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What are Gallstones

Gallstones are tiny but hard pebble-like deposits that develops inside the gallbladder. Gallstones may be of the size of a grain of sand or as big as a golf ball. The gallbladder is a pear shaped organ of the digestive system, located in the right upper side of the abdomen right below the Liver. Gallstones develop when bile, i.e. the fluid inside the gallbladder solidifies into stone like pieces. This fluid is made in Liver and later stored in gallbladder for future usage. Bile is composed of water, fats, bile salts, cholesterol and waste products like bilirubin. Excess amount of these substances results in the hardening of bile liquid into gallstones

There are basically two types of gallstones:

  • Cholesterol stones: These are yellowish-green and are made up of hardened cholesterol. Most gallstones cases are of this kind.
  • Pigment stones: These are small, dark stones made up of bilirubin.

Causes, incidence, and risk factors

Gallstones are more widespread in women than in men and it affects people who are over age 40. Gallstones may also be inherited.

The following are some of the causes and risk factors that lead to gallstones.

  • When gallbladder is unable to empty bile properly
  • Diseases like chronic hemolytic anemia and sickle cell anemia
  • Billiary tract infections and Liver cirrhosis
  • Diabetes Mellitus
  • Eating a very low-calorie diet and rapid weight loss
  • Intravenous feedings

Symptoms

Symptoms of gallstones are as follows:

  • Pain or cramping in the right upper or middle upper abdomen:
  • Fever
  • Clay-colored stools
  • Jaundice with Yellowing of skin and whites of the eyes
  • Abdominal fullness
  • Vomiting and nausea

Diagnosis

Tests used to detect gallstones or gallbladder inflammation includes:

  • Bilirubin level test
  • Liver function tests
  • Pancreatic enzymes test.
  • Abdominal USG and/ or CT Scan
  • Gallbladder radionuclide scan
  • ERCP -Endoscopic Retrograde Cholangio Pancreatography
  • Magnetic resonance cholangiopancreatography (MRCP)
  • Percutaneous transhepatic cholangiogram (PTCA)

Treatment

Following are some of the treatment options for Gallstones:

  • Surgery: The surgery for gallbladder removal is known as Cholecystectomy.It is of two types Open cholecystectomy and laparoscopic cholecystectomy. In Laproscopic procedure smaller surgical cuts are done which allows faster recovery.
  • Sphincterotomy: This is done with the help of Endoscopic Retrograde Cholangio Pancreatography (ERCP), this procedure is carried out to situate and treat gallstones in the common bile duct.
  • Drug therapy: Certain medication is given to dissolve the cholesterol gallstones. But this treatment takes very long to cure the gallstones. There are possibilities of relapse of the disease after drug therapy.
  • Electrohydraulic shock wave Lithotripsy (ESWL): This is advised for patients who cannot undergo surgery. ESWL is the non-invasive treatment of gallstones. In this procedure the stone is broken by applying nominal collateral damage by using an externally-applied, focused, high-intensity acoustic pulse.

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