis of the liver, inflammation of the bile duct, and some types of anemia.
What contributes to the formation of stones?
1) Women three times higher rate of occurrence than men
2) Body weight. Excessive body weight, body mass index over 27 favors the formation of stones.
3) Diet. Very low calorie diet and rapid weight loss favor the formation of stones.
4) Age. Persons older than 60 years are more likely to have gallstones.
When you need to seek medical treatment
In the case of abdominal pain accompanied by nausea, vomiting and fever contact your doctor.
Emergency medical assistance must be requested in case of intense abdominal pain that is accompanied by a yellowness of skin/mucous membranes, dark urine, fever and chills/shivers .
Diagnosis
Often gallstones are detected on abdominal ultrasound in the systematic examination.
In case of problems, doctor will recommend additional laboratory tests: blood count, sedimentation rate, liver enzymes (transaminases AST, ALT, bilirubin) and pancreatic enzymes (amylase, lipase).
Examinations used for the diagnosis of stones:
• Ultrasound
• Computed tomography (CT)
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Cholangiopancreatography by means of magnetic resonance
• Endoscopic ultrasound
Therapy
In the event that the stones do not create problems, therapy is not required and the patient is easily monitored .
Cholecystectomy (gall bladder surgery) is one of most commonly performed procedures in the world and it is performed in two ways:
1) Laparoscopy: A very thin tube with a video camera is introduced into the abdomen through a very small opening in the abdominal wall and the gall bladder removed. Therefore the recovery is shorter, there is less risk of scarring and the person may return to normal activities earlier.
2) Open surgery; laparotomy is needed in case when the membrane of the gall bubble is thickened and inflamed. The incision is much larger and the recovery is longer. Sometimes laparoscopic surgery is planned but during the operation it changes to the open laparotomy.
Nonsurgical therapies are not used often because the stones usually reaccumulate, but there are cases in which surgery is contraindicated (such as serious heart or lung patients).
1 ) Drug used for the purpose of dissolution of stones over a longer time period is called ursodiol. Therapy is effective in less than 50 percent of cases and is used for very small stones.
2 ) Extracorporeal lithotripsy.
3 ) Electrohydraulic lithotripsy.
After surgery
The liver still produces bile but it has nowhere to store it so it is emptied directly into the small intestine which can speed up digestion and result in a higher rate of stools and diarrhea. Over time, the stool normalizes but 1% of the patients suffer from chronic diarrhea after gallbladder surgery.
In such cases it is recommended to avoid dairy products and fats in the diet and to increase fiber intake.
There are also questions about alternative approaches to therapy, the use of methods to “clean” the intestine with a variety of herbal preparations. Scientific methods and research have not proven that herbal remedies and teas can “dissolve” gallstones so it is not recommended.
What is “natural” and the vegetable does not necessarily mean that it is without side effects.