Definition• A gallstone is a solid crystal deposit that forms in the gallbladder, which is a pear- shaped organ that stores bile salts until they are needed to help digest fatty foods.
Causes• The gallbladder functions to store bile, a brown or greenish fluid that helps the body break down fatty foods. Normally, the concentration of bile acid is high enough to break down the cholesterol in the mixture and keep it in liquid form. But, when a diet it high in fat, it can tip the balance causing the liver to produce more cholesterol than the bile acids are able to handle. When this happens, some of this excess cholesterol begins to solidify into crystals, which we call gallstones. Most gallstones are created this way. The other way they could be created is of calcium mixed with the bile pigment bilirubin.
Symptoms• If one or more stones block the cystic duct or the common bile duct, symptoms might occur. These symptoms include: Mild to severe upper abdominal pain and nausea and vomiting.
Body systems affected• Stones that remain lodged in the bile ducts block the release of bile. This can cause severe inflammation of infection of the gallbladder and bile ducts. Blocked bile ducks may also cause jaundice, in which the skin and whites of the eyes become yellow. Also, blockage of the common bile duct may cause inflammation in the pancreas.
Diagnosis• For a diagnosis you may have blood tests to check your red blood cell count and cholesterol levels if the doctors suspects from you symptoms you have gallstones. You may also have imaging tests, like an ultrasound scanning or another imaging procedure called ERCP. This is preformed if a bile duct if found to be blocked. During an ERCP a endoscope is passed through the mouth into the duodenum to inject a contrast medium into the bile ducts prior to x-rays being taken.
Treatment• Gallstones that do not cause symptoms do not need treatment. If your symptoms are constant or persistent you may have to get your gallbladder removed by conventional surgery or by minimal access surgery. Gallbladder removal usually cures the problem but sometimes, in rare cases, the stones re-form from the bile duct and may then need to be removed either by open surgery or ERCP. Drugs are also available. They dissolve gallstones made of pure cholesterol, but it may take months of a year. Another alternative is high-energy ultrasonic shock waves which shatter the stones into tiny pieces so they can pass painlessly. Although, new gallstones can form since the gallbladder is still present.
Outcome of the disease• People fully recover with treatment. Open surgery requires a longer recovery period. The liver can be weakened due to bile accumulation. Since there is no gallbladder to store the bile, it stays in the liver and it’s production may be slower than before surgery.
People at risk• Gallstones occur more frequently in women then men. Gallstone prevalence increases with age. Obese individuals are more likely to form gallstones then thin individuals. Pregnancy increases the risk for cholesterol. The increased levels of hormones increases chances of getting gallstones. Rapid weight loss by whatever means, very low calorie diets or obesity surgery, causes cholesterol gallstones in up to 50% of individuals. Individuals with crohns disease of the terminal ileum are more likely to develop gallstones. Gallstones occur more frequently in individuals with elevated blood triglyceride levels.
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