GALL BLADDER STONES (GALLSTONES)
· The gall bladder is a small organ just below the liver in the right upper abdomen.
· It stores bile juice formed by the liver which helps in digestion of food.
· Stones in the gall bladder (gallstones) can create health problems and it is best to remove them surgically.
1. Types of gallstones
· Cholesterol gallstones develop when bile contains excess cholesterol and not enough bile salts.
· The risk factors include obesity, diabetics, those losing weight rapidly, besides women on estrogen medication.
· A healthy lifestyle minimizes development of cholesterol gallstones.
· Pigmented gallstones are made up of bilirubin salts.
· The risk factors include hemolytic anemia such as sickle cell disease and hereditary spherocytosis, cirrhosis or liver failure, and biliary tract infections.
· Mixed gallstones are the most common and are composed of both cholesterol and bilirubin salts.
2. Symptoms
· Gallstones may remain asymptomatic or may lead to ‘gallstone attack’.
· The attack is an intense pain in the upper-right side of the abdomen, often accompanied by nausea and vomiting, that steadily increases.
· Attacks may often occur after a fat-leaden meal.
· Other symptoms include abdominal bloating, intolerance of fatty foods, belching, gas, and indigestion.
3. Complications
· The gallstone can block flow of bile and interfere with flow of pancreatic juices leading to complications like pus in the gall bladder, jaundice, cholangitis, bile duct infection, pancreatitis or inflammation of pancreas.
· These are potentially life-threatening complications.
· Prolonged inflammation of the gall bladder from stones can also lead to gall bladder cancer.
4. Diagnosis
· An ultrasound can identify gallstones.
· High-risk asymptomatic patients include diabetics, patients on chemotherapy or those who are HIV positive.
· Symptomatic patients should consult a medical expert for surgery.
5. Treatment
· Laproscopic, key hole, and gall bladder surgery are the accepted treatments.
· Stone-dissolving therapy is ineffective for pigmented and mixed gallstones and shows inconsistent results for cholesterol gallstones.
6. Prevention
· There is no sure way to prevent gallstones, but risk can be reduced with lifestyle modifications.
· Losing weight with regular exercise is important.
· Also, avoid foods with excess fat, and take a high-fibre diet.