Gallstones - Prevention

Cholelithiasis

It is also known as gallstone. It is a crystalline concretion formed within the gallbladder by accretion of bile components. They can be smaller than a grain of sand or as large as a golf ball. Most gallstones do not cause problems but if they block a duct, they usually need treatment.

Causes:

In most cases, cholelithiasis is caused by excessive amounts of cholesterol in the bile that is stored in the gallbladder. The cholesterol hardens to form stone-like substances. Increased body weight and older age are associated with increased levels of cholesterol in the bile.

Symptoms:

Most people who have gallstones do not have symptoms. Gallstones may be asymptomatic, even for years. Symptoms commonly begin to appear once the stones reach a certain size (>8 mm).

A characteristic symptom of gallstones is intense pain in the upper-right side of the abdomen, often accompanied by nausea and vomiting, that steadily increases up to several hours. You may also experience referred pain between the shoulder blades or below the right shoulder. Often, attacks occur after a particularly fatty meal

Treatment:

The treatment of gallstones depends upon the stage of disease. Asymptomatic gallstones may be managed conservatively. Once gallstones become symptomatic, definitive surgical intervention with cholecystectomy is usually indicated.

Several treatment options are now available for cholelithiasis. Laparoscopic cholecystectomy is currently the most frequently used technique. Options include:

Endoscopic retrograde cholangiopancreatography(ERCP), an imaging procedure that allows treatment of some bile duct problems, including removal of gallstones that are causing obstruction

Laparoscopic cholecystectomy (removal of the gallbladder through multiple small incisions; this is less invasive and a more commonly used technique)

Lithotripsy (technique that uses electric shock waves to dissolve gallstones; it is not commonly used today)

Medication to dissolve gallstones (this treatment takes a long time, and gallstones may recur)

Open cholecystectomy (removal of the gallbladder through a single, large incision; this is a more invasive and less commonly used technique)

Complications:

Cholelithiasis may cause serious complications if gallstones lodge in the common bile duct, which is the large duct formed where the major gallbladder bile duct joins the major liver bile duct. Complications of cholelithiasis include:

Acute cholecystitis (sudden inflammation of the gallbladder)

Cholangitis (an infection or inflammation of the common bile duct)

Choledocholithiasis (gallstone in the common bile duct)

Pancreatitis (infection or inflammation of the pancreas)