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Gall Bladder Pain: Causes, Symptoms, Treatment

Your gallbladder is a small, pear-shaped organ that’s tucked below your liver. You probably don’t think much about it — until it hurts.

Your gallbladder releases a greenish fluid called bile every time you eat to help your body digest fats and vitamins. The bile flows down to your small intestine through tubes called ducts. When something goes wrong with your gallbladder or the bile ducts, the upper right side of your belly may hurt. You may also feel:

  • Pain in your back or chest, especially when you take deep breaths
  • Feverish
  • Like throwing up
  • Bloated
  • Itchy
  • Tired

Other common symptoms include yellow skin and eyes (known as jaundice), weight loss, and color changes in your pee or poop.

Causes

Gallstones. These are the top reason for gallbladder pain. You get them when bile clumps together into hard masses. Gallstones can be tiny specks or the size of a golf ball. If they get big enough, these stones can block bile from flowing out. That can lead to a gallstone attack, a sudden pain in the upper right part of your belly.

These attacks often happen after a big steak dinner or other fatty meals, and they can last for many hours. But most people who have gallstones don’t know it. These “silent” stones don’t cause problems in your organs. Diagnostic tests like an ultrasound , a magnetic resonance cholangiopancreatography (MRCP), an endoscopic retrograde cholangiopancreatography (ERCP), blood test,, or  other imaging tests can show if you have gallstones. Your doctor can get rid of them with surgery, medication, or even shockwaves.

Bile duct stones. These are either gallstones that get stuck in your bile ducts or stones that form there. They may give you no trouble until they block the bile ducts. Then you might have serious pain in your belly that comes and goes for hours at a time. Your skin and eyes might turn yellow, and you might feel like throwing up. Your doctor can remove the stones by threading a thin tube with a light at the end called an endoscope through your mouth down to the bile ducts.

Perforated gallbladder. This can happen when your gallstones over time wear a hole in the walls of your organ. It’s rare, but it can be deadly. The upper right part of your belly might hurt. You also may have a high fever, nausea, and vomiting. You’ll need medical treatment or surgery right away.

Gallbladder abscess (Empyema). This is causesd by infection from bile buidlup from duct obstruction (including gallstones). The infection may resist treatment with antibiotics and need to be drained. A serious abcess can result in a tear, allowing the infection to enter the inside lining of the abdomen (peritonitis).

Gallbladder inflammation. Also called cholecystitis, this can happen for several reasons, including trauma, illness, infection, tumors or when bile builds up in your gallbladder from gallstones. Less often, other culprits can include tumors, certain bacteria, or problems in your bile ducts. When your gallbladder gets inflamed and swollen, symptoms include pain in your belly, including the area just above your stomach. You also may feel an ache in your back or right shoulder blade.

Usually, an ultrasound and other imaging tests can diagnose it. You may need surgery to remove your gallbladder. (Your body can work fine without it.) Without treatment, the organ can burst.

Primary sclerosing cholangitis (PSC). This is a liver disease that damages your bile ducts. It’s progressive, meaning it gets worse over time. About 4 out of 5 people who PSC also have inflammatory bowel disease. PSC can lead to liver failure. Many people have no symptoms. Or you might feel tired or have pain in the upper right side of your abdomen or itchy skin. This condition is often found when routine blood tests show your liver isn’t working right.

Gallbladder cancer. This is rare and hard to diagnose. More often than not, you won’t have symptoms until the cancer has spread. Signs may include abdominal pain, especially on the upper right side, as well as weight loss, jaundice, and belly bloating. A family history of gallstones; being older, female, or obese; and eating unhealthy foods can make you more likely to get cancer in the gallbladder.

Bile duct cancer. You may not have symptoms in the early stages of this cancer. If you do, it’s often because the bile duct is blocked. Jaundice is the most common symptom, along with itchy skin and light-colored or greasy poop. If your tumors are big enough, you may have belly pain, especially below your ribs on the right side. Surgery gives you the best chance at a cure. But most bile duct cancers are found too late for that. In that case, you may need radiation or chemotherapy to shrink the tumors first.

Bile duct scars. Narrowed bile ducts from scar tissue can keep the bile from flowing out of your liver and gallbladder into the small intestine. That can make you hurt on the right side of your abdomen where the organs are. You also might be itchy or tired, have a lack appetite, and have jaundice, night sweats, or a fever.

A number of things can cause the scars, including bile duct stones, injury, infections, and alcohol and drugs. Your doctor can confirm it with a procedure called endoscopic retrograde cholangiopancreatography (ERCP), which gives them an inside peek into your bile and pancreatic ducts.

Complications

Gallbladder pain goes beyond disconmforst. Some of the more minor complications include:

  • discomfort with eating
  • weight loss
  • electrolyte abnormalities
  • consumption of pain medications
  • disruption of daily activities.

More serious complications of gallbladder disease include

  • bile duct blockage,
  • serious infections (empyema and gangrene of the gallbladder)
  • pancreatitis,
  • peritonitis
  • infrequently, gallbladder cancer

What You Can Do

Lifestyle changes can help keep your gallbladder shipshape.

Load up on fiber and cut back on sugar and carbs. Problems with your gallbladder often can be traced back to too much cholesterol — a fat from meat, dairy, and other animal sources. But don’t be afraid of good unsaturated fats from foods like olive and canola oil, salmon and other fatty fish, and nuts.

Exercise regularly. Aim for 30 minutes of brisk walking and other moderate workouts every day.

Keep a healthy weight. If you’re heavy, aim to lose pounds slowly and avoid fasting. Otherwise, it can make the level of cholesterol in your gallbladder go up.

When to Call Your Doctor

Problems with your gallbladder or bile ducts should be checked out. Talk to your doctor right away if you:

  • Feel bad pain in your belly for many hours
  • Are nauseated or throwing up
  • Are sweaty
  • Have chills or a fever
  • Have yellow skin or eyes
  • Notice your pee is darker or your poop is lighter than usual

Cholecystitis (Gall Bladder Infection): Symptoms, Causes, Treatment

What Is Cholecystitis?

Cholecystitis is a swelling and irritation of your gallbladder, a small organ in the right side of your belly near your liver.

The gallbladder’s job is to hold a digestive juice called bile. It releases bile into your small intestine when your body needs it to break down fats. But if the path to your small intestine is blocked, bile gets trapped. That backup can irritate your gallbladder. That’s how cholecystitis happens.

Nausea and vomiting are common symptoms. They often show up after you’ve eaten a big or especially fatty meal.

It’s easy to mistake cholecystitis for other health problems, but another telltale sign is intense pain — in your belly, in your back, or under your right shoulder blade.

If you don’t see a doctor and get treatment, it can lead to dangerous infections or become a long-term condition. The most common solution is surgery to remove your gallbladder.

Cholecystitis Symptoms

Cholecystitis can mimic other health problems, so you’ll need to see a doctor for a diagnosis.

You might feel a sharp, sudden pain in the upper right side of your belly. You may also feel pain in your back or below your right shoulder blade. Deep breaths may make it worse. Some other symptoms to watch out for include:

Symptoms may get worse after a high-fat meal. If you can’t get comfortable or sit still because your pain is so strong, head to an emergency room.

Cholecystitis Causes

The usual reason bile backs up is that gallstones — lumps of bile turned solid — block the way to the small intestine. Gallstones are common. About 10% to 20% of Americans have them. About half of people with gallstones will get cholecystitis.

But gallstones aren’t the only problem that can cause this condition. Others include:

  • Gallbladder sludge, a thick liquid, builds up in the organ. This can happen if you’re pregnant or if you’ve lost a lot of weight quickly.
  • Tumors block bile’s path. A growth in your pancreas or liver can stop it from draining.
  • Your gallbladder doesn’t have a good blood supply. People with diabetes can have this problem.
  • An infection affects your gallbladder. Bacteria can damage the system that drains bile, causing it to back up.

Cholecystitis can come on suddenly. You may hear a doctor or nurse call it an “acute” case. Or it can be a long-term problem. Those cases are called “chronic.”

Cholecystitis Risk Factors

You have a higher chance of getting cholecystitis if you:

  • Are a woman older than 50
  • Are a man older than 60
  • Are overweight
  • Have diabetes
  • Are pregnant

Or if you have:

You also run a bigger chance of getting it if your diet is high in fat and cholesterol or your ancestry is Native American, Hispanic, or Scandinavian.

Cholecystitis Diagnosis

The doctor will examine you, ask a few questions about your symptoms, and probably order some tests. You should be ready to:

  • Detail when your symptoms started. Have you felt this way before?
  • Describe how severe your pain is.
  • Talk about whether anything makes your pain better or worse.

Your doctor can tell from blood tests whether you have an infection and whether your liver is working the way it should. They may also want you to have some imaging tests. These may include:

  • X-ray of your belly, which will show your internal organs, bones, and tissues
  • Ultrasound, which will show your gallbladder and liver and let doctors check blood flow
  • CT scan, which gives doctors a more detailed look at organs, muscles, and bones than an X-ray can
  • HIDA scan, which checks how your gallbladder moves and shows if bile is blocked. You get a shot of a chemical, and then a scanner traces it as it moves through your body.
  • PTC, which uses a dye injected into your liver to show how bile is moving through your body
  • ERCP, which uses a long, flexible tube threaded down your throat, through your stomach, and into your small intestine. It has a light and camera at the end. This test also uses a dye to check how bile is flowing through your system.

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Cholecystitis Treatment

If you have cholecystitis, especially an acute case, you may have to spend some time in the hospital.

You will have to keep your stomach empty so your gallbladder can rest. You’ll probably get fluids through a tube put into a vein. You may get pain medicine and, if doctors are concerned about infection, an antibiotic. Once treatment begins, you should start to feel better.

If gallstones caused your problem, doctors may try medications to dissolve them and give you a prescription drug to keep them from forming again. A very low-fat diet may also keep them from coming back.

What if I Need Surgery?

By far the most common treatment is to take out the gallbladder.

Your doctor may decide to do the surgery right away, unless you’re too sick. If you need to wait, doctors can ease symptoms by putting a tube through your skin straight into the gallbladder and draining some bile.

Surgery to remove your gallbladder, called a cholecystectomy, usually takes about an hour and is considered low-risk.

You’ll get general anesthesia, so you won’t be awake or feel any pain during the procedure. The doctor will make a small cut in your bellybutton to take a look inside with a special instrument. They’ll then take out the gallbladder through another small cut.

You can live a healthy life without your gallbladder.

Cholecystitis Prevention

You can take steps to lower your chances of getting gallstone and cholecystitis. They include:

  • Lower your cholesterol.
  • Exercise regularly.
  • Eat a diet rich in fruits, vegetables, and healthy fats. Eggs, soybeans, and peanuts are great choices.

Obesity is a major risk factor for getting gallstones. Losing weight can reduce your chances, but be sure you do it in a healthy way. If you’re planning a rapid weight loss program, such as weight loss surgery, your doctor or nurse should monitor you. They may recommend bile acid pills to prevent gallstones as you lose weight.

Cholecystitis Complications

If you don’t get treatment, your gallbladder can become infected, and some of the tissue may die. Infection can also spread to other parts of your body, including your pancreas (pancreatitis) and the lining of your belly (peritonitis).

If the tubes that carry bile are damaged too much, cholecystitis can harm your liver, too. You could have repeated bouts of painful symptoms. Eventually, your gallbladder will shrink and not work as well. The condition would become a long-term, or chronic, problem.

Gallbladder Disease: Stages and Symptoms



Symptoms of gallbladder disease can include nausea, vomitting and more. The Department of Hepato-pancreato-biliary and Transplant Surgery​ at Singapore General Hospital (SGH) explains in detail.

Continued from previous page.

Stages and symptoms of gallbladder disease

“The symptoms of gallbladder disease vary widely,” says​ ​Dr Teo Jin Yao​, Consultant from the Department of Hepato-pancreato-biliary and Transplant Surgery​ at Singapore General Hospital (SGH), a member of the
SingHealth group. ​​“It depends on which of the three clinical stages of gallbladder disease you are experiencing – asymptomatic, symp​tomatic or complicated.”

At the asymptomatic stage

There are no symptoms. At this stage,
gallstones are usually incidentally detected during screening. They do not interfere with liver, gallbladder or pancreas function, so treatment is typically not necessary. Nowadays, due to improvements in modern imaging technology, we see more and more patients with no symptoms.

At the symptomatic stage

As
gallstones block the bile ducts, pressure increases in the gallbladder. This can cause an “attack” of sporadic pain in the centre of the upper abdomen called biliary colic, which is often confused with gastric pain. It typically follows heavy or fatty meals, and can occur at night.

A typical attack usually results in steady pain in the centre of the upper abdomen. The pain can increase rapidly and can last for 30 minutes to several hours. There might also be pain in the back between the shoulder blades, and under the right shoulder.

At the complicated stage

Acute gallbladder disease is one of the most frequent causes for emergency hospital admissions. This includes
obstructive jaundice due to obstructed bile ducts, acute cholecystitis (inflammation of the gallbladder) and acute pancreatitis.

When the gallstones obstruct the common bile duct, you can get jaundice. Symptoms include a yellow discolouration of the skin and whites of eyes, itchy skin, pale bowel motions and dark urine. Jaundice together with fever can be extremely serious, and you should seek urgent medical attention.

Patients with acute cholecystitis will have a persistent right or upper abdominal pain, and fever. This pain can be made worse by movement or coughing. Nausea and vomiting are also common.

Typically, patients with acute gallstone pancreatitis will present with sudden severe upper abdominal pain, often associated with back pain. The pain is usually severe enough to bring the patient to the emergency room. If the gallstones obstruct the pancreatic duct, there may be back pressure in the pancreas, causing pancreatitis. Most attacks of pancreatitis are mild, while some are severe and life-threatening.

Possible symptoms of complicated gallbladder disease

Should you have any of these symptoms, consult a doctor immediately:

  • Prolonged abdominal pain lasting more than four hours
  • Nausea and vomiting
  • Fever and chills (or shivering)
  • Yellowing of the skin and whites of the eyes
  • Pale-coloured stools

Dr Teo explains, “Any of the above symptoms may signal complicated gallbladder disease, which warrants immediate attention.”

See page 1 to learn
why gallbladder disease can be mistaken as gastric pain. 

Ref: P16

Check out other articles on abdominal pain:

What’s Causing Your Gastric Pain?

How to Prevent Gastric Pain

Gastric Pain FAQs – Our Doctor Answers

7 Tips to Reduce Belching or Burping

Stomach Flu: Causes and Prevention Tips

Is It IBS (Irritable Bowel Syndrome) or More Serious?

What You Need to Know About Gallbladder Conditions

Compared to the heart, lungs or brain, the gallbladder isn’t an organ that most people often discuss. However, it still serves a very important function in the body. The gallbladder stores bile, or the digestive fluid, that is created in the liver. The bile is stored until you need it to help break down fat in your diet.

Whenever you eat foods that contain cholesterol or fats, your body will tell the gallbladder to contract. The contraction allows the bile to move down the main duct from the liver into the intestines where it meets the food and helps digest the fat.

However, sometimes this process doesn’t go according to plan and gallstones or other problems with the gallbladder can develop.  One of the most common disorders that affects the gallbladder are gallstones.

When this occurs, the overall consequences can range anywhere from mild discomfort, bloating or nausea after eating to very severe upper abdominal pain, which sometimes can spread all the way to your right shoulder or to your back. If you’ve never experienced gallstone disease or aren’t familiar with the signs and symptoms of this condition, here’s what you should know:

It Usually Starts with Abdominal Pain

The majority of people that come to my practice with gallbladder complaints are people who have experienced pain in their upper abdomen or upper right abdomen after eating, and sometimes this will wake them at night.

Commonly, the gallbladder is the source of their symptoms and it generally presents as problems that fall into one of two broad categories. The first would be gallstones, which is the most common problem and occurs when bile in the gallbladder hardens and forms stones that can block the cystic duct, or the passageway the removes bile from the gallbladder. These stones can lead to pain or symptoms that we call symptomatic cholelithiasis, the medical term for gallstones that are causing symptoms. Other, more complex problems related to gallstones are acute cholecystitis or common bile duct obstruction. 

The other broad category is called biliary dyskinesia, where a person’s gallbladder may not have gallstones, but it isn’t squeezing appropriately. This can lead to the abdominal pain and cause symptoms that typically occur after they eat fatty or spicy foods.

Symptoms Differ in Every Patient

Symptoms vary from patient to patient. Some people will have mild symptoms for months or even years until they finally seek treatment. Other people may have symptoms only once or twice a year or even weekly, but their symptoms never reach the level to where they need medical attention. In some cases, the first gallbladder attack or the pain or symptoms associated with their gallbladder disease can be so severe that it forces them to go to the ER. 

Occasionally, people will experience unusual symptoms such as heartburn, chest pain, indigestion, bloating, nausea or diarrhea. These symptoms can occur by themselves or in combination. If you are experiencing these symptoms it may be a diseased gallbladder contributing. However, it is always important to seek immediate medical attention if you are experiencing chest pain, as heart conditions can present with this symptom and can be life threatening. 

When this happens, it’s usually because the symptoms have not resolved on their own.  This is most commonly due to a gallstone that is blocking the exit to the gallbladder leading to inflammation or infection that requires surgical removal of the gallbladder. In more severe cases, the gallstones can pass out of the gallbladder and enter into the main duct that drains the liver, blocking the exit of that duct into the intestines. This can cause inflammation in the liver and the pancreas and symptoms like yellowing of the skin or eyes, fever, nausea or vomiting, which would lead to a more urgent medical situation and require hospitalization.

How We Treat Different Cases 

If a patient comes in and has had ongoing symptoms, the first test ordered is an ultrasound of the gallbladder, which helps us look at the gallbladder for signs of inflammation or signs that a patient does have stones or sludge that may be causing their symptoms. We may also order blood tests to make sure their liver is functioning appropriately and that there aren’t any signs the gallstones are causing more concerning problems. If those tests are all negative, sometimes we move onto what’s called a HIDA scan, which is a nuclear medicine scan where a patient is given a special dye into the IV and we watch the contrast flow from the liver down into the gallbladder and then get squeezed out of the gallbladder. We can then measure how effectively the gallbladder is squeezing.

If someone develops sudden severe symptoms, in most cases, we will surgically remove the gallbladder if it’s inflamed to the point that it causes worsening symptoms or lab abnormalities.  This is called acute cholecystitis. We usually take the gallbladder out in the first three days, if possible, because that’s when the surgery itself is the safest. Most commonly we can use minimally invasive surgery or less commonly open surgery. In most cases laparoscopic approach can allow same day or next day discharge. Open surgery will sometimes require a two or three day hospitalization. Usually 95 percent or more of patients undergo laparoscopic surgery, which only requires four incisions. The remaining five percent or less will require open surgery with a larger incision under their right ribs. In a very small number of cases, we may give the patient antibiotics first and then take the gallbladder out a few weeks later, but that’s rare. Typically, surgery is safest when it’s done soon after the onset of severe symptoms.

Most people who have their gallbladder removed won’t notice any difference in their lives other than the fact that they can return to eating the foods that may have caused symptoms like bloating, nausea and abdominal pain in the past. A very small percentage of patients will experience symptoms like diarrhea after gallbladder removal, but this is rare and usually resolves spontaneously. The majority of the time, the body will adjust and it will go back to functioning normally.

About 10 to 15 percent of Americans will have gallstones. Unfortunately, there’s not a sure-fire way to prevent gallstones. The Western diet, which is generally higher in cholesterol than the typical diet in other countries, contributes to this. There also are several risk factors for gallstones: women are more likely to develop gallstones than men; people over age 60 are more likely to have gallstones than younger people, and obesity, diabetes, high cholesterol, ethnicity, family history and blood disorders also can increase the risk of this condition.

Once you have developed symptomatic gallstones there is no medical treatment that effectively dissolves them or treats them long term other than removing the gallbladder.  

The best thing to do is pay attention to what your body is telling you. If you have ongoing symptoms, it never hurts to see a doctor and undergo tests to identify the underlying cause. And if you have severe symptoms that emerge out of nowhere, go to the ER immediately. This will enable us to identify the problem and remove the gallbladder as soon as possible if that is the cause of the symptoms.

Gallbladder Disease: Pathophysiology, Diagnosis, and Treatment

US Pharm. 2013;38(3):33-41.

ABSTRACT: Gallbladder disease, particularly cholelithiasis
(gallstones), affects more than 20 million Americans each year. Patients
often go undiagnosed because cholelithiasis often does not present with
symptoms. Symptoms range from nausea or abdominal discomfort to biliary
colic and jaundice. Gallbladder diseases are diagnosed most accurately
via imaging techniques. However, laboratory values such as CBC,
liver-function testing, and serum amylase and lipase should be included
to help distinguish the type of gallbladder disease and/or identify
associated complications. The most effective treatment for patients with
gallbladder disease is surgery. Gallbladder disease is influenced by
diet, exercise, and nutrition, and patients should be encouraged to
incorporate these healthy habits into their lifestyle in order to reduce
their risk of gallbladder disorders.

The most common form of gallbladder disease is cholelithiasis (gallstones).1 Cholelithiasis affects more than 20 million Americans annually, resulting in a direct cost of more than $6.3 billion.2
Gallstones generally are asymptomatic and typically are discovered
during a surgical procedure for an unrelated condition or during
autopsy.1,2 In the United States, cholelithiasis is the most common inpatient diagnosis among gastrointestinal and liver diseases. 3,4
Although gallstones are usually asymptomatic, some patients progress to
symptomatic disease. The primary clinical manifestation and
complication of cholelithiasis is cholecystitis (inflammation of the
gallbladder).1,2 Less commonly, patients with severe cases
may develop gallstone pancreatitis, gallbladder perforation, or other
gallbladder diseases (TABLE 1).1,5-8


Pathophysiology

Gallstones are hard, pebble-like structures that obstruct the cystic
duct. The formation of gallstones is often preceded by the presence of
biliary sludge, a viscous mixture of glycoproteins, calcium deposits,
and cholesterol crystals in the gallbladder or biliary ducts.5 In the U.S., most gallstones consist largely of bile supersaturated with cholesterol.1,2
This hypersaturation, which results from the cholesterol concentration
being greater than its solubility percentage, is caused primarily by
hypersecretion of cholesterol due to altered hepatic cholesterol
metabolism. 1,3 A distorted balance between pronucleating
(crystallization-promoting) and antinucleating
(crystallization-inhibiting) proteins in the bile also can accelerate
crystallization of cholesterol in the bile.1-3,5 Mucin, a
glycoprotein mixture secreted by biliary epithelial cells, has been
documented as a pronucleating protein. It is the decreased degradation
of mucin by lysosomal enzymes that is believed to promote the formation
of cholesterol crystals.3

Loss of gallbladder muscular-wall motility and excessive sphincteric contraction also are involved in gallstone formation.1 This hypomotility leads to prolonged bile stasis (delayed gallbladder emptying), along with decreased reservoir function.3,5
The lack of bile flow causes an accumulation of bile and an increased
predisposition for stone formation. Ineffective filling and a higher
proportion of hepatic bile diverted from the gallbladder to the small
bile duct can occur as a result of hypomotility. 1,5

Occasionally, gallstones are composed of bilirubin, a chemical that
is produced as a result of the standard breakdown of RBCs. Infection of
the biliary tract and increased enterohepatic cycling of bilirubin are
the suggested causes of bilirubin stone formation. Bilirubin stones,
often referred to as pigment stones, are seen primarily in patients with infections of the biliary tract or chronic hemolytic diseases (or damaged RBCs).1,3,6 Pigment stones are more frequent in Asia and Africa.3,6

The pathogenesis of cholecystitis most commonly involves the
impaction of gallstones in the bladder neck, Hartmann’s pouch, or the
cystic duct; gallstones are not always present in cholecystitis,
however.5 Pressure on the gallbladder increases, the organ
becomes enlarged, the walls thicken, the blood supply decreases, and an
exudate may form.2,5 Cholecystitis can be either acute or
chronic, with repeated episodes of acute inflammation potentially
leading to chronic cholecystitis. The gallbladder can become infected by
various microorganisms, including those that are gas forming. An
inflamed gallbladder can undergo necrosis and gangrene and, if left
untreated, may progress to symptomatic sepsis.1,2,5 Failure to properly treat cholecystitis may result in perforation of the gallbladder, a rare but life-threatening phenomenon.2,5,7
Cholecystitis also can lead to gallstone pancreatitis if stones
dislodge down to the sphincter of Oddi and are not cleared, thus
blocking the pancreatic duct.1

Risk Factors

Genetic and environmental factors contribute to gallbladder disease.
Female gender, previous pregnancies, and family history of gallstone
disease are highly correlated with cholelithiasis.1,3 Approximately 60% of patients with acute cholecystitis are women; however, the disease tends to be more severe in men.2 Estrogen increases cholesterol and its saturation in bile and promotes gallbladder hypomotility. 1 Diminished gallbladder motility is commonly seen during pregnancy.9

Other risk factors include a high dietary intake of fats and
carbohydrates, a sedentary lifestyle, type 2 diabetes mellitus, and
dyslipidemia (increased triglycerides and low HDL).3,9 A diet
high in fats and carbohydrates predisposes a patient to obesity, which
increases cholesterol synthesis, biliary secretion of cholesterol, and
cholesterol hypersaturation. However, a direct correlation between high
dietary intake of fats and cholelithiasis risk has not been established
because previous studies have yielded controversial results.9
Acute cholecystitis develops more frequently in symptomatic
cholelithiasis patients with type 2 diabetes mellitus than in
symptomatic patients without it.2 These patients also are more likely to have complications.

American Indians have the highest prevalence of cholelithiasis, with
the disease reaching epidemic proportions in this population. Gallstone
disease is also prevalent in Chilean and Mexican Hispanics.3,9
In addition to ethnicity, age plays a role in gallstone disease.
Patients who develop complicated symptomatic cholelithiasis tend to be
older, and the typical patient with gallstones is in her 40s.1,2

Clinical Presentation

Gallstones are generally asymptomatic. In the uncommon event that a
patient develops symptomatic cholelithiasis, presentation can range from
mild nausea or abdominal discomfort to biliary colic and jaundice.1,5,10
Biliary colic, usually sharp in nature, is postprandial epigastric or
right-quadrant pain that lasts for several minutes to several hours. The
pain often radiates to the back or the right shoulder, and in more
intense cases it may be accompanied by nausea and vomiting.
Upper-right-quadrant tenderness and palpable infiltrate in the region of
the gallbladder are revealed upon physical examination.5,10
Cholecystitis presents in the same manner; however, the obstruction of
the cystic duct is persistent (rather than transient), and fever is
common. 10 A patient with cholecystitis also may exhibit
Murphy’s sign (discomfort so severe that the patient stops inspiring
during palpation of the gallbladder) or jaundice.  Jaundice, a
yellow discoloration of the skin and the sclera of the eyes, occurs
when the common bile duct is obstructed because of an impacted stone in
Hartmann’s pouch (Mirizzi’s syndrome). Other nonspecific symptoms, such
as indigestion, intolerance to fatty or fried foods, belching, and
flatulence, may also be present.1,5,10

Diagnosis

Current techniques for diagnosing gallbladder disease are less
invasive and allow patients to recover more quickly than was the case
with earlier diagnostic procedures.10 Although the incidence of cholelithiasis is quite high in the U.S., few patients present with symptoms.4
This can complicate and prolong the diagnosis. CBC, liver-function
testing, and serum amylase and lipase should be included in the
laboratory tests to help discriminate between the various types of
gallbladder disease and/or identify complications caused by gallbladder
disease (TABLE 2). 5,10


The diagnosis of cholelithiasis, cholecystitis, and other gallbladder
diseases can be confirmed via a number of different imaging techniques.
Ultrasonography and cholescintigraphy are the imaging studies most
commonly used to diagnose cholelithiasis and cholecystitis.10
Positive findings upon ultrasonography include stones, thickening of
the gallbladder wall, pericholecystic fluid, and Murphy’s sign (i.e.,
pain) upon contact with the ultrasonographic probe.10
Ultrasonography performed in the fasting state reveals the correct
diagnosis in more than 90% of cases, but bile-duct stones may be missed
in 50% of cases.3

Cholescintigraphy, also called hepatobiliary iminodiacetic acid (HIDA) scan,
is used to assess the function of the gallbladder and to diagnose acute
cholecystitis. HIDA scans are not helpful in identifying cholelithiasis
or chronic cholecystitis.11 In ambulatory patients,
cholescintigraphy provides a correct diagnosis more than 95% of the
time. However, cholescintigraphy may produce false-positive results in
30% to 40% of hospitalized patients, particularly those receiving
parenteral nutrition. Ultrasonography is the preferred diagnostic method
in these patients.10 Cholescintigraphy results are
considered abnormal when the radioactive tracer or dye does not
visualize the gallbladder, moves slowly through the bile ducts, or is
detected outside the biliary system.12

If choledocholithiasis is suspected, endoscopic retrograde
cholangiopancreatography (ERCP) may be beneficial. ERCP is used to
identify common bile-duct stones and also may be used to remove them.
ERCP is associated with complications such as pancreatitis. Noninvasive
techniques, such as endoscopic ultrasonography, may be used to detect
cholelithiasis, but not to remove the stones.4,11 CT may be used, but it is considered less accurate than other imaging methods, as it detects approximately 75% of gallstones.4,10
Magnetic resonance cholangiopancreatography (MRCP) is an imaging method
used to detect choledocholithiasis and other abnormalities of the
biliary tract. MRCP has a sensitivity of approximately 98%.4,11

Treatment

Patients experiencing asymptomatic cholelithiasis do not require treatment.5
The treatment of choice for symptomatic cholelithiasis currently is
laparoscopic cholecystectomy, whereas previously it was open
cholecystectomy.3,10 Laparoscopic cholecystectomy is
associated with a shorter hospital stay and a faster recovery period
than open cholecystectomy is. Absolute contraindications to this
procedure include the inability to withstand general anesthesia, an
intractable bleeding disorder, and end-stage liver disease.3,5
In patients who are unable or unwilling to undergo surgery, endoscopic
decompression by internal gallbladder stent can help prevent
complications from developing and can serve as palliative long-term
treatment.5 Nonoperative therapy, which includes dissolution
of gallstones using oral bile acids and shock wave lithotripsy, may be
another option in such patients. However, nonoperative therapy is time
consuming and is associated with high cost, low effectiveness, and a
high recurrence rate.5,13

Oral bile acids used for the dissolution of gallstones include
chenodeoxycholic acid (chenodiol) and ursodeoxycholic acid (ursodiol) (TABLE 3).5,14
Oral bile acids are most effective for small gallstones (0.5-1 cm) and
may take up to 24 months to clear the stones. Ursodiol is the most
commonly used oral bile acid, secondary to its safer side-effect profile
compared with chenodiol. Chenodiol is associated with dose-dependent
diarrhea as well as with hepatotoxicity, hypercholesterolemia, and
leukopenia, all of which limit its use.14


Nutrition and lifestyle changes may be beneficial for the prevention
and treatment of cholelithiasis. Because obesity is associated with an
increased risk of cholelithiasis, weight loss may help prevent gallstone
formation.15 However, excessively rapid weight loss may
promote gallstone formation. Dietary factors that may help prevent
gallstone formation include polyunsaturated fat, monounsaturated fat,
fiber, and caffeine.15 Fish oil and moderate alcohol
consumption have been shown to lower triglycerides, lessen bile
cholesterol saturation, and increase HDL.3,9

Patients with acute cholecystitis require hospitalization for
complete bowel rest, parenteral fluids and nutrition, and IV
antibiotics.5 Surgical treatment options for cholecystitis
include percutaneous cholecystostomy, open cholecystostomy, and
laparoscopic cholecystostomy.10

Conclusion

Gallbladder diseases are most commonly secondary to cholelithiasis.
While most cases of gallstones are asymptomatic, some cases may progress
to a symptomatic disease. Factors that may increase the risk or
susceptibility to gallbladder disease include gender, ethnicity, medical
history, family history, and diet and nutrition. Gallbladder disease is
diagnosed primarily via imaging techniques. These diagnostic techniques
have their pros and cons, and, most important, their accuracy varies.
One technique may be preferred over another depending upon the type of
gallbladder disease or the presenting symptoms. Asymptomatic patients
generally do not require treatment. Surgery is the most common
treatment, but nonsurgical alternatives are available for patients who
cannot or are unwilling to undergo surgery. Pharmacists can play a role
in the treatment of gallbladder disease by educating patients about the
risk factors for gallbladder disease—particularly cholelithiasis—and
about how the risk can be reduced with proper nutrition, diet, and
exercise.

REFERENCES

1. Mills JC, Stappenbeck TS, Bunnett NW. Gastrointestinal disease. In: McPhee SJ, Hammer GD, eds. Pathophysiology of Disease: An Introduction to Clinical Medicine. 6th ed. New York, NY: McGraw-Hill Medical; 2010.

2. Strasberg SM. Acute calculous cholecystitis. N Engl J Med. 2008;358:2804-2811.

3. Marschall HU, Einarsson C. Gallstone disease. J Intern Med. 2007;261:529-542.

4. Bar-Meir S. Gallstones: prevalence, diagnosis and treatment. Isr Med Assoc J. 2001;3:111-113.

5. Kalloo AN, Kantsevoy SV. Gallstones and biliary disease. Prim Care. 2001;28:591-606.

6. Choi Y, Silverman WB. Biliary tract disorders, gallbladder
disorders and gallstone pancreatitis. American College of
Gastroenterology.
http://patients.gi.org/topics/biliary-tract-disorders-gallbladder-disorders-and-gallstone-pancreatitis.
Accessed October 27, 2012.

7. Derici H, Kara C, Bozdag AD, et al. Diagnosis and treatment of gallbladder perforation. World J Gastroenterol. 2006;12:7832-7836.

8. Myers RP, Shaffer EA, Beck PL. Gallbladder polyps: epidemiology, natural history and management. Can J Gastroenterol. 2002;16:187-194.

9. Cuevas A, Miquel JF, Reyes MS, et al. Diet as a risk factor for cholesterol gallstone disease. J Am Coll Nutr. 2004;23:187-196.

10. Vogt DP. Gallbladder disease: an update on diagnosis and treatment. Cleve Clin J Med. 2002;69:977-984.

11. University of Maryland Medical Center. Gallstones and gallbladder
disease.
www.umm.edu/patiented/articles/what_gallstones_gallbladder_disease_000010_1.htm.
Accessed November 27, 2012.

12. Mayo Clinic. HIDA scan. www.mayoclinic.com/health/hida-scan/MY00320/DSECTION=results. Accessed November 27, 2012.

13. Ahmed A, Cheung RC, Keeffe EB. Management of gallstones and their complications. Am Fam Physician. 2000;61:1673-1680.

14. Nunes D. Dissolution therapy for the treatment of gallstones. UpToDate [by subscription]. www.uptodate.com/contents/dissolution-therapy-for-the-treatment-of-gallstones. Accessed February 4, 2013.

15. Gaby AR. Nutritional approaches to prevention and treatment of gallstones. Altern Med Rev. 2009;14:258-267.

To comment on this article, contact [email protected] com.

Acute Cholecystitis – NORD (National Organization for Rare Disorders)

Acute cholecystitis has no single clinical or laboratory finding with the level of diagnostic accuracy needed for diagnosis. Instead, the recommended diagnostic technique combines clinical observations with an abdominal ultrasound. The Tokyo Guidelines require one local sign or symptom, one systemic sign, and a confirmatory image test to form a diagnosis. However, these requirements may lead to under-diagnosis in patients presenting fewer symptoms. The Murphy’s sign test is a commonly used diagnostic tool. The physician applies pressure just below the ribs on the right side and asks the patient to inhale. Inhalation will bring the gallbladder into contact with the physician’s fingers, causing pain and an arrest in inspiration if the gallbladder is inflamed. Blood tests showing elevated levels of white blood cells (leukocytosis), elevated C-reactive protein, may be signs of infection and inflammation.

Imaging techniques are used to directly observe gallstones, gallbladder wall thickness, or cystic duct obstruction. The gallbladder wall is pathologically thickened if it is >3mm or wider. The two main imaging techniques used for cholecystitis are abdominal ultrasound and hepatobiliary scintigraphy (HIDA scan). Abdominal ultrasound is often the first test due to its widespread availability, lack of invasiveness, lack of ionizing radiation, and high accuracy in detecting gallbladder stones. Ultrasound can show the presence of stones, wall thickening and pericholecystic fluid.

A hepatobiliary iminodiacetic acid (HIDA) scan tracks the production and flow of bile from the liver to the small intestine and shows blockage. This test involves the intravenous injection of HIDA, a radioactively labelled compound, secreted into bile. A specialized camera can detect the radioactivity, allowing it to trace the movement of this bile. If the gallbladder does not fill within an hour, the cystic duct is likely obstructed. Although it is the most sensitive and specific diagnostic tool, it is limited in its use because of limited availability, long testing time, and ionizing radiation exposure. It can also be inaccurate if bilirubin is elevated which is indicative of decreased ability of the liver to secrete compounds such as HIDA into bile.

Cholangiography and computed tomography (CT) may also be used to identify cholecystitis, although their diagnostic accuracy is unknown. During CT scanning, a computer and x-rays are used to create a film showing cross-sectional images of certain tissue structures. During cholangiography, a contrast dye is injected into the bloodstream, which enables x-rays to create an image of the bile ducts. Additional imaging techniques include MRI.

Diagnosis is often delayed in elderly patients, as the only symptoms may be an alteration of mental state or decreased food intake.
The 2007 Tokyo Guidelines grade the severity of the disease to help guide its treatment. Cases are graded as mild, moderate, and severe as follows:

Mild (grade 1):
• Having none of the features of moderate or severe cholecystitis

Moderate (grade 2):
● Elevated white cell count
● Palpable, tender mass in upper right quadrant
● Duration longer than 72 hours
● Local inflammation (could be biliary peritonitis, pericholecystic abscess, hepatic abscess, gangrenous cholecystitis, or emphysematous cholecystitis)

Severe (Grade 3):
● Cardiovascular dysfunction
● Neurological dysfunction
● Respiratory dysfunction
● Renal dysfunction
● Hepatic dysfunction
● Hematologic dysfunction

Acute Acalculous Cholecystitis (AAC)

Diagnosis of AAC is often much more difficult than that of typical cholecystitis because it is much less common and patients often have severe concomitant medical problems that are the reason for hospital admission. The disease is generally suspected in any critically or chronically ill patient presenting with abdominal pain, fever and unexplained leukocytosis and sepsis. Blood tests may show increases in white blood cells (leukocytosis), transaminases, alkaline phosphatase, bilirubin, and amylase. As in calculous cholecystitis, ultrasound is the primary diagnostic imaging technique for AAC. Ultrasound may show gallbladder wall thickening greater than 5 mm, pericholecystic fluid, biliary sludge, gallbladder distention, gallbladder striation, mucosal peeling, air bubbles (emphysematous cholecystitis), and gallbladder perforation. Presence of at least two of the following is generally used to diagnose AAC: positive ultrasound Murphy’s sign, gallbladder wall thickening, gallbladder distension and pericholecystic fluid, in the absence of gallstones.

CT and MRI are used when ultrasounds are inconclusive. An MRI can show gallbladder wall thickening, increased bile density, air bubbles, fluid buildup, and bleeding inside the gallbladder.

Hepatobiliary scintigraphy is the best diagnostic tool for AAC because it can detect those without the disease 100% of the time. This test shows improper gallbladder filling in both AAC and calculous cholecystitis.

Gallstones | PeaceHealth

Condition Basics

What are gallstones?

Gallstones are stones that form in the gallbladder. The gallbladder is a small sac located just under the liver. It stores bile released by the liver. Bile helps you digest fats. Gallstones can be smaller than a grain of sand or as large as a golf ball.

Gallstones form when cholesterol and other things found in bile make stones. They can also form if the gallbladder doesn’t empty as it should.

Gallstones can also form in the common bile duct or cystic duct. These tubes carry bile from the gallbladder and the liver to the small intestine.

What causes them?

Gallstones form when cholesterol and other substances found in bile make stones. They can also form if the gallbladder doesn’t empty as it should. People who are overweight or who are trying to lose weight quickly are more likely to get gallstones.

What are the symptoms?

Most people who have gallstones don’t have symptoms. If you have symptoms, you likely will have pain in your stomach or the upper right part of your belly. Pain may spread to your right upper back or shoulder blade area. When gallstones block a bile duct, you may have pain with fever and chills.

How are they diagnosed?

Your doctor will do a physical exam and ask you questions about when the pain in your belly started, where it is, and if it comes and goes or is always there. If your doctor thinks you have gallstones, he or she may order an ultrasound of the belly to confirm the diagnosis.

How are gallstones treated?

If you don’t have symptoms, you probably don’t need treatment. If your first gallstone attack causes pain, your doctor may tell you to take pain medicine and wait to see if the pain goes away. If you have more attacks, you may want to have your gallbladder removed.

How can you prevent them?

There is no sure way to prevent gallstones. But you can reduce your risk of forming gallstones that can cause symptoms.

  • Stay at a healthy weight. If you need to lose weight, do so slowly and sensibly.
  • Eat regular, balanced meals.
  • Be active, and exercise regularly.

Cause

Gallstones develop when cholesterol and other substances in the bile form crystals that become hard stones in the gallbladder. The gallbladder is a small sac located just under the liver. Gallstones can form when too much cholesterol is in the bile or when the gallbladder does not empty properly.

What Increases Your Risk

Your chances of forming gallstones that can cause symptoms are higher if you:

  • Are female. Females are twice as likely as males to have gallstones.
  • Are older than 55.
  • Are Native American or Mexican-American.
  • Have a family history of gallstones.

You may also be increasing your risk for gallstones if you:

  • Are overweight.
  • Lose weight rapidly or lose weight by dieting and then gain weight back again.
  • Are pregnant.
  • Are taking estrogen (after menopause) or high-dose birth control pills.
  • Get very little or no exercise.
  • Do not eat for a period of time (fast).

Symptoms

Most people who have gallstones don’t have symptoms. When symptoms occur, they can include:

  • Pain in the pit of your stomach or in the upper right part of your belly. It may spread to your right upper back or shoulder blade area.
  • Pain that may come and go or be steady. It may get worse when you eat.
  • Fever and chills, if a gallstone is blocking a bile duct and causing an infection.
  • Yellowing of your skin and the whites of your eyes.

Pain can last 15 minutes to 24 hours. Continuous pain for 1 to 5 hours is common. The pain may begin at night and be severe enough to wake you. Pain often starts after eating food that is high in fat. The pain usually makes it hard to get comfortable. Moving around doesn’t make the pain go away.

What Happens

The progression of gallstones depends on whether you have symptoms. Most people with gallstones have no symptoms and do not need treatment.

The most common problem caused by gallstones occurs when a gallstone blocks the cystic duct that drains the gallbladder. It often causes bouts of pain that come and go as the gallbladder contracts and expands. The bouts of pain are often severe and steady. The pain can last from 15 minutes to up to 6 hours. And the pain may get worse after a meal. Symptoms usually improve within a few days.

If the pain is severe or if you have had gallbladder pain before, you may need to have your gallbladder removed.

In rare cases, gallstones can cause pancreatitis, an inflammation of the pancreas. Gallstones back up the flow of digestive enzymes made by the pancreas. Pancreatitis may cause sudden, severe belly pain, loss of appetite, nausea and vomiting, and fever.

Learn more

When to Call

Call
911
or other emergency services immediately if you:

  • Have sudden or severe abdominal pain.
  • Have trouble breathing.
  • Faint or lose consciousness.

Call your doctor now if you have:

  • Pain that may be caused by gallstones (continuous moderate to severe pain in the upper right abdomen) along with a fever of 100.4°F (38°C) or higher and chills that are clearly not caused by stomach flu or any other reason.
  • Pain in the upper midsection or upper right abdomen, along with a yellow tint to your skin and the white part of your eyes, dark yellow-brown urine, or light-colored stools.
  • Diabetes or an impaired immune system and you have symptoms that may be caused by gallstones.

If you have symptoms of gallstones but no fever, chills, or yellowing of your skin or the white part of your eyes, you may still need to be checked and treated. Schedule an appointment with your doctor.

Watchful waiting

Watchful waiting means taking a wait-and-see approach. You and your doctor watch your symptoms or condition to see if you need treatment. It’s often the first approach to a first attack of gallstone pain.

Check your symptoms

Exams and Tests

Most people who have gallstones don’t know it because they don’t have symptoms.

If you have symptoms, your doctor will do a physical exam. He or she will ask you questions about when the pain in your belly started, where it is, and if it comes and goes or is always there. If your doctor thinks you have gallstones, your doctor may order tests to confirm the diagnosis. Tests might include:

  • An abdominal ultrasound. This is the best way to confirm gallstones. A technologist moves a wand across your belly to create pictures on a screen.
  • A gallbladder scan. Your doctor may do this if your ultrasound didn’t show gallstones. In this test, a special dye is injected into a vein in your arm.
  • An endoscopic retrograde cholangiopancreatogram (ERCP). This test checks the tubes (ducts) that drain the liver, gallbladder, and pancreas. A flexible, lighted scope (endoscope) and X-ray pictures are used.

What a gallstone looks like on an abdominal
ultrasound

Courtesy of Intermountain Medical Imaging, Boise, Idaho.

Figure 1 shows a normal gallbladder on ultrasound. Figure 2 shows a large gallstone in the gallbladder.

Learn more

Treatment Overview

If you don’t have symptoms, you probably don’t need treatment.

If you do have symptoms and your first gallstone attack causes pain, your doctor may tell you to take pain medicine and wait to see if the pain goes away. You may never have another attack. Waiting to see what happens usually won’t cause problems.

If you have a second attack, you may want to have your gallbladder removed. A second attack means you’re more likely to have future attacks. Many people have their gallbladders removed. And the body works fine without a gallbladder.

Learn more

Self-Care

  • Rest until you feel better.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • Avoid foods that cause symptoms, especially fatty foods. These can make the gallbladder tighten and cause pain.

Surgery

Surgery to remove the gallbladder (cholecystectomy) is the treatment of choice for gallstones that cause moderate to severe pain or other symptoms. Symptoms usually don’t return after the gallbladder is removed. If you have certain health problems, surgery may also be done even if you don’t have symptoms. In a small number of cases, surgery may be done to prevent other problems from gallstones.

Laparoscopic surgery is the most common way to remove the gallbladder. A doctor puts a lighted viewing tool and surgical tools into your belly through several small cuts. People who have this surgery usually recover in about 1 week.

Open surgery involves one larger cut. The gallbladder is removed through this cut. It may be done if laparoscopic surgery isn’t an option. Or it may be done when other problems are found during laparoscopic surgery. This type of surgery requires a longer recovery period. It also causes more pain.

Learn more

Watch

Credits

Current as of:
February 10, 2021

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Kathleen Romito MD – Family Medicine
Arvydas D. Vanagunas MD – Gastroenterology

Current as of: February 10, 2021

Author:
Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & Arvydas D. Vanagunas MD – Gastroenterology

Diseases of the liver and gallbladder – signs and symptoms

Malfunctions of the liver and gallbladder are studied by hepatology. Doctors-hepatologists of our clinic treat hepatitis, cirrhosis, cholecystitis, tumor neoplasms, diseases of the biliary tract and much more. The clinic performs a thorough examination to establish an accurate diagnosis, as well as to identify the causes of the disease. Further, our qualified doctors select the desired treatment method. We use the latest equipment.If you are concerned about hepatological problems, we are guaranteed to help you get rid of them.

When should I see a gastroenterologist?

Diseases of the liver, biliary tract, gallbladder are accompanied by certain symptoms. Symptoms for which you need to consult a hepatologist are as follows:

  • nausea
  • discomfort, heaviness or pain in the right hypochondrium
  • bitterness in the mouth
  • loss of appetite
  • yellowing of the skin and sclera (whites of the eyes)
  • skin itching
  • ascites (excess fluid in the abdominal cavity)
  • too dark urine
  • grayish-white stool
  • bloody vomit.

What diseases your symptoms can signal

The above symptoms can accompany various diseases of the gallbladder, liver, namely:

  • hepatitis: autoimmune, hepatitis C, viral chronic B, C, D, toxic hepatitis, non-alcoholic steatohepatitis.
  • Primary biliary cirrhosis.
  • alcoholic liver disease.
  • cirrhosis of the liver of any etiology.
  • hereditary hemochromatosis (excess iron accumulation).
  • Primary sclerosing cholangitis.
  • gallstone disease.
  • Wilson-Konovalov disease.
  • chronic cholecystitis.
  • fatty hepatosis.
  • biliary dyskinesia.

What diagnostic methods will the clinic offer you?

Sometimes an experienced hepatologist of the clinic can assume the diagnosis immediately, at first glance, since some of the symptoms of liver diseases are visible to the naked eye (typical types of jaundice, skin rash).But more often diseases of both the liver and the gallbladder proceed unnoticed for a rather long time, manifesting clinically in the later stages, and then it is already more difficult to help.

Therefore, it is so important to notice in time insignificant, but inexplicable symptoms, such as fatigue, poor appetite, discomfort in the right hypochondrium. Not only notice, but also come to our clinic on time.

Diagnosis of gallbladder and liver diseases begins with a conversation with a specialist about your symptoms.It is also important to find out what diseases you have suffered.

A physical examination will reveal a number of symptoms. You will be offered all the necessary instrumental and clinical examinations to accurately diagnose your disease.

Laboratory research methods are as follows:

  • blood biochemistry
  • general blood and urine tests
  • serological reactions
  • molecular genetic studies.

Instrumental methods of diagnostics:

These examinations are often sufficient to detect liver diseases and you can pass them in our clinic.For a more detailed examination, the doctor may refer the patient to a diagnostic center for:

  • radiation diagnostics
  • fibroelastography
  • computed tomography
  • magnetic resonance imaging
  • X-ray examination
  • liver biopsy
  • invasive colonoscopy studies
  • invasive studies

Treatment technologies

After processing all the data, three options are possible: the doctor will prescribe a special diet for you; prescribe a comprehensive drug treatment to eliminate the causative agent of the disease; or he will also prescribe additional treatment, taking into account the existence of other pathologies in you (diseases of the cardiovascular system, respiratory, urinary, etc.))

Acute diseases of the liver and gallbladder are quite curable in most cases, but chronic ones are almost impossible to cure. With chronicity in our clinic, doctors are striving for the earliest possible relief of the exacerbation, long-term remission, preservation of the maximum function of the liver (that is, compensation of liver failure), of the gallbladder.

Timely diagnostics, prompt start of treatment will reduce medical intervention, as well as the consequences of the disease to a minimum.Contacting a gastroenterologist of our clinic guarantees you qualified services in diagnostics and therapy. You will be treated according to an individual program.

Diseases of the gallbladder: symptoms, causes, treatment

Diseases of the gallbladder: symptoms, causes, treatment

By: Administrator | Tags: gallbladder disease, dyskinesia, gallstone disease, tumor, causes of gallbladder pain, ultrasound of the gallbladder, cholangitis, cholecystitis | Comments:
0 | May 20, 2021

Problems with the gallbladder are common, especially among women.Knowing what type of pain occurs with pathology, you can respond to it in a timely manner and prevent serious consequences. It is important to understand that you cannot do without medical intervention, and home methods can aggravate a person’s situation.

Causes of gallbladder pain

Only a specialist is able to establish the cause of pain, based on the results of laboratory and instrumental diagnostics, ultrasound of the gallbladder. Unpleasant sensations provoke mainly inflammatory reactions, trauma to the mucous membrane with calculi, infection or stagnation of bile.

Chronic or acute cholecystitis

The disease is provoked by inflammation of the mucous membrane. The nature of pain in cholecystitis is increasing, increasing, turning into a chronic form. Abuse of fried food and alcohol, frequent stress can cause illness.

Symptoms of cholecystitis:

  • episodic pain in the right side of the abdomen, radiating to the back;
  • weakened physical condition;
  • vomit mixed with bile;
  • increased gassing;
  • rancid taste in the mouth.

Gallstone disease

Accompanied by dull but constant pain. Intolerable painful sensations arise when the calculus moves along the bile duct. In this situation, the patient’s condition is considered critical, urgent medical attention is needed.

Gallstone disease can lead to irreversible consequences if all calculi are not removed in a timely manner. The safety of the organ is also questionable.

Signs of illness are as follows:

  • pain in the right side;
  • copious vomit;
  • after a meal there is a heaviness in the abdomen;
  • gradual weakening of the body;
  • yellowness of the skin due to a sharp jump in bilirubin in the blood;
  • impaired peristalsis.

In remission, the disease does not bother a person, but turning into a chronic or acute form is accompanied by severe pain.

Biliary dyskinesia

Dyskinesia is a functional disorder of the biliary system. A person’s motility worsens, the excretion of bile passes with severe problems. Symptoms include stabbing pain in the right side, vomiting and abnormalities in the stool.

The disease often takes on a chronic form. Taking antispasmodics relieves the condition, but does not eliminate the problem.You need to go to the hospital if you suspect dyskinesia and undergo an ultrasound of the gallbladder.

Tumor

Malignant formations that have affected the gallbladder or nearby organs put pressure on the tissues. Bile outflow is disturbed, there are strong painful sensations. Visually, the tumor cannot be detected; instrumental diagnostics will be required.

Benign hyperplasia also occurs, but over time it develops into a malignant tumor. Timely detection of a neoplasm can save a person’s life.

Cholangitis

In cholangitis, inflammation of the bile ducts is present. The disease causes severe pain in the right side, vomiting, yellowing of the skin (due to an increased level of bilirubin in the blood). The pathology is provoked by pancreatitis or similar diseases. The provoking cause is the ingress of pathogens into the ducts that cause inflammation.

Symptoms in women

Women are more likely to suffer from lesions of the gallbladder than men.A similar trend can be traced due to disruptions in the hormonal background, provoked by childbirth, contraceptives, antibiotics, weight change and various diets. All these factors together form an environment favorable for the onset of pain in the gallbladder.

Painful sensations can be the result of improper nutrition. The gallbladder contracts during the consumption of fatty or fried foods. It is not recommended to completely abandon such dishes, otherwise the bile will thicken and this will lead to the formation of stones.

The main symptoms of pain in the gallbladder in women are as follows:

  • vomiting that occurs before or after eating fatty foods;
  • pain in the right side, episodic flatulence;
  • dull and bursting pain in the right hypochondrium, radiating to the back;
  • loss of appetite;
  • increase in bilirubin in the blood;
  • stool problems.

If the above symptoms were noticed, you should immediately consult a specialist and undergo an ultrasound of the bladder.

Symptoms in men

Symptoms for pain in the gallbladder in men are completely similar to those that appear in women. But provoking factors differ.

Excessive alcohol abuse negatively affects the state of the gallbladder. Smoking can also make things worse. A sharp transition from fatty and fried foods to a light menu will certainly cause stress in the body, which will worsen the condition of the biliary organ.

In the presence of these signs, it is required to consult a doctor to prevent unwanted consequences.

90,000 Cholelithiasis: signs, symptoms, treatment

Signs of pathology

A person does not even know about the development of gallstone disease: at the first stages, the pathology does not manifest itself in any way. The onset of pronounced symptoms occurs during a period of active progression. A characteristic symptom is a sudden, pronounced pain under the right rib. Sometimes the pain syndrome responds in the region of the heart, under the right shoulder blade or shoulder.

Most often, painful sensations occur after eating spicy, fatty, spicy foods and alcohol.The mentioned symptom also appears after stress or heavy physical exertion.

Other symptoms accompanying gallstone disease:

  • bitterness in the mouth, especially in the morning;
  • nausea and vomiting, not relieving;
  • belching;
  • flatulence;
  • stool violation.

The general condition of the body is sluggish, irritability and increased fatigue are observed. An additional symptom of the disease is an increase in body temperature and a feverish state.In some cases, there is a yellowish tinge of the skin (icteric) and a feeling of heaviness in the abdomen after eating.

Causes of development and prevention

Medicine identifies several reasons for the development of gallstone disease. One of the most common is eating disorders. An unbalanced diet, a passion for fast food and foods with an excess of cholesterol become a common cause of the disease. However, with the rejection of fatty foods or a sharp transition to a diet, bile becomes unclaimed, which causes changes in its structure and gradual crystallization.Because of this, the metabolism is disturbed – cholesterol and fat.

Among other causes of the development of the disease, there are:

  • Anatomical structural anomalies;
  • heredity;
  • inflammatory processes of the gallbladder;
  • organ infections;
  • stagnation of bile.

Stagnation of bile and, as a consequence, cholelithiasis, occur against the background of other factors. Our specialists often find adhesions, tumors, kinks of the bladder, scar formations.

Classification of stones, stages of the disease

Stones collected in the gallbladder have different chemical composition, which helps to distinguish two groups:

  1. Cholesterol – appear when cholesterol absorption is impaired. The substance begins to accumulate in the liver, gradually forming stones.
  2. Bilirubin – are formed when there is an excess of hemoglobin in the body. They are inferior in size to the first group, but outnumber them.

There is also a classification by size: large (over 3 cm) cause health problems, provoking acute pain.Small ones (less than 3 cm) do not cause discomfort and do not manifest themselves in any way.

There are several stages of cholelithiasis:

  1. Pre-stone – the first stage, during which there is a change in the composition of bile. The main symptoms are absent, the person does not feel discomfort and does not know about the developing disease. The problem is revealed, as a rule, by chance – with a biochemical study of bile.
  2. Latent – active stone formation begins at this stage.A special study helps to identify the problem. This degree is also characterized by no discomfort or mild symptoms.
  3. Active stage – ailments are manifested in full, accompanied by acute pain.

Diagnostics and treatment

If you suspect the onset of cholelithiasis, you need to urgently make an appointment with a specialist. First of all, a visual examination and questioning of the patient about disturbing symptoms is carried out. Diagnostic measures include a general and biochemical blood test, ultrasound of the abdominal cavity.A thorough examination may require MRI and other instrumental studies.

Depending on the type of stones, the method of treatment is selected. Stones that can be “dissolved” are treated with special medications or shock wave therapy.

There are a number of restrictions for the treatment of a disease with medicines, which must be taken into account when choosing a method of exposure. Under the influence of drugs, stones are destroyed and removed from the body. Herbal medicine can be an additional method of treatment.But it should be carried out according to the prescription and supervision of a specialist.

Very often, cholelithiasis is diagnosed quite late, when the drug effect is no longer effective. In this case, they resort to surgical treatment, which involves the removal of stones and the gallbladder.

Diet plays an important role in the treatment regimen. Throughout the course of treatment of the disease, food should be taken in small portions 5-6 times a day. It is necessary to exclude from the diet “harmful” types of foods, alcohol, chocolate and sugary carbonated drinks.Allowed for gallbladder disease:

  • fermented milk products;
  • bran and other types of fiber;
  • vegetable fats;
  • low-fat fish varieties;
  • liquid porridge;
  • weak broths.

In case of bile duct disease, it is recommended to observe the drinking regime. Preferred options are green tea and purified water.

Prevention after treatment

Diseases of the gallstone bladder are not completely removed by medicines.Therefore, dietary recommendations must be followed strictly. In case of exacerbation, make an appointment as soon as possible, do not self-medicate.

After medical and surgical treatment of the disease, it is necessary to engage in prophylaxis. Such measures can help reduce the risk of developing health problems in middle age.

A balanced diet, moderate physical activity, and rejection of bad habits will help to eliminate stagnation of bile in the ducts. Regular examination in one of the MEDKOM centers will be important.Our experts monitor the health status of people with a tendency to obesity and genetic predisposition.

90,000 diagnostics and treatment of cholecystitis in St. Petersburg, price

Chronic cholecystitis is a disease characterized by inflammation of the gallbladder wall. Women suffer from this disease 3-4 times more often than men, it is most often found in overweight people, however, in persons with asthenic physique it is not an exceptional case.

Cholecystitis can be caused by bacteria (E. coli, streptococcus, staphylococcus, etc.), helminths, lamblia, fungi; there are cholecystitis of a toxic and allergic nature. The microbial flora enters the gallbladder by the ascending (from the intestines), hematogenous (through the blood) or lymphogenous (through the lymph) pathway.

It predisposes to the development of cholecystitis stagnation of bile in the gallbladder, which can lead to gallstones, compression and kinks of the bile ducts, dyskinesia of the gallbladder and biliary tract (i.e.i.e. violation of their tone and motor function under the influence of stress, endocrine and autonomic disorders, reflexes from pathologically altered organs of the digestive system), prolapse of the viscera, pregnancy, a sedentary lifestyle, rare meals, throwing into the biliary tract with their dyskinesia of pancreatic juice from it a damaging effect on the mucous membrane of the bile ducts and gallbladder.

Overeating, especially the consumption of fatty and spicy foods, the intake of alcoholic beverages, an acute inflammatory process in another organ (tonsillitis, pneumonia, adnexitis, etc.), is often an immediate impetus to an outbreak of the inflammatory process in the gallbladder.etc.). Chronic cholecystitis can occur after acute, but more often develops independently and gradually, against the background of cholelithiasis, gastritis with secretory insufficiency, chronic pancreatitis and other diseases of the digestive system, obesity.

Chronic cholecystitis symptoms

For chronic cholecystitis, a dull, aching (sometimes sharp) pain in the right hypochondrium of a constant nature or arising 1-3 hours after an abundant meal, especially fatty and fried, is typical.The pain radiates upward to the area of ​​the right shoulder and neck, right shoulder blade. Dyspeptic symptoms are frequent: a feeling of bitterness and a metallic taste in the mouth, belching with air, nausea, flatulence, impaired bowel movements (constipation and diarrhea may alternate), as well as irritability, insomnia. Jaundice is uncommon.

Signs of chronic cholecystitis are determined by ultrasound. The course in most cases is long, with alternating periods of remission and exacerbations; the latter often result from malnutrition, alcohol intake, hard physical work, acute intestinal infections, hypothermia.The prognosis is favorable in most cases. However, inflammation often contributes to the formation of gallstones.

Diagnostics of the chronic cholecystitis

The diagnosis of chronic cholecystitis begins with the identification of the main complaints and external signs of the disease, prompting the doctor for a further diagnostic algorithm. To clarify the diagnosis of chronic cholecystitis, the following diagnostic methods are used:

  • Ultrasound of the abdominal organs, in particular of the gallbladder can detect the presence of stones or signs of inflammation in the gallbladder.
  • Cholegraphy – X-ray examination method that allows you to identify signs of inflammation of the gallbladder. Cholegraphy is not performed during an exacerbation of the disease, as well as during pregnancy (in these cases, ultrasound is preferred).
  • General and biochemical blood test – allows you to identify signs of inflammation and other signs characteristic of liver and gallbladder diseases
  • Analysis of feces for parasites (roundworm, lamblia) – is required for all patients with cholecystitis.

Treatment of chronic cholecystitis

With exacerbations of chronic cholecystitis, hospitalization in a surgical or therapeutic hospital is necessary; therapy is the same as for acute cholecystitis. In mild cases, outpatient treatment is possible: bed rest, dietary food – restriction of fatty foods and their calorie content (diet No. 5a), food intake 4–6 times a day. In the phase of exacerbation of the process, antibiotics of a wide spectrum of action are used, which accumulate in the bile in a sufficiently high concentration, in usual therapeutic doses for 7-10 days.With giardiasis, antiparasitic drugs are effective. To eliminate biliary dyskinesia and spastic pain, symptomatic treatment is prescribed with one of the antispasmodic drugs (no-shpa, motilium, etc.). Violation of the outflow of bile in patients with chronic cholecystitis is corrected by choleretic agents (synthetic and plant origin), which stimulate the formation and secretion of bile by the liver, as well as enhance the muscular contraction of the gallbladder and the flow of bile into the duodenum.It is advisable to use enzyme preparations containing bile acids.

In patients with non-calculous cholecystitis, therapeutic duodenal intubation is effective. To normalize the bile-forming function of the liver, reduce the viscosity of bile, eliminate its stagnation, prevent the formation of stones, improve blood circulation, achieve an anti-inflammatory, antispasmodic and analgesic effect, physiotherapy is used (electrophoresis on the liver area with novocaine, magnesium, papaverine, no-spa; UHF on the liver area ; ultrasound; electrical stimulation of the gallbladder).Many mineral waters (“Moskovskaya”, “Smirnovskaya”, “Slavyanovskaya”, “Dzhemruk”, “Arzni”, “Borzhomi”, “Essentuki”, “Naftusya”), general baths (sodium chloride, carbonic) have a beneficial effect.
One of the most effective remedies is mud therapy. It has a positive effect on the functional state of the gallbladder, liver, pancreas, improves the immunological reactivity of the body, stimulates the glucocorticoid function of the adrenal glands, has an analgesic, anti-inflammatory, desensitizing effect.Remedial gymnastics using a special technique is advisable. With the failure of conservative therapy and frequent exacerbations, surgical treatment is indicated.

Removal of gallstone (cholecystectomy)

When there are obvious symptoms of gallstones, treatment is necessary, which consists in removing the gallbladder (cholecystectomy) or stones that cause obstruction of the biliary tract. Nowadays, more and more often, cholecystectomy is performed without opening the anterior abdominal wall, using the endoscopic method.If the symptoms are not very pronounced and the stones are small, then you can try to dissolve them with certain medications. An endoscope, a fiberglass optical instrument, is inserted into the abdominal cavity through a small incision in the anterior abdominal wall near the navel. The gallbladder is isolated, freed from its connections and adhesions with other tissues and removed through a small additional opening.

Gallstones can be removed through the common bile duct using a flexible endoscope.The device is inserted through the mouth into the esophagus, then through the stomach into the duodenum. A thin instrument is inserted through the tube of the device, which is passed into the common bile duct. The location of the stone is determined using radiography. If the stone turns out to be too large, then it is crushed and removed in parts.

Need to see a doctor

  • In the presence of pain in the right hypochondrium (abdominal pain). In chronic cholecystitis, the pain is dull, aching, lasting from several hours and days to several weeks.A characteristic feature of pain in chronic cholecystitis is their occurrence or intensification after taking fatty or fried foods. In chronic cholecystitis, pain from the right hypochondrium extends upward to the right shoulder and neck. Often, against the background of dull aching pain, the patient notes short bouts of acute cutting pain characteristic of an exacerbation of chronic cholecystitis.
  • With vomiting, which is a less permanent symptom of chronic cholecystitis and, like pain, occurs mainly after the patient’s violation of the dietary regimen.In addition to vomiting, patients with chronic cholecystitis may notice prolonged nausea, a bitter or metallic taste in the mouth, and a deterioration in appetite.
  • If you are concerned about bloating, constipation and diarrhea – these are quite frequent symptoms of chronic cholecystitis, indicating a gradual deterioration in its function and upset digestion. Bloating, diarrhea, or constipation are rarely caused by chronic cholecystitis alone. As a rule, in patients with more or less long “experience” of this disease, there is a parallel disorder of the function of the stomach and pancreas (gastritis and pancreatitis), which also affects the quality of digestion.
  • In patients with advanced cholecystitis, severe weakness, a predisposition to frequent colds, decreased performance, irritability can be observed.

Gallstone disease: symptoms, diagnosis and treatment

Gallstone disease is also known as cholelithiasis in professional circles. In general, this is a disease that is directly related to human metabolic disorders. The classic sign of gallstone disease is stones that form in a person’s gallbladder or in the ducts that drain bile from the body.If a malfunction is detected in the human body and the metabolism is significantly disturbed, then this can lead to the fact that the composition of bile also changes. If a failure occurs, then over time, bile begins to thicken, and the acid precipitates. After this transformation, the liquid hardens and stones are formed. The stones not only prevent the body from functioning calmly, but also contain cholesterol and harmful salts.

People who suffer from gallstone disease and know what it is, note that the number of stones can be different, just like their size.In some, doctors find hundreds of stones very small like sand, and in others only a few, but the size of a large walnut. Quite often, stones are located in the gallbladder, causing a number of other chronic diseases. There are times when specialists in the clinic find stones in the bile ducts of the liver.

Classic gallstone disease is a disease that can and should be treated under the supervision of a physician. If you immediately pay attention to some signs and react in time, then soon you can forget about the problem forever.Often, in a person suffering from this disease, the gallbladder becomes inflamed and the flow of bile into the stomach is disrupted. There are also severe cases when the patient ignored all the signs or was self-medicating at home. In such cases, the stone can block the outflow of bile completely and cause the development of obstructive jaundice.

It is important to note that both gallstone disease and obstructive jaundice cannot be joked, because the latter is a disease that can lead to death.Generally ignoring the disease can lead to a number of other serious complications, such as, for example, peritonitis, toxic shock, body imbalance and death. Often women suffer more from this disease. Even pregnancy can become the cause of its development. But there are a number of other factors, such as diet, lifestyle, habitat, genetics, chronic diseases, which can cause gallstone disease to develop. In general, everyone can get sick with this disease, regardless of age or gender, so it is important to pay attention to the symptoms that appear.

The most common occurrence of the disease occurs in people who are overweight or, on the contrary, who have dramatically lost weight, as well as in women who are over 60 years old. Diabetes mellitus can also cause complications in the form of gallstone disease, so one disease can cause the development of another. If the disease is not cured and gallstone disease continues to progress, then gallbladder cancer may well develop.

Symptoms and signs

According to experienced specialists and doctors, often at the stage of their manifestation, stones that are in the gallbladder do not cause absolutely any symptoms of gallstone disease.The main symptom appears only when the stone begins to gradually get out of the bubble. The stone leaves through the bile ducts, which are in the body of every person. The ducts themselves are rather small and narrow. Due to the ingress of a stone into one of the ducts, such a main symptom as a sharp pain appears due to the fact that the stone or all of them get stuck in the duct.

The main symptoms of gallstone disease:

  • sharp pain in the abdomen. Most of the pain is felt in the upper right side near the hypochondrium;
  • a symptom such as pain in the back or right shoulder blade.The disease itself can also spread to discomfort in the shoulders;
  • nausea and vomiting are frequent, but such symptoms are justified only if bile is noticed along with the exiting mass.

There are several stages at which gallstone disease can develop, each of the stages has its own gallstone disease symptoms and cause. For example, if the patient is only at an early stage and thinks to fight the disease, then a doctor is needed.As mentioned earlier, at first, the disease does not in any way declare itself and the course of gallstone disease may be without symptoms. Sometimes it also happens that the disease develops on its own and even at further stages does not make itself felt. Then it can come to cancer and death.

If the pain with gallstone disease has not been experienced, then the disease can be detected only by accidentally contacting a doctor. Then the X-ray examination will help to identify the stone bearing, which did not show any symptoms.But most often, after some time, the patient still feels some signs of cholelithiasis. In addition to the aforementioned nausea, vomiting and pain in the rib area, there may be a persistent bitterness in the mouth or even a feeling that something is moving under the skin.

When the stones begin to actively move through the channels and the manifestation of cholelithiasis occurs, then one of the symptoms of cholelithiasis, which will help determine the cholelithiasis, becomes colic. During colic, the patient goes to the doctor with a complaint of pain from the rib to the shoulder blades.Basically, the pain manifests itself after eating, so it can appear at any time, and the head can still hurt. Accompanied by a feeling of pain again, nausea or vomiting.

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Diagnostics

In order to accurately identify the symptoms of the disease and determine the further treatment of the disease, the doctor sends the patient for tests and consultation with a specialist.The first thing that helps to accurately diagnose is a physical examination. With its help, the doctor can accurately identify some of the signs that confirm the presence of the disease. Only technology can confirm the presence in the human body of Murphy, Zakharyin – clear signs of problems with the gallbladder. Professional diagnostics by a doctor in Moscow allows you to determine the level of soreness of the skin and the degree of muscle tension in a person, this is very important if the area of ​​the gallbladder is being examined.

In the real presence of the disease, a specialist can notice yellowness on the skin of the xanthem, and this is a clear sign of gallstone disease.A general blood test can reveal problems and the presence of stones in the body. If the patient has a clinical exacerbation at the moment, then the blood will quickly indicate all the problems and inflammations, but only a professional can deal with them. It is impossible to make an accurate diagnosis only based on the results of blood diagnostics. But he will indicate the presence of leukocytosis in the blood, bile and other aspects that only a specialist understands.

The maximum amount of information during diagnostics is provided by ultrasound of the abdominal cavity.With the help of ultrasound radiation, the gallbladder is examined, and the doctor can determine if there are echo-tight formations in the patient’s body. This complex name means the already known stones that are deformed on the walls of the bladder and change its motility. In addition, if the patient has already had heart problems while checking for other diseases, then an ultrasound scan will help to find out the cholesterol level.

During gallstone disease, the patient must constantly pass tests, since their results can affect the entire treatment.If you refuse procedures or come unprepared for tests, this can affect all diagnostic results. The fact is that, as mentioned earlier, gallstone disease develops gradually and manifests itself at different stages or does not manifest itself at all, so a blood test, urine test can help.

Such a diagnosis of gallstone disease as MRI is also considered successful, but this is a kind of analysis that the doctor recommends only one or several times, as this can adversely affect the body.CT of the biliary tract is also actively used in a specialized clinic, but only by the decision of a specialist, which was transferred to the doctor. Such an analysis carries quite a lot of information, since it reveals whether there are any irregularities in the work and circulation of bile using special methods and approaches.

Without diagnostic studies and specialized analysis, the patient may have some complications of the disease, which at first are not detected by general tests.Most often, due to gallstone disease, as a result, if you do not apply specialized treatment, inflammation of the gallbladder can begin. The lumen of the biliary tract in the body of a sick person can become clogged and this in turn causes pancreatitis.

It is best to undergo a diagnostic examination in one of the professional clinics in a timely manner, take tests, adhere to the doctor’s advice. One analysis of gallstone disease from all that a medical institution offers can help a specialist choose the right direction in treatment.Then it will be faster, easier and even cheaper to get rid of the disease, since the prices for treatment depend on the level of the neglected case.

Reasons

If the diagnosis of gallstone disease reveals certain symptoms of the disease, then it is quite logical that there are reasons due to which the disease begins to progress. If the quantitative ratio of the constituents of bile is violated, then the creation of flakes in the human body automatically begins.These peculiar hard flakes, as the results of the analysis show, turn into stones along with the development of the disease. Most often this happens due to the fact that a person suffers from impaired cholesterol metabolism. If there is too much cholesterol, then because of this reason, bile changes and stones appear in it.

A person suffers from excess cholesterol for the following reasons:

  • the body suffers from obesity due to improper nutrition, the reason for everything is the huge consumption of foods that contain a large dose of cholesterol;
  • the amount of bile acid decreased, due to which the body ceased to function normally, and bile does not receive the elements it needs;
  • in human blood, the volume of phospholipids decreased, which led to the fact that cholesterol cannot harden and settle in the body;
  • bile began to stagnate and the whole reason is the improper circulation of fluid throughout the human body.

It is important to note that bile can stagnate both mechanically and functionally, therefore, when prescribing treatment, the doctor pays attention to this. If we are talking about the fact that bile in the human body has stagnated for mechanical reasons, then an additional tumor may occur, sometimes lymph nodes are enlarged. Patients often complain of scarring, constant swelling and other discomfort, which becomes another cause for anxiety.

As for the functional stagnation of bile, the problem here lies in the fact that the motility of the gallbladder is upset, and the bile ducts are clogged.Human genetics can also play a role here. If a woman or a man has a predisposition to cholelithiasis. It is important to note that poor diet, a sedentary lifestyle, drastic weight loss or weight gain can affect the development of the disease.

Treatment

Nowadays, effective treatment of gallstone disease is more than realistic if you use the services of a professional clinic that offers innovative treatment methods.Many books and scientific articles are written about how to treat a disease, but there are general rules that should be relied on. If the patient to begin with just needs to identify the presence of stones in the gallbladder and at the same time he does not have any complications, then specific treatment is not required. In this case, such a method of treating gallstone disease as waiting is used. This is a special tactic, during which the doctor monitors a change in the human body and tries to cure it with medication.

If gallstone foreign bodies were noticed by a specialist during the examination or acute cholecystitis was diagnosed, then a method such as surgical removal of the gallbladder is used.This is already a more complex approach in the treatment of gallstone disease, because it requires urgent surgical intervention. The fact is that it is the gallbladder that becomes the catalyst for the development and formation of stones. There are several types of surgical intervention, one of which is determined by a specialist after a thorough examination of the body. To do this, you need to get tested, since improperly selected treatments can lead to cancer.

In the clinic, only the most effective and modern principles of treatment are used.The use of such a method of treatment as lithotripsy is considered to be progressive. Its main qualities are characterized by the fact that this method is used if there is one calculus. It is important to note that, in principle, there are a lot of treatment methods that can be used to treat gallstone disease.

It is impossible to test absolutely every approach, because the treatment and the gallstone process must follow the same plan. Through trial and possibly error, the attending physician will determine the best treatment conditions that the clinic can offer.Of course, first of all, they try to eliminate the disease with medication and with the help of physical therapy, but sometimes this leads to the emergence of new stones. In this case, it is best to resort to surgery and further postoperative recovery.

Physicians treating this disease

If we consider the question of which doctor treats gallstone disease, then it is impossible to name only one specialist. The fact is that this disease is treated by both a gastroenterologist and a surgeon.In addition, the therapist must follow the success of the treatment. In general, the gastroenterologist deals not only with the treatment of gallstone disease, he also specializes in other problems that may arise with the organs of the digestive system.

If we generally talk about the doctors of the treating clinics, then it is best to study the list of proposed specialists, since in the medical center each patient receives individual service. Initially, you can try to decide on the attending physician yourself, having studied the specifics of each activity.The modern clinic offers a wide range of specialists, which is constantly increasing.

So, already at the first appointment with the doctor, you can determine the symptoms, hear the indications, choose the appropriate diagnostic methods and discuss the prices for treatment. Further, if the patient is satisfied with everything, the specialist begins to carry out an operative technique or prescribes an ultrasound scan, after which an active fight against the disease is conducted. If it is impossible to cure the disease with medication, then the surgeon intervenes in the treatment and promptly removes the gallbladder.This is a teamwork of doctors, during which each patient will receive due attention and an individual approach.

Indication

In the presence of gallstone disease, experts recommend several indications that will help alleviate the disease, or they can be used as a prophylaxis.

Tips and Preventive Measures:

  • it is recommended to consume less foods that contain a high dose of cholesterol, because it is because of it that stones begin to form actively;
  • it is best to monitor the level of bilirubinemia, because this also plays an important role in the prevention or treatment of the disease;
  • bile should never stagnate in the human body;
  • in order to maintain health and not suffer from this disease, you need to monitor body weight and eat a balanced diet;
  • with gallstone disease, there should be no sudden weight loss or weight gain;
  • it is recommended to lead a healthy and active lifestyle, exercise, so that in the future there is no metabolic disorder;
  • one of the main indications is that it is worth paying attention to all the symptoms and solving the problem in a timely manner;
  • a person with a genetic predisposition to gallstone disease should periodically visit a doctor.

Contraindications

There are several contraindications that should never be forgotten to a person suffering from gallstone disease. The first thing that every doctor focuses on is constant observation. The disease should not run on its own. If it has already been identified by suitable symptoms or professional diagnosis, it is imperative to consult a therapist or gastroenterologist in order not to allow the disease to go to another stage.Surgery is not always necessary to treat gallstone disease, so it is experienced professional supervision that can help avoid this.

It is impossible not to visit an ultrasound scan every six months, since it is such an assessment of organs and possible stones that can help to find out whether a person has a bedsore or not. It is not recommended to constantly change the doctor, so it is better to immediately choose a specialist with whom it will be comfortable to cooperate. If a gallstone disease is detected in a patient, then he is strictly prohibited from engaging in serious physical activity.With such a disease, you cannot work in the garden, because because of this, everything can only worsen and this will interfere with treatment.

It is important to remember that the patient is strictly prohibited from cholesterol, because of this, one should not exchange the diet for improper nutrition. It is best not to be active during diagnosis and treatment. In addition, after the operation, the patient definitely needs a long recovery.

The cost of initial admission, research, treatment

As for the treatment in the clinic, it is impossible to name a definite and exact cost of treatment for each patient who wishes to apply for services.Everyone seeks individual help with their own stage of the disease, so the price may differ. It is most correct to pay attention to the table, which indicates the entire cost of treatment from any of the doctors. Already at the first appointment or having decided on the diagnosis, research, it will be possible to understand how much the treatment will cost.

Benefits of treatment in the clinic of JSC “Medicine”

JSC “Medicine” (Clinic of Academician Roitberg) is a professional private medical institution that provides medical care in various areas of diseases at a high level.The clinic employs experienced professionals, and the institution itself is equipped with innovative devices for the treatment of various diseases. In our clinic, each patient will receive due attention, treatment and care. In addition, each patient will have their own personal doctor.

Diseases of the gallbladder, postcholecystectomy syndrome

Biliary dyskinesia – a disease in which the flow of bile into the duodenum is impaired due to impaired motor activity of the biliary tract.

There are two types of this pathology: hypertensive, in which the tone of the sphincters of the biliary tract is increased, and hypotonic, in which the tone and motor activity of the biliary tract is reduced.

The main symptom of the disease is pain in the right hypochondrium, in the epigastrium. With hypertensive type of biliary dyskinesia, pain is usually paroxysmal, acute, but short-term. More often they are associated with emotional or physical stress, the intake of fatty foods.With the hypotonic type – dull pain, aching, with a feeling of fullness in the right hypochondrium. Loss of appetite, bitterness in the mouth, nausea, bloating, belching, and stool disorder may also be troubling.

Diagnostics :
– Complete blood count
– Biochemical blood test
– Ultrasound of the abdominal organs
– Ultrasound with test breakfast
– Duodenal intubation
– ERCP
– Endo ultrasound

Late treatment of biliary dyskinesia leads to the appearance of biliary sludge – (heterogeneity of bile, the formation of sediment, flakes).Biliary sludge, in turn, can lead to gallstone disease.

Chronic non-calculous (acalculous) cholecystitis is a disease characterized by chronic inflammation of the gallbladder and may be accompanied by disorders of its biliary function.

Clinic:
– pain localized in the right hypochondrium, less often in the epigastric region. The pain is more often aching in nature, lasts for many hours, days, sometimes weeks.Pain radiates, as a rule, to the right lumbar region, right shoulder blade, right shoulder. Characterized by the onset or intensification of pain after taking fatty and fried foods, eggs, cold and carbonated drinks, wine, beer, spicy snacks.
– Nausea, belching of air, bitterness, or a persistent bitter taste in the mouth are often noted.
– sometimes an exacerbation of the disease is accompanied by a rise in body temperature to subfebrile numbers

Diagnostics:
– general blood test
– b / x blood test
– ultrasound of the abdominal organs
– duodenal intubation
– endo ultrasound

Postcholecystectomy syndrome occurs in some patients after removal of the gallbladder (cholecystectomy).
Pathological conditions that are observed in patients after cholecystectomy can be divided into 2 groups.
• Functional disorders of the sphincter of Oddi
• The presence of organic obstacles to the flow of bile

Clinical manifestations: recurrent colicky pains, mainly in the right upper quadrant of the abdomen; fat intolerance; diarrhea; nausea; bloating and other dyspeptic symptoms; jaundice; increased body temperature

Diagnostics:
– general blood test
– b / x blood test
– ultrasound of the abdominal cavity
– X-ray of the abdominal cavity
– CT of the abdominal cavity
– EGDS
– ERCP
– Endo-ultrasound

For the treatment of diseases of the hepato-biliary system, drug therapy and an individually selected diet are used.

90,000 Gallstone disease. Cholecystitis | Center for Endosurgical Technologies

Cholelithiasis (GSD) is a disease accompanied by the formation of stones in the gallbladder.

Cholecystitis – inflammation of the gallbladder wall.

CLD suffers from every fifth woman and every tenth man. More than 1,000,000 surgeries are performed in the world annually.

Causes of ZhKB

occurrence of gallstone disease is not fully understood.There are a number of factors contributing to the appearance of stones in the gallbladder: malnutrition, a sharp change in diet, obesity, hereditary predisposition, helminths, lamblia, and others.

The mechanism for the formation of stones consists of three links. First, an increase in cholesterol in bile – the bile becomes thick. Second, the concentration and crystallization of bile – fine sand is formed. Third, a violation of the contractile function of the gallbladder wall – it can no longer cope with the excretion of bile.As a result of these three factors, stones appear, over time more and more salts settle on them, stones grow.

Up to 60-80% of carriers of gallstones have no complaints. Gallstone disease can manifest itself as pain (or heaviness, discomfort in the right hypochondrium, pain can be given under the scapula) or functional disorders of the gastrointestinal tract (disorders, heartburn, bitterness in the mouth). Also, gallstones can lead to hepatic (biliary) colic. An attack of severe pain occurs, often the attack is accompanied by vomiting.

ZhKB diagnostics

is based on characteristic complaints. The main method of instrumental diagnostics of gallstones is ultrasound. The sensitivity and specificity is 95%.

Drug therapy (dissolution) of stones has not been justified. Stones can dissolve in only 20% of patients. Moreover, in 80% of them they are formed anew within a year.

The fact is that if there are stones, then the gallbladder is already insolvent, sick.The contractile function of the gallbladder wall is impaired, the gallbladder cannot perform its function. Gallstones is a disease of the gallbladder, stones are only one of the links in the disease. Dissolving the stones cannot cure the disease.

In the world with gallstone disease, the “gold” standard is the operation – laparoscopic cholecystectomy (LCE, removal of the gallbladder).

Why do the operation:

  1. The operation completely cures the disease. In 80-90% of patients after the operation, all complaints disappear, there is no need to comply.In 10-20%, when the disease has already passed to the biliary tract and the pancreas, after the operation there is a significant improvement in the condition, but there is still a need to observe and take enzymes.
  2. ZhKB tends to progress. The asymptomatic form becomes painful. The attacks become more frequent and more severe. At the same time, concomitant diseases (primarily cardiovascular diseases) often progress with age, which means that the earlier the operation is performed, the easier it will be tolerated by the body.
  3. With gallstones, it has a significant likelihood of severe complications. Obstructive jaundice: small stones can slip into the common bile duct and block the outflow of bile, bile pigments begin to be absorbed into the blood. Acute cholecystitis is an acute inflammation of the gallbladder. Epmema is a purulent inflammation. Bedsore – a hole is formed from the stones in the wall of the bladder, bile enters the abdominal cavity, and peritonitis occurs. All these are serious conditions that can be life-threatening, and an emergency, most often open, operation may be required.
  4. We have been performing

LHE since 1999. During this time, more than 1,500 thousand operations were performed.

In our clinic, the technology of the operation is so well developed that we perform LCE even after previous open operations, the presence of adhesions, we perform LCE for acute cholecystitis and other severe forms of cholecystitis. For 15 years, we have never needed to switch to open surgery. If necessary, in adulthood (over 65 years) and the presence of cardiovascular diseases, the patient is examined, in most cases the operation is feasible (we had patients at the age of 89).

For 15 years, we have not had severe complications associated with the LCE. The percentage of minor complications (inflammation of the postoperative sutures, can be cured by dressings) is minimal, which corresponds to global practice. The operation is very well tolerated by the body. After our operations, the patient is in the hospital for 1 day (on average). Most patients are discharged the next day. Pain is minimal.

We perform the operation by laparoscopic (endovideosurgical) access.

There is no large incision with this technique. 4 punctures of the anterior abdominal wall are performed (5 and 10 mm each). Inert gas is pumped inside, a video camera and tools are introduced. The operation is performed from the inside. The gallbladder is removed along with the stones and removed through one of the incisions. It should be understood that the gallbladder is functionally unstable and is only a source of pain and infection. In the future, bile from the liver directly enters the intestines and promotes the digestion of food.

After the operation, you must follow a diet for a month.After a month, the restrictions are lifted. Most of the patients (80-90%) do not need a diet after a month.

To book a consultation: e-mail: [email protected], tel .: +7 (391) 297-52-52

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