Diagnostic Tests for Gallbladder Disease

The gallbladder — a sac located near the liver that serves as a storage space for bile — can be stricken with various problems, such as gallbladder cancer or inflammation (called cholecystitis).

Gallstones are also a common gallbladder problem, and infection can occur if the gallbladder remains blocked by a gallstone or continues to be inflamed.

Gallbladder disease is the term used to describe many of these maladies that can plague the gallbladder. But in many forms of gallbladder disease, a person may have no symptoms — up to 90 percent of people with gallstones, for example, don’t have any symptoms at all. So how can gallbladder disease be diagnosed?

Gallbladder Disease: When Diagnostic Tests Are Needed

Your doctor isn’t going to test you for something that you’re not complaining about, so generally, the only time diagnostic tests for gallbladder problems are done is when a person experiences symptoms. Warning signs of gallbladder problems include:

• Bouts of severe pain in the right upper abdomen and sometimes the right chest or back
• Pain after eating, particularly high-fat foods, or at night
• Fever, with shaking and chills, especially if occurring with, or after, abdominal pain
• Nausea and perhaps vomiting
• Heartburn and indigestion
• A feeling of fullness in the abdomen, or excess gas

If you don’t have symptoms, that doesn’t mean your gallbladder is perfectly normal. Often, doctors will spot signs of gallbladder problems during diagnostic testing for some other symptom or health condition.

Gallbladder Disease: Eliminating Other Causes

If you have some combination of these symptoms, your doctor probably will start by asking detailed questions about them. He may ask for more details about the pain — what it feels like, when it happens, and where in your belly it hurts. Your doctor will also ask questions to look for other possible causes of abdominal pain, like:

Gallbladder Disease: Diagnostic Imaging Tests

After asking questions about your symptoms, doing a physical exam, and eliminating some causes from the list of possibilities, your doctor probably will perform some imaging tests to look at your gallbladder.

Imaging tests used to diagnose gallbladder problems include:

• An ultrasound. This is the most commonly used of the diagnostic tests for gallbladder problems. While very effective in diagnosing even very small gallstones, it can’t always clearly diagnose cholecystitis (inflammation of the gallbladder).
• X-rays. An abdominal X-ray can spot gas and some types of gallstones containing calcium. Some X-ray types require that a patient swallow a dye or have dye injected into the body so the X-ray can capture a clearer picture of the gallbladder.
• Computed tomography (CT) scan. This imaging test uses a computer and X-rays to spot gallbladder problems, but isn’t the most effective method of diagnosing gallstones. CT scans can help spot ruptures (tears in the gallbladder wall) and infections inside the gallbladder or its bile ducts.
• Magnetic resonance imaging (MRI) . Regular MRI, or another type called magnetic resonance cholangiography (MRC), can help diagnose stones in the bile ducts. MRC uses regular MRI imaging technology plus a dye administered into the bile duct. This test is very useful for diagnosing biliary tract (gallbladder and surrounding ducts) cancer, but may not be able to spot tiny stones or persistent infections.
• Endoscopic retrograde cholangiopancreatography (ERCP) . This test uses an endoscope (a tube fitted with a tiny camera and light) that is inserted into the throat, down through the stomach, and into the small intestine. This test can help spot gallstones or problems in the bile ducts of the gallbladder — it’s considered the “gold standard” when it comes to diagnosing stones blocking bile ducts, and allows for removal (using a small basket-like device) during the test. But there is a risk of complications, so the test is typically only given to people who are thought to be very likely to have stones blocking the bile ducts.
• Cholescintigraphy (also called DISIDA, HIDA scan, or gallbladder radionuclide scan). A small amount of radioactive dye is administered, and then a scanning device is used to track the dye as it moves into the gallbladder. This screening method can spot a blocked duct and acute inflammation, but not chronic gallbladder inflammation or gallstones.

Gallbladder Disease: Blood and Urine Tests

A blood test may also be performed to help diagnose gallbladder disease. A complete blood count, or CBC, can help confirm an infection if there is a high white blood cell count. Other specific blood tests can also reveal high bilirubin levels (the cause of jaundice, a complication of gallbladder problems) or elevated enzymes suggesting an obstruction in the gallbladder.

Urine tests may also be performed to help diagnose problems with the gallbladder by looking for abnormal levels of chemicals like amylase, which is an enzyme that aids in the digestion of carbohydrates, and lipase, another enzyme that helps break down fats.

Even if signs and symptoms are not directly suggesting gallbladder disease, your doctor has many ways to visualize the gallbladder. With these tests, your gallbladder disease can usually be promptly diagnosed — and just as importantly, properly treated.

Tests to Diagnose Gallstone Disease

The digestive system, including the gallbladder

What tests are done to detect gallstones?

Gallstone disease can develop in many different ways. A number of tests may be used to establish the diagnosis:

• Ultrasound: Ultrasound testing uses sound waves to take images of the gallbladder. It is the gold-standard to look for gallstones because it is simple and non-invasive. Ultrasound is very good at highlighting gallstones within the gallbladder, as well as features, such as a thickened gallbladder wall, that point to inflammation of the gallbladder (acute cholecystitis).
• Liver function tests (LFTs): Although these tests are not done specifically for gallstone disease, a simple blood test looking at the enzyme levels in the liver can show inflammation in the gallbladder caused by gallstones. Other combinations of liver tests are arranged if gallstones fall out of the gallbladder and are blocking the bile duct, which can lead to jaundice (the skin, whites of the eyes and mucous membranes turn yellow).
• Complete blood count (CBC): If there is inflammation caused by gallstones, the white blood cell count is usually elevated (higher). In this situation, the patient will often have a fever.
• Computed tomography (CT): This test uses X-rays to construct detailed images of the abdominal organs. CT can give additional information on the bile ducts and liver, which may be affected by gallstone disease.
• HIDA scan (cholescintigraphy): During this test, a radioactive material called hydroxy iminodiacetic acid (HIDA) is injected into the patient. The material is taken up by the gallbladder and shows how the gallbladder is functioning. This test is useful when the ultrasound result is inconclusive, especially if there is acute inflammation of the gallbladder and the outlet of the gallbladder is blocked. It is also beneficial when the gallbladder is diseased but there are no stones present (acalcalous cholecystitis).
• Magnetic resonance cholangiopancreatography (MRCP): This test uses magnetic resonance imaging (MRI) to produce detailed pictures of the biliary tree (liver, gallbladder and bile ducts). It is of particular use to look at the bile ducts for signs of stones that have escaped from the gallbladder and are blocking the bile duct, which can lead to jaundice.
• Endoscopic retrograde cholangiopancreatography (ERCP): In this procedure, a tube is placed down the patient’s throat, into the stomach, then into the small intestine. Dye is injected and the ducts of the gallbladder, liver, and pancreas can be seen on X-ray. ERCP is now mainly used to treat patients in whom a gallstone has blocked the bile duct causing pancreatitis (inflammation of the pancreas), jaundice or cholangitis (infection of the bile).

How to Test for Gallbladder Problems

Do you have gallbladder issues?

If this tiny organ, which is found under the liver and stores bile, isn’t bothering you, you may never think twice about it. Some conditions that involve this small sac don’t generate symptoms. Other gallbladder ailments can bring on rapid, intense pain in the upper right portion of your abdomen.

A variety of tests are helpful for diagnosing gallbladder problems. If you think that yours isn’t functioning properly, contact a local gallbladder doctor who can help you with your condition.

Common Gallbladder Issues

Although the liver produces bile, that liquid is stored in the gallbladder. The tissue on the interior of this organ contains hundreds of tiny protrusions that increase the surface area and maximize absorption. The walls of the gallbladder soak up water and inorganic salts, concentrating the bile so that it can be used effectively for digestion.

If this process doesn’t operate properly, you can develop gallbladder problems.

When you eat, the gallbladder emits bile into the small intestine to break down fats so that they can be taken up properly by the digestive system. If the gallbladder doesn’t empty properly, the bile can become too concentrated. Excess cholesterol or bilirubin in the liquid can solidify into gallstones.

These hard formations can also form when the bile contains too much cholesterol or bilirubin for reasons other than problems with gallbladder emptying. Certain hormones, diseases such as diabetes and cirrhosis and rapid weight loss can increase the risk of gallstones.

The deposits vary in size. They may be as small as a grain of sand or as large as a golf ball. Once they’re that big, you’ll probably feel the symptoms. As the gallstones grow, they begin to obstruct the bile ducts.

Inflammation of the gallbladder is called cholecystitis. It can be caused by certain diseases, infections or cancers.

It can also develop from the presence of gallstones or problems with the blood vessels. Cholecystitis can lead to tissue death and gallbladder tears.

It could also cause the organ to burst.

How do you know if you have a bad Gallbladder?

Your gallbladder may not work well if you have gallstones, cholecystitis or gallbladder cancer.

Because your body cannot dissolve fats without bile, you might be able to tell if you have a gallbladder condition if you pass fatty stools, which may float, have frequent diarrhea or experience gas and bloating. These symptoms may be heightened after eating a fatty meal.

Many digestive conditions present with similar symptoms, however, so what are signs of a bad gallbladder specifically?

Gallstones and cholecystitis can cause a specific type of abdominal pain. The discomfort may come and go, but you usually feel it in the upper-right area of the abdomen, and it can extend to the chest and back.

Because your gallbladder is tied to your digestion, problems with it can also cause nausea and vomiting.

A gallbladder attack usually happens when you have a blockage, large stones, a tumor or severe inflammation. The pain may start suddenly and feel like a sharp stab, a dull ache or cramps. The steady pain may occur after meals and spread to the area underneath the right shoulder blade. Symptoms of an acute dysfunction include fever, chills, jaundice and grayish stools.

Diagnosing Gallbladder Problems

If you have any of these symptoms, a doctor might ask specific questions to narrow down the potential problem and rule out other conditions. He or she may also look for Murphy’s sign, tenderness that occurs when the patient’s abdomen is palpated in a certain way.

If gallbladder trouble is suspected, the medical professional may conduct a gallbladder test.

How do you test for gallbladder problems?

Ultrasound is commonly used to get an image of the gallbladder and belly. This may detect gallstones or an enlarged gallbladder but not cholecystitis. Ultrasound may also pinpoint whether your symptoms are caused by a blockage, clot or tumor in the gallbladder or different area within the abdomen.

X-rays and CT scans can help doctors diagnose ruptures, which may be caused by large gallstones, and infections. A gallbladder scan, also referred to as a HIDA scan, is more intensive than a regular X-ray or CT scan. It involves injecting a small amount of radioactive substance into the patient. This tracer is absorbed by healthy gallbladder tissue.

By examining the activity of the radionuclide in the organ, health professionals can assess its function and diagnose potential problems, including gallstones, infections, tumors, cysts, and other issues.

Blood tests can be conducted in addition to imaging assessments. A complete blood count can also look for signs of infection. Liver function tests evaluate the levels of certain proteins, digestive chemicals, and bilirubin in the bloodstream.

Some specific liver function tests include:

• Alanine transaminase (ALT) test
• Alkaline phosphatase (ALP) test
• Aspartate transaminase (AST) test
• Bilirubin test
• Gamma-glutamyltransferase (GGT) test
• L-lactate dehydrogenase (LD) test
• Prothrombin time (PT) test

Some of these tests look for liver damage as well as gallbladder issues. People with liver problems may be more likely to experience gallbladder disease.

In some cases, gallbladder problems may be caused by tumors. The American Cancer Society reports that many cases of gallbladder cancer are found when inspecting a gallbladder that has been removed for other reasons, such as gallstones or inflammation. Most of the time, however, patients visit a physician because they have symptoms that indicate trouble.

A doctor may feel the belly for lumps or tender areas. They’ll look for fluid buildup in the abdomen and signs of jaundice in the skin and eyes. Lymph nodes may be examined for swelling and bulges.

The Bottom Line

You can live without your gallbladder. Although it facilitates the flow of bile, when it’s removed, your liver can send bile straight to the small intestine.

If you have symptoms of gallbladder disease or suspect that this organ doesn’t function as well as it should, find a doctor that specializes in liver and gallbladder conditions.

An experienced physician can conduct a comprehensive examination and order the tests that you need for a proper diagnosis and prevent serious complications.

Diagnosis of Gallstones | NIDDK

How do doctors diagnose gallstones?

Doctors use your medical history, a physical exam, and lab and imaging tests to diagnose gallstones.

A health care professional will ask you about your symptoms. He or she will ask if you have a history of health conditions or health concerns that make you more likely to get gallstones. The health care professional also may ask if you have a family history of gallstones and what you typically eat. During a physical exam, the health care professional examines your body and checks for pain in your abdomen.

A health care professional will ask if you have a history of health conditions that make you more likely to get gallstones.

What tests do health care professionals use to diagnose gallstones?

Health care professionals may use lab or imaging tests to diagnose gallstones.

Lab tests

A health care professional may take a blood sample from you and send the sample to a lab to test. The blood test can show signs of infection or inflammation of the bile ducts, gallbladder, pancreas, or liver.

Imaging tests

Health care professionals use imaging tests to find gallstones. A technician performs these tests in your doctor’s office, an outpatient center, or a hospital. A radiologist reads and reports on the images. You usually don’t need anesthesia or a medicine to keep you calm for most of these tests. However, a doctor may give you anesthesia or a medicine to keep you calm for endoscopic retrograde cholangiopancreatography (ERCP).

Ultrasound. Ultrasound is the best imaging test for finding gallstones. Ultrasound uses a device called a transducer, which bounces safe, painless sound waves off your organs to create an image or picture of their structure. If you have gallstones, they will be seen in the image. Sometimes, health care professionals find silent gallstones when you don’t have any symptoms.

Computed tomography (CT) scan. CT scans use a combination of x-rays and computer technology to create images of your pancreas, gallbladder, and bile ducts. CT scans can show gallstones, or complications such as infection and blockage of the gallbladder or bile ducts. However, CT scans also can miss gallstones that you may have.

Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed images of your organs and soft tissues without x-rays. MRIs can show gallstones in the ducts of the biliary tract.

MRIs can show gallstones in the ducts of the biliary tract.

Cholescintigraphy. Cholescintigraphy—also called a hydroxyl iminodiacetic acid scan, HIDA scan, or hepatobiliary scan—uses a safe radioactive material to produce pictures of your biliary tract. You’ll lie on a table while a health care professional injects a small amount of the radioactive material into a vein in your arm. The health care professional may also inject a substance that causes your gallbladder to squeeze. A special camera takes pictures of the radioactive material as it moves through your biliary tract. Doctors use cholescintigraphy to diagnose abnormal contractions of your gallbladder or a blockage in the bile ducts.

Endoscopic retrograde cholangiopancreatography (ERCP). ERCP combines upper gastroendoscopy and x-rays to treat problems of your bile and pancreatic ducts. ERCP helps the health care professional locate the affected bile duct and the gallstones. This test is more invasive—or involves more instruments inside your body—than other tests. Doctors use it selectively, usually to remove a gallstone that is stuck in the common bile duct.

Tests for Gallbladder Cancer

Some gallbladder cancers
are found after the gallbladder has been removed because of gallstones or to treat chronic (long-term) inflammation. Gallbladders removed for those reasons are always looked at under a microscope to see if there’s cancer cells in them.

Most gallbladder cancers, though, aren’t found until a person goes to a doctor because they have symptoms.

Medical history and physical exam

If there’s reason to suspect you might have gallbladder cancer, your doctor will want to take a complete medical history to check for risk factors and to learn more about your symptoms.

Your doctor will examine you to look for signs of gallbladder cancer and other health problems. The exam will focus mostly on the abdomen (belly) to check for any lumps, tenderness, or fluid build-up. The skin and the white part of the eyes will be checked for jaundice (a yellowish color). Sometimes, cancer of the gallbladder spreads to lymph nodes,
causing a lump that can be felt beneath the skin. Lymph nodes above the collarbone and in several other locations may be checked.

If symptoms and/or the physical exam suggest you might have gallbladder cancer, tests will be done. These might include lab tests, imaging tests, and other procedures.

Blood tests

Tests of liver and gallbladder function

Lab tests
might be done to find out how much bilirubin is in your blood. Bilirubin is the chemical that causes jaundice. Problems in the gallbladder, bile ducts, or liver can raise the blood level of bilirubin.

The doctor may also do tests for albumin, liver enzymes (alkaline phosphatase, AST, ALT, and GGT), and certain other substances in your blood. These may be called liver function tests. They can help diagnose liver, bile duct, or gallbladder disease.

Tumor markers

Tumor markers are substances made by cancer cells that can sometimes be found in the blood. People with gallbladder cancer may have high blood levels of the markers called CEA and CA 19-9. Usually the blood levels of these markers are high only when the cancer is in an advanced stage
. These markers are not specific for gallbladder cancer – that is, other cancers or even some other health conditions also can make them go up.

These tests can sometimes be useful after a person is diagnosed with gallbladder cancer. If the levels of these markers are found to be high, they can be followed over time to help tell how well treatment is working.

Imaging tests

Imaging tests
use x-rays, magnetic fields, or sound waves to create pictures of the inside of your body. Imaging tests can be done for a number of reasons, including:

• To look for suspicious areas that might be cancer
• To help a doctor guide a biopsy needle into a suspicious area to take a sample for testing
• To learn how far cancer has spread
• To help make treatment decisions
• To help find out if treatment is working
• To look for signs of the cancer coming back after treatment

People who have (or might have) gallbladder cancer may have one or more of these tests:

Ultrasound

Ultrasound
uses sound waves and their echoes to create images of the inside of the body. A small instrument called a transducer gives off sound waves and picks up their echoes as they bounce off organs inside the body. The echoes are converted by a computer into an image on a screen.

Abdominal ultrasound: This is often the first imaging test done in people who have symptoms like jaundice or pain in the right upper part of their abdomen (belly). This is an easy test to have and it doesn’t use radiation. You simply lie on a table while a technician moves the transducer on the skin over the right upper abdomen.

This type of ultrasound can also be used to guide a needle into a suspicious area or lymph node so that cells can be removed (biopsied) and looked at under a microscope. This is called an ultrasound-guided needle biopsy.

Endoscopic or laparoscopic ultrasound: In these techniques, the doctor puts the ultrasound transducer inside the body and closer to the gallbladder. This gives more detailed images than a standard ultrasound. The transducer is on the end of a thin, lighted tube that has a camera on it. The tube is either passed through the mouth, down through the stomach, and near the gallbladder (endoscopic ultrasound) or through a small surgical cut on your belly (laparoscopic ultrasound).

If there’s a tumor, ultrasound might help the doctor see if and how far it has spread into the gallbladder wall, which helps in planning for surgery. Ultrasound may be able to show if nearby lymph nodes are enlarged, which can be a sign that cancer has reached them.

Computed tomography (CT) scan

A CT scan
uses x-rays to make detailed cross-sectional images of your body. It can be used to

• Help diagnose gallbladder cancer by showing tumors in the area.
• Help stage the cancer (find out how far it has spread). CT scans can show the organs near the gallbladder (especially the liver), as well as lymph nodes and distant organs the cancer might have spread to.
• A type of CT known as CT angiography can be used to look at the blood vessels near the gallbladder. This can help determine if surgery is an option.
• Guide a biopsy needle into a suspected tumor. This is called a CT-guided needle biopsy. To do it, you stay on the CT scanning table while the doctor advances a biopsy needle through your skin and toward the mass. CT scans are repeated until the needle is inside the mass. A small amount of tissue (a sample) is then taken out through the needle.

Magnetic resonance imaging (MRI) scan

Like CT scans, MRI scans
show detailed images of soft tissues in the body. But MRI scans use radio waves and strong magnets instead of x-rays. A contrast material called gadolinium may be injected into a vein before the scan to see details better.

MRI scans provide a great deal of detail and can be very helpful in looking at the gallbladder and nearby bile ducts and other organs. Sometimes they can help tell a benign (non-cancer) tumor from one that’s cancer. Special types of MRI scans can also be used in people who may have gallbladder cancer:

• MR cholangiopancreatography (MRCP) can be used to look at the bile ducts and is described below in the section on cholangiography.
• MR angiography (MRA) looks at blood vessels and is also covered in the next section on angiography..

Cholangiography

A cholangiogram is an imaging test that looks at the bile ducts to see if they are blocked, narrowed, or dilated (widened). This can help show if someone might have a tumor that’s blocking a duct. It can also be used to help plan surgery. There are several types of cholangiograms, each of which has different pros and cons.

Magnetic resonance cholangiopancreatography (MRCP): This is a way to get images of the bile ducts using the same type of machine used for standard MRIs. Neither an endoscope or an IV contrast material is used, unlike other types of cholangiograms. Because it’s non-invasive (nothing is put in your body), doctors often use MRCP if they just need images of the bile ducts. This test can’t be used to get biopsy samples of tumors or to place stents (small tubes) in the ducts to keep them open.

Endoscopic retrograde cholangiopancreatography (ERCP): In this procedure, a doctor passes a long, flexible tube (endoscope) down your throat, through your stomach, and into the first part of the small intestine. This is usually done while you are sedated (given medicine to make you sleepy). A small catheter (tube) is passed out of the end of the endoscope and into the common bile duct. A small amount of contrast dye is injected through the catheter. The dye helps outline the bile ducts and pancreatic duct as x-rays are taken. The images can show narrowing or blockage of these ducts. This test is more invasive than MRCP, but it has the advantage of allowing the doctor to take samples of cells or fluid for testing. ERCP can also be used to put a stent (a small tube) into a duct to help keep it open.

Percutaneous transhepatic cholangiography (PTC): To do this procedure, the doctor puts a thin, hollow needle through the skin of your belly and into a bile duct inside the liver. You will get medicine through an IV line to make you sleepy before the test. A local anesthetic is also used to numb the area before putting the needle. A contrast dye is then injected through the needle, and x-rays are taken as it passes through the bile ducts. Like ERCP, this test can also be used to take samples of fluid or tissues or to put a stent (small tube) into a duct to help keep it open. Because it’s more invasive, PTC is not usually used unless ERCP has already been tried or can’t be done for some reason.

Angiography

Angiography or an angiogram is an x-ray
test used to look at blood vessels. A thin plastic tube called a catheter is threaded into an artery and a small amount of contrast dye is injected to outline blood vessels. Then x-rays are taken. The images show if blood flow in an area is blocked anywhere or affected by a tumor, as well as any abnormal blood vessels in the area. The test can also show if a gallbladder cancer has grown through the walls of certain blood vessels. This information is mainly used to help surgeons decide whether a cancer can be removed and to help plan the operation.

Angiography can also be done with a CT scan (CT angiography) or an MRI (MR angiography). These tend to be used more often because they give information about the blood vessels without the need for a catheter. You may still need an IV line so that a contrast dye can be injected into the bloodstream during the imaging.

Laparoscopy

Laparoscopy is a type of surgery. The doctor puts a thin tube with a light and a small video camera on the end (a laparoscope) into a small incision (cut) in the front of your abdomen (belly) to look at the gallbladder, liver, and other nearby organs and tissues. (Sometimes more than one cut is made.) This is usually done in the operating room while drugs are used to put you into a deep sleep and not feel pain (general anesthesia) during the surgery.

Laparoscopy can help doctors plan surgery or other treatments, and can help determine the stage (extent) of the cancer. If needed, doctors can also put special instruments in through the incisions to take out biopsy samples for testing.

Laparoscopy is often used to take out your gallbladder. This operation is called a laparoscopic cholecystectomy. If gallbladder cancer is found or suspected during that operation, surgeons usually change to an open cholecystectomy (removal of the gallbladder through a larger cut in the abdomen). The open method lets the surgeon see more and may lower the chance of releasing cancer cells into the abdomen when the gallbladder is removed. The use of the open procedure depends on the size of the cancer and whether surgery can remove it all.

Biopsy

During a biopsy, the doctor removes a tissue sample to be looked at with a microscope to see if cancer (or some other disease) is present. For most types of cancer, a biopsy is needed to make a diagnosis. Biopsies are also used to help find out how far the cancer has spread. This is important when choosing the best treatment plan.

But a biopsy isn’t always done before surgery to remove a gallbladder tumor. Doctors are often concerned that sticking a needle into the tumor or otherwise disturbing it without completely removing it might allow cancer cells to spread.

If imaging tests show a tumor in the gallbladder and there are no clear signs that it has spread, the doctor may decide to proceed directly to surgery and treat the tumor as a gallbladder cancer. (See Surgery for Gallbladder Cancer.) In this case, the gallbladder is checked for cancer after it’s been removed.

In other cases, a doctor may feel that a biopsy of a suspicious area in the gallbladder is the best way to know for sure if it’s cancer. For example, imaging tests may show that a tumor has spread or grown too large to be removed completely by surgery. Many gallbladder cancers are not removable by the time they’re first found.

Types of biopsies

There are many ways to take biopsy samples of the gallbladder.

During cholangiography: If ERCP or PTC is being done, a sample of bile may be collected during the procedure to look for cancer cells in the fluid.

During laparoscopy: As noted earlier, biopsy samples can be taken during laparoscopy. Laparoscopy lets the doctor see the surface of the gallbladder and nearby areas and then take small pieces of tissue from any suspicious areas.

Needle biopsy: If the cancer is too big or has spread to much to be removed with surgery, a needle biopsy may be done to confirm the diagnosis and help guide treatment. For this test, a thin, hollow needle is put in through the skin and into the tumor without making a cut in the skin. (The skin is numbed first with a local anesthetic.) The needle is usually guided into place using ultrasound or CT scans. When the images show that the needle is in the tumor, cells and/or fluid are drawn into the needle and sent to the lab to be tested.

In most cases, this is done as a fine needle aspiration (FNA) biopsy, which uses a very thin needle attached to a syringe to suck out (aspirate) a sample of cells.Sometimes, the FNA doesn’t get enough cells for a definite diagnosis, so a core needle biopsy, which uses a slightly larger needle to get a bigger sample, may be done.

For more information on biopsies and how samples are tested, see Testing Biopsy and Cytology Specimens for Cancer.

Gallstones – Diagnosis and Treatment

Gallstones are solid build-ups of crystallized bile, which is produced by the liver, stored in the gallbladder and secreted into the bowel through the bile ducts to help digest fats. Some gallstones do not produce symptoms. However, they can cause a blockage within the bile duct or gallbladder which may result in pain and inflammation, a condition called cholecystitis.

Your doctor may use abdominal CT, magnetic resonance cholangiopancreatography (MRCP), or abdominal ultrasound to help diagnose your condition. Treatment may not be necessary if you do not have symptoms. If, however, you are diagnosed with cholecystitis, your doctor may prescribe antibiotics and surgical removal of the gallbladder. If a gallstone has blocked a bile duct, your doctor may prescribe biliary interventions such as endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) to locate and/or remove the blockage.

What are gallstones?

Gallstones are solid particles that develop in the gallbladder. Stones are formed from the crystallization of bile, a fluid made by the liver and secreted into the bowel through the bile ducts to help digest fats.

Some gallstones do not produce noticeable symptoms. However, if a gallstone causes blockage of the gallbladder or the bile duct, it can cause inflammation and pain in the right upper abdomen, upper right shoulder or between the shoulder blades, lasting from a few minutes to several hours. Other symptoms include nausea and vomiting, fever, and chills. Inflammation of the gallbladder is called cholecystitis.

top of page

How are gallstones diagnosed and evaluated?

Imaging is used to provide your doctor with valuable information about gallstones, such as location, size and effect on organ function. Some types of imaging that your doctor may order include:

top of page

How are gallstones treated?

Treatment of gallstones may not be necessary if you do not have symptoms. However, if you have cholecystitis, or if you are having symptoms related to gallstones, the standard treatment is intravenous antibiotics and surgical removal of the gallbladder (cholecystectomy). In most cases, your surgeon will perform a cholecystectomy laparoscopically (with endoscopes placed through small incisions in your abdomen).

If the gallstones have also caused blockage of the biliary ducts, other procedures may be performed, including:

• Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is used to examine the bile ducts using an endoscope, a flexible tube that is passed from the mouth through the stomach and into the duodenum. Iodinated contrast material is injected into the bile ducts to locate gallstones that may be causing blockage. Some stones may be successfully removed during ERCP.
• Percutaneous transhepatic cholangiography (PTC): PTC is performed by making a small incision on the skin, and advancing a needle into the bile ducts. Iodinated contrast material is injected into the bile ducts to locate gallstones that may be causing blockage. Some stones can be removed during a PTC and others may be bypassed by leaving a catheter or small thin tube in place.

If your doctor decides that you are too sick to undergo surgery, there are other procedures that may be done until surgery can be performed.

• Cholecystostomy tube placement: A cholecystostomy tube is a small plastic tube (catheter) placed into your gallbladder through a small incision in the skin. The aim of this procedure is to decompress the distended, blocked and inflamed gallbladder by emptying out the backed up, under pressure bile in your gallbladder and diverting it outside the body into a bag attached to the tube. This allows decrease in pain and inflammation in the gallbladder and allows time for the antibiotics to work and for the surgery to be performed at a later date. However, it does not treat the underlying cause (the stones).

top of page

Which test procedure or treatment is best for me?

top of page

This page was reviewed on January, 21, 2020

Cholecystitis (Gallbladder inflammation), Diagnosis & Treatment

Cholecystitis (ko-luh-sis-TIE-tis) is inflammation of the gallbladder. It usually occurs when drainage from the gallbladder becomes blocked (often from a gallstone). It may be acute (come on suddenly) and cause severe pain in the upper abdomen. Or it may be chronic (multiple recurrent episodes) with swelling and irritation that occurs over time.

Your doctor may use abdominal ultrasound, abdominal CT, magnetic resonance cholangiopancreatography (MRCP) or nuclear imaging to help diagnose your condition. Treatment may include fasting, antibiotic medication and having a drainage tube placed in the gallbladder. However, because it can often reoccur, the most common treatment is to have surgery to remove your gallbladder.

What is cholecystitis?

Cholecystitis means inflammation of the gallbladder. The gallbladder is a pear-shaped organ that sits beneath your liver and stores bile. If your gallbladder is inflamed, you may have pain in the upper right or mid-portion of the abdomen and you may be tender to the touch there.

Bile is made in the liver. The gallbladder stores bile and pushes it into the small intestine where it is used to help digest food. When the drainage pathway for the bile stored in the gallbladder (called the cystic duct) becomes blocked, usually by a gallstone, the gallbladder becomes swollen and may become infected. This results in cholecystitis. The cystic duct drains into the common bile duct, which carries the bile into the small intestine. A gallstone may also become stuck in the common bile duct. This condition (choledocholithiasis) requires a procedure to remove or bypass the blockage.

Cholecystitis may be:

• Acute (occur suddenly) – This inflammation often causes severe pain in the mid or right upper abdomen. Pain can also spread between the shoulder blades. In severe cases, the gallbladder may tear or burst and release bile into the abdomen, causing severe pain. This can be a life-threatening situation that requires immediate attention.
• Chronic (multiple episodes of inflammation) – Recurrent bouts of mild swelling and irritation/inflammation will often damage the wall of the gallbladder causing it to thicken, shrink and lose proper function

Other symptoms include:

• nausea
• vomiting
• fever
• abdominal pain that gets worse when taking a deep breath
• abdominal pain and cramping after meals (especially fatty foods)

top of page

How is cholecystitis diagnosed and evaluated?

Your doctor may order blood tests to see if you have a gallbladder infection. Often, the white blood cell count in our blood may become elevated as a sign of the infection. One or more of the following radiology tests also may be done:

• Abdominal ultrasound: This is often the first test done to evaluate for cholecystitis. Ultrasound uses sound waves to produce pictures of the gallbladder and the bile ducts. It is used to identify signs of inflammation involving the gallbladder and is very good at showing gallstones.
• Abdominal CT: Computed tomography (CT) uses x-rays to produce detailed pictures of the abdomen, liver, gallbladder, bile ducts and intestine to help identify inflammation of the gallbladder or blocked bile flow. Sometimes (but not always) it can also show gallstones. See the Radiation Dose page for more information about CT.
• Magnetic resonance cholangiopancreatography (MRCP): MRCP is a type of MRI exam that makes detailed images of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. It is very good at showing gallstones, gallbladder or bile duct inflammation, and blocked bile flow. See the MRI Safety page for more information.
• Hepatobiliary nuclear imaging: This nuclear medicine test uses an injected radiotracer to help evaluate disorders of the liver, gallbladder and bile duct (biliary system). In acute cholecystitis, it can detect blockage of the cystic duct (the duct that is always blocked with acute cholecystitis).

top of page

How is cholecystitis treated?

Your doctor may suggest:

• fasting to rest the gallbladder
• a special, low-fat diet
• pain medication
• antibiotics to treat infection

However, because the condition may come back often, your doctor may recommend you have your gallbladder removed using either:

• laparoscopic surgery. The surgeon uses the belly button and several small cuts to insert a laparoscope to see inside the abdomen and remove the gallbladder. You will be asleep for the surgery.
• open surgery. The surgeon makes a cut in the abdomen and removes the gallbladder. You will be asleep for the surgery. See the Anesthesia Safety page for more information.

If you cannot have surgery, your doctor may drain bile from the gallbladder. This may be done by:

• Percutaneous cholecystostomy: This procedure is done by a radiologist. It places a tube through the skin directly into the gallbladder using ultrasound or CT guidance. Blocked or infected bile is removed to reduce inflammation. This procedure is typically done in patients who are too sick to have their gallbladder removed. You will be sedated for this procedure. The tube typically has to stay in for at least a few weeks.
• Endoscopic retrograde cholangiopancreatography (ERCP): This procedure is typically done by a doctor who specializes in abdominal disorders (a gastroenterologist). A camera on a flexible tube is passed from the mouth through the stomach and into the beginning of the small bowel. This is where the common bile duct meets the small intestine. The valve mechanism (called the sphincter) at the end of the bile duct can be examined and opened to clear blocked bile and stones, if necessary. Doctors can also insert a small tube into the main bile duct and inject contrast material to better see the duct. They also may use a laser fiber to destroy small gallstones or use a basket or balloon to retrieve stones or stone fragments. All of this may be done without making any incisions in the abdomen. This procedure poses a small, but real risk of pancreas inflammation or injury. You will be sedated for this procedure.
• Percutaneous transhepatic cholangiography (PTC): This procedure is done by a radiologist. A needle is placed in the bile ducts within the liver using imaging guidance. Contrast material is injected to help locate gallstones that may be blocking bile flow. Some stones can be removed during a PTC. Others may be bypassed by leaving a small stent in place to allow bile to get around the area of blockage. This helps reduce inflammation. You will be sedated for this procedure. See the Biliary Interventions page for more information.

top of page

Which test, procedure or treatment is best for me?

top of page

This page was reviewed on January, 15, 2019

90,000 blood tests for examining the liver and gallbladder

ALT (alanine aminotransferase) and AST (aspartate aminotransferase)

These are enzymes contained in the liver, as well as other organs and tissues of our body. Normally, both enzymes are present in the blood serum, and their activity does not exceed 40 U / L. An increase in ALT and AST in a blood test occurs with any damage to liver cells, hepatocytes caused by diseases and liver damage.

Whey proteins

Albumin, fibrinogen, haptoglobin and beta-depths are synthesized by liver cells, hepatocytes, gamma globulins are produced by lymphocytes and plasma cells of the liver. In most liver diseases, the level of albumin and other liver proteins in the blood serum decreases, while the level of globulins, on the contrary, increases. Albumin levels below normal and globulin levels above normal may indicate chronic and progressive liver disease.

Coagulogram

This is a comprehensive study of homeostasis, which allows you to assess the state of coagulation and other blood systems. Almost all blood clotting factors are synthesized in the liver, in addition, it removes these factors from the bloodstream and participates in the dissolution of blood clots.If the parameters included in the coagulogram deviate from the norm, it can be assumed that the synthesis of coagulation factors in the liver is impaired due to damage and death of hepatocytes in infectious liver diseases, cirrhosis, chronic hepatitis, acute liver failure and other diseases.

GGT (gamma glutamyltransferase)

This is an enzyme found in the liver, pancreas and kidneys. It increases with diseases of the liver and pancreas, significantly increases with alcoholic liver damage;

ALP (alkaline phosphatase)

It is an enzyme produced in the liver and biliary tract, bone tissue and intestines.An increase in this enzyme is possible in case of impaired patency of the intra- and extrahepatic biliary tract and infiltrative liver diseases, in which substances, for example fats, or foreign cells, for example, metastases, penetrate the liver cells. Bilirubin

This is a bile pigment, which is one of the most important components of bile and is formed as a result of the breakdown of hemoglobin and other blood components; the resulting bilirubin is removed from the bloodstream by the liver and excreted in the bile.An increase in the level of bilirubin in the blood signals a decrease in the ability of the liver to remove bilirubin from the body and a violation of the outflow of bile, occurs in acute and chronic liver diseases, chronic cholecystitis, blockage of the bile ducts and other diseases.

Cholesterol

This is an organic compound that is found in the cell membranes of all animal organisms and is used for the synthesis of bile acids, hormones and vitamin D. Approximately 50% of cholesterol is produced by the liver, some comes from food, the rest is produced by other cells in our body.A decrease in blood cholesterol levels can signal a decrease in the liver’s ability to produce it, and is found in cirrhosis of the liver, malignant liver diseases and other diseases. An increase in cholesterol levels may accompany a violation of the outflow of bile through the intra- and extrahepatic biliary tract.

Who and why is biochemistry prescribed?

Blood biochemical parameters are prescribed by a doctor after examining the patient if

• it is necessary to undergo a preventive examination;
• there are complaints of a bitter taste in the mouth, pain and heaviness in the right hypochondrium, nausea, rapid fatigue;
• found yellowing of the skin and whites of the eyes and the presence of edema;
• close relatives have liver and gallbladder diseases;
• there is a need to constantly take hepatotoxic drugs.

🧬 Surprises of the gallbladder

Gastroenterologist, hepatologist GMS Clinic Sergey Vyalov gave an interview to the stopkilo.net Internet portal and spoke about the problems and treatment of the gallbladder.

Introduction

The gallbladder is one of the “special” organs that can literally prepare surprises. Such surprises represent an unexpected attack of severe pain in the abdomen on the right, somewhere under the ribs, which we call “bilious colic”.

The gallbladder acts as a kind of reservoir that collects and stores bile until the right moment, and then throws it out for digestion. If the bile begins to be poorly “stored” or “stagnate”, then its composition changes. Then it all depends on how far the process has gone …

But it all starts with a violation of the normal contractions of the gallbladder – it contracts either too quickly and strongly, or too weakly and slowly. Both of these disorders lead to improper bile secretion and changes in the composition of bile, and in the long term – to the formation of stones.

Most often, errors in nutrition lead to this when we overeat or eat a lot of fatty, fried, smoked foods. In some people, an additional contribution to the development of gallbladder diseases is made by high cholesterol levels, hormonal imbalance, taking certain medications, and a hereditary predisposition. Stress, emotional and nervous tension also leads to dysfunction of the gallbladder. That is why the last stage, cholelithiasis, often affects women after a critical age.Although in recent years, gallbladder diseases have become very “younger” and are very often detected even in children!

Sensations located in the upper abdomen (in the stomach area) or under the ribs on the right are most often associated with a disease of the stomach or gallbladder, and in rare cases, even the intestines. It is very difficult to distinguish them from each other on your own. When examining the abdomen, the doctor can easily determine what exactly led to the onset of symptoms. A connection with food intake may suggest: if symptoms appear after eating, the problem is most likely related to the gallbladder or stomach. If the symptoms with food intake do not have a clear connection, there is reason to assume a problem with the intestines.

Symptoms

Typical symptoms of gallbladder disease are discomfort or soreness in the upper abdomen or under the ribs on the right, often associated with eating. Many people have mild nausea, a bitter taste in the mouth, a heaviness under the ribs, or an aching sensation. Most often they occur when the gallbladder is provoked with fatty, fried, spicy or smoked food.However, they can develop a few days after taking antibiotics, antifungal and antiviral drugs.

Chronic cholecystitis develops for a long time and slowly, often manifests itself in discomfort and pain. Acute cholecystitis has more severe symptoms, the temperature may even rise, the pain is forced to sit bent over and hold on to the right side, sometimes even to the back. And I want to go to the doctor. Most often, these symptoms are fairly typical in most people.

Cholecystitis, in essence, is an inflammation of the gallbladder, which is accompanied by both a violation of its contractions and a violation of bile secretion.

It is the violation of normal bile secretion that leads to an increase in pressure in the bladder, concentration and thickening of bile. It begins to collect in clots, flakes and lumps appear, which crystallize in the form of stones in a bubble. If cholecystitis is not treated, it can become acute or stones will appear in the bladder.We call this sequential change of stages the “bilious continuum.”

The lifestyle does NOT significantly affect the state of the gallbladder or the development of the inflammatory process in it. Nutrition is more important, as well as taking medications that are excreted along with bile.

The relationship between stress and increased anxiety and gallbladder contractions is important. Very often, an emotional breakdown or a nervous period can lead to the development of the disease.

Recommendations

For diseases of the gallbladder, table No. 5 is recommended. It is also used in the treatment of diseases of the liver and pancreas. Food for diseases of the stomach or intestines is different from the food required for diseases of the gallbladder. The main restrictions apply to fatty, fried, spicy and smoked foods, as well as alcohol. We have developed a special application for the phone “Table No. 5”, which covers nutrition issues in detail.

Cold and hunger treat the most acute period of acute pancreatitis, which sometimes occurs due to gallstone disease. Therefore, there is such a stereotype. Also, hunger is sometimes used for biliary colic. With exacerbation of cholecystitis (not acute cholecystitis!), The standard of treatment is drugs that restore contractions of the gallbladder and ursodeoxycholic acid preparations (ursosan). In the initial period of exacerbation, antispasmodics are used (mebeverin, drotaverin, gimecromone).Further, it is possible to use prokinetics (itomed), but they are not used for cholelithiasis, only in the early stages. These drugs normalize bile secretion. It is strictly forbidden to use choleretic drugs without ultrasound results!

This recommendation is not a guide to treatment – the doctor should prescribe the treatment after examination!

In some cases, indeed, diseases of other organs can lead to the development of cholecystitis. Duodenitis is the most common disease, which, due to edema of the “exit” of the biliary tract, leads to impaired bile flow.This increases pressure in the gallbladder and promotes inflammation or stones. Also contributes to cholecystitis and gallbladder dysfunction is excess bacteria in the intestine, the so-called bacterial overgrowth. This condition can occur after food poisoning, long-standing constipation or prolonged diarrhea, as well as inflammatory bowel disease and diverticular disease.

Source: stopkilo.net

Gallstone disease

Cholelithiasis

Gallstone disease is the presence of stones in the gallbladder and bile ducts.Stones are solid formations of various sizes made of cholesterol or bilirubin.

The disease can develop asymptomatically for a long time. As a result, stones clog the bile ducts and cause biliary colic, inflammation of the gallbladder, jaundice, and pancreatitis (inflammation of the pancreas).

This disease is widespread throughout the world and most often occurs in older women.

Treatment of gallstone disease consists in removing stones from the gallbladder or ducts.

If stones do not cause symptoms, their removal is not indicated.

Synonyms Russian

Stones in the gallbladder and ducts, cholelithiasis, choledocholithiasis, gallstones.

English synonyms

Gallstones, Cholelithiasis, Choledoholitheasis, Gallstone in the bile duct, Bile duct stone.

Symptoms

Gallstones may not cause any symptoms for decades. If they block the bile ducts, causing tension in the gallbladder wall, this is manifested:

• Acute stabbing pain in the right upper abdomen, in the center of the abdomen;
• pain between the shoulder blades;
• pain in the right shoulder.

As a rule, a painful attack lasts 30-90 minutes. It can pass with increased sweating, nausea, vomiting. In the absence of episodes of acute pain, patients usually do not complain.

The complicated course of the disease is sometimes accompanied by jaundice.

General information about the disease

Gallstone disease is the presence of one or more stones in the gallbladder and bile ducts.

The gallbladder is a small, pear-shaped, sac-shaped organ located on the right side of the abdomen below the liver.It is a “reservoir” for the bile produced by the liver. It passes into the cystic bile duct, which flows into the common bile duct.

The disease can develop unnoticed for a long time without causing any symptoms. It is widespread throughout the world and is most common in older women and obese people.

As a rule, stones form in the gallbladder. This occurs when cholesterol (a fatty substance) or bilirubin (a breakdown product of hemoglobin) is present in bile at an increased concentration.In this case, other components of bile cannot dissolve these substances. From bile, supersaturated with them, a sediment can form – microscopic crystals that settle on the mucous membrane of the gallbladder. Over time, the crystals grow and merge, gradually forming small stones. Gallstones can be composed of various substances:

• Cholesterol stones are the most common type of stones; consist mainly of cholesterol and are yellow;
• Pigment stones are less common and are small hard black stones or soft, fatty stones of brown color; consist of the breakdown products of bilirubin.

The appearance of stones in the gallbladder or ducts can be caused for the following reasons.

• Hyper-saturation of bile with cholesterol due to …

• Excessive excretion of cholesterol in the bile (for example, with diabetes mellitus, increased blood pressure, hyperlipidemia, obesity, while taking certain drugs).
• Decrease in the production of bile salts, which make up the dry residue of bile and regulate the production of its other constituents, including cholesterol.

• Lecithin deficiency, the breakdown of which produces bile acids. This may be due to genetic disorders.
• Bile hyper-saturation with bilirubin. It leads to an increased formation of hemoglobin caused by sickle cell anemia (a hereditary disease that disrupts the structure of hemoglobin), cirrhosis of the liver (cicatricial degeneration of liver tissue).
• Impaired motility of the gallbladder and, as a consequence, its incomplete emptying and stagnation of bile, as in pregnancy, fasting, sudden weight loss, with spinal cord injuries.
• Certain parasites (eg liver fluke).

Gallstone disease has the following complications.

• Inflammation of the gallbladder (cholecystitis), which can cause severe pain in the upper right abdomen and fever.
• Blockage (obstruction) of the common bile duct. This can lead to jaundice or inflammation of the bile ducts (cholangitis).
• Blockage of the pancreatic duct – the tube through which juice that helps digest food from the pancreas through the common bile duct enters the duodenum. A blocked duct can cause pancreatitis, an inflammation of the pancreas.
• Cancer of the gallbladder. Gallstone disease increases the risk of developing gallbladder cancer.

Who is at risk?

• Women.
• People over 60 years old.
• People who are overweight or obese.
• Pregnant women and women who have given birth several times.
• People who eat foods high in fat and low in fiber.
• Dramatically thinner.
• Persons with a hereditary predisposition to the development of the disease.
• Patients with diabetes mellitus.
• Those with high cholesterol levels.
• Persons taking certain medications (containing estrogens, etc.)
• Suffering from high blood pressure, liver cirrhosis.

Diagnostics

Gallstone disease is suspected after the patient complains of acute pain in the right upper abdomen. Abdominal ultrasound can help determine the presence of stones. Often stones are discovered by accident when doing research for other purposes. A number of calcium-soaked stones can be seen on radiographs.

Laboratory research methods

Other research methods

• Abdominal ultrasound. This widely used test can detect gallstones with a high degree of accuracy.
• Computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen.They are an alternative to ultrasound.

• Endoscopic retrograde cholangiopancreatography (ERCP) – examination of the bile ducts and pancreatic duct by introducing a radiopaque substance through a special probe.

Treatment

Most people with gallstones do not need treatment: stones that do not cause symptoms should not be removed, and in some cases the disease is asymptomatic throughout the person’s life.However, gallstones must be removed in diabetes.

Treatment of gallstone disease depends on the symptoms of the disease and may include:

• surgery to remove the gallbladder (cholecystectomy), which is performed with frequent relapses and complications of the disease; removal of the gallbladder does not affect the vital functions of a person;

• taking medications aimed at dissolving gallstones.

To prevent complications of gallstone disease, the patient may be given a diet high in fiber and low in saturated fat.

Prevention

To reduce the risk of developing gallstone disease, you should maintain a healthy diet, without taking long breaks between meals (more than 3-4 hours).

Recommended analyzes

• Complete blood count
• Amylase total in serum
• Serum cholinesterase
• Lipase
• Aspartate aminotransferase (AST)
• Alanine aminotransferase (ALT)
• Phosphatase alkaline total
• Total bilirubin

Literature

• Glasgow RE, Mulvihill SJ. Treatment of gallstone disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010: chap 66.

Treatment of gallbladder diseases – treatment in Medline in Kemerovo

Despite its small size, the gallbladder is an important organ in the digestive system. It performs the function of collecting bile from the liver and regulating its secretion into the duodenum, depending on the food intake.

The function of bile is to activate digestive enzymes in the intestines and emulsify fats (the process of breaking down large droplets of fat into smaller ones) to facilitate the digestion process. In addition, resorption (reabsorption) of protein, important salts, amino acids into the blood occurs in this organ, as well as the secretion of mucus and a special hormone – cholecystokinin.

Cholecystokinin (CCK) is a neuropeptide hormone produced by the intestinal mucosa. It is responsible for: reducing the release of hydrochloric acid; stimulation of the pancreas, digestive enzymes, bile secretion, contraction of the gallbladder, is directly related to the relaxation of the bile duct sphincters and stimulation of the vagus nerve. Lack of this substance in the body is fraught with:

• disorders in the work of the gallbladder
• violation of the flow of bile into the duodenum
• disruption of the digestive tract in general

In addition, this hormone is involved in maintaining calmness, regulating sleep, suppressing fear and pain, and mental stress.

Gallbladder: Interesting Facts

• The gallbladder contains about 50 ml of bile formed in the liver cells, then through special bile ducts, which form a complex network, it enters the gallbladder, where it is stored until a person is eaten
• As soon as food enters the duodenum, the gallbladder contracts, and bile, along with pancreatic juice, moves into the intestines
• A healthy person can produce from 500 to 1000 ml of bile per day
• It contains water, bile acids, inorganic substances, vitamins A, B, C, D, amino acids, phospholipids, cholesterol, bilirubin, proteins, mucus and drug residues
• Bile functions: neutralization of gastric juice; activation of intestinal and pancreatic enzymes; inhibiting the growth of harmful bacteria in the intestines; improvement of intestinal motility; elimination of toxic substances and drugs

Major pathologies of the gallbladder

Cholelithiasis (cholelithiasis) is a disease of the biliary system associated with a violation of bilirubin metabolism and cholesterol, characterized by the formation of stones inside the liver, in the common bile duct and in the gallbladder.

According to the mechanism of formation, 3 types of stones are distinguished:

• cholesterol
• pigment bilirubin brown
• black

Cholelithiasis can be asymptomatic for a long time, sometimes manifesting itself in the form of bouts of hepatic colic.

Chronic non-calculous cholecystitis is a prolonged inflammatory process that affects the inner membrane of the bladder and is not accompanied by the formation of stones.

The main causes of the disease:

• bacterial infection – intestinal microflora (Escherichia coli, enterococcus), staphylococci and streptococci, Proteus, typhoid and paratyphoid sticks, anaerobic microflora
• parasitic invasion – feline fluke, lamblia, roundworm
• reverse flow of bile from the intestine – dangerous by the pancreatic enzymes in it, which, when entering the bladder, begin to digest its wall (this pathology is also called chemical cholecystitis)
• allergies – food and aerogenic allergens
• inflammatory diseases of the digestive system – especially negatively affected by hepatitis and pancreatitis
• bile stasis

Dyskinesia of the biliary tract is a functional disease of the biliary tract associated with a change in the tone of the gallbladder or ducts. As a rule, it is accompanied by periodic pain in the right hypochondrium and dyspeptic disorders. Dyskinesia usually occurs with constant stress, psychoemotional stress, neuroses. Depending on the change in the tone of the bladder, pain (hyperkinetic) and dyspeptic (hypokinetic) types of the disease are distinguished.

Acute cholangitis is an inflammatory process in the stage of acute exacerbation, which affects the bile ducts. It usually occurs as a complication of chronic cholecystitis, cholelithiasis, or after removal of the gallbladder.The development of infection is facilitated by stagnation of bile, compression of the ducts by tumors, stones. There are obstructive, recurrent, bacterial, secondary sclerosing cholangitis.

Cholecystitis – inflammation of the gallbladder. Signs of the disease – pain in the right hypochondrium of a pulling nature, may increase after eating. Drug treatment – antibiotics, choleretic and anti-inflammatory drugs.

Cholesterosis – the process of deposition of cholesterol in the walls of the gallbladder, for a long time does not manifest itself in anything.Treatment – diet and diet.

Polyps – benign tumor, asymptomatic, except in cases of blockage of the exit from the gallbladder. Treatment is surgical removal of polyps.

Cancer of the gallbladder is a rather rare pathology, in most cases it is the outcome of a chronic inflammatory process in the organ. Treatment is removal of the gallbladder and chemotherapy. Allocate adenocarcinoma, mucous, solid and squamous cell carcinoma.Gallbladder cancer is characterized by high malignancy, early metastasis and invasion of adjacent organs.

Pay attention

• Diseases of the gallbladder are the second most frequent among diseases of the liver and biliary tract and the third among all diseases of the gastrointestinal tract.
• With regard to age, they are more often affected by people over 50 years old, and women are more affected than men.

Symptoms of gallbladder diseases

• Pain – localized in the hypochondrium, of varying intensity (less with the bend of the gallbladder, more pronounced with cholecystitis and stones, may be absent with polyps).The pain intensifies within 24 hours after eating, especially fatty, fried or smoked food. If a stone leaves the gallbladder and blocks the common bile duct, a sharp paroxysmal pain occurs – hepatic colic
• Nausea, intermittent vomiting, flatulence (bloating) and stool disorders (loosening or a tendency to constipation) – these symptoms of digestive disorders are associated with the flow of bile into the intestine in an incomplete volume or a change in its composition, the process of food digestion is disrupted
• Bitter taste in the mouth – accompanies almost all diseases of the liver and gallbladder
• Crimson tongue – redness of the tongue, a specific symptom of various problems with the liver or biliary tract
• Intense color of urine – the urine becomes deep yellow, up to brown.This is due to the fact that in diseases of the gallbladder, bile acids are partially absorbed into the blood and excreted in the urine, which gives it a characteristic staining
• Light stool – normally brown stool is provided by the presence of bile acids in it, respectively, with a decrease in the flow of bile into the intestine, the stool becomes light
• Jaundice of the skin and sclera (from subtle to pronounced yellow coloration of the skin and sclera) – occurs when bile acids enter the blood from the gallbladder and settle in the tissues of the body (jaundice)

Troubleshooting

When the above symptoms appear, in addition to a doctor’s examination, laboratory and instrumental diagnostics are required.

In the medical center “Medline” at the services of patients:

• Clinical blood test – to identify the inflammatory process in the body, in which there is an increase in ESR (erythrocyte sedimentation rate) and the number of leukocytes
• Duodenal intubation is an informative diagnostic test in which a thin tube (probe) is inserted into the duodenum and bile is collected through it for examination in a laboratory. This is how the chemical composition of bile, inflammatory elements (leukocytes and mucus appear), atypical cells in tumor processes are determined.Also, bacterial inoculation of bile on nutrient media is carried out in order to identify the causative agent of infection
• Ultrasound examination of the abdominal organs – this method of examination visualizes the gallbladder, its bend, the thickness of the walls of the gallbladder, the expansion of the common bile duct, the presence of stones, polyps, etc.
• Fine-needle biopsy – under ultrasound guidance, a thin needle is inserted into the gallbladder to take a piece of tissue for analysis.Microscopic examination reveals atypical (tumor) cells
• X-ray examination with contrast agent – contrast agent is injected intravenously. Then it, together with liver cells, is excreted and accumulates in the gallbladder. This allows you to estimate the size of the bubble and the change in shape (deformation)
• Computed and magnetic resonance imaging (CT and MRI) – radiation layer-by-layer examination of tissues and organs, shows even small small tumors, polyps and stones (inclusions) and changes in them

Treatment of gallbladder diseases

The drug therapy prescribed in the gastroenterology department of the Medline clinic is complex – taking into account the cause of the disease and pathological changes.There are fundamental principles that are followed here in the treatment of all gallbladder diseases.

Etiotropic therapy is aimed at completely eliminating the cause of the disease. For this, antibiotics are used for cholecystitis, surgical treatment for gallstone disease, polyps and tumors of the gallbladder.

Pathogenetic therapy – used to restore the function of the gallbladder (antispasmodics for hyperkinetic type of dyskinesia), reduce the intoxication of the body with cholecystitis and tumors.Enzymatic preparations with bile acids (mezim) are used to improve digestion.

Symptomatic therapy – treatment aimed at reducing discomfort and discomfort, pain relievers (ketanov, analgin) and anti-inflammatory (paracetamol) drugs, antispasmodics (no-shpa, drotaverine) or combinations thereof (noshpalgin, spazmalgon).

Diet. Diet for gallbladder disease is to minimize the harmful effects of food on the functioning of the gallbladder.For this, table No. 5 according to Pevzner is used, which excludes fatty meats and poultry (pork, duck), rich broths (enhances the contraction of the walls of the gallbladder).

It is advisable to eat lean meats (beef, rabbit), poultry (chicken), fish (preferably river fish), dairy products, vegetables and fruits. The process of cooking is also important; you cannot fry or smoke it. All dishes are steamed or stewed.

Food.A very important factor in gallbladder problems is not only what food you can and cannot eat, but also how and when to eat. The most optimal is 5 meals a day in small portions, the last dinner at least 2 hours before bedtime. Snacks on the go and dry food are not allowed.

Cholelithiasis / Diseases / Clinic EXPERT

Cholelithiasis (GSD) is a disease of the hepatobiliary system caused by impaired cholesterol and / or bilirubin metabolism, characterized by the formation of gallstones in the gallbladder, hepatic bile ducts or in the common bile duct.More often, gallstones form in the gallbladder.

What factors contribute to the development of gallstone disease?

1. Belonging to the female sex. According to statistics, women get sick 2-3 times more often than men. Pregnancy and childbirth also increase the chance of developing this disease.
2. Age. The risk of developing the disease increases every year by 1% in women, and 0.5% in men
3. Hereditary predisposition.
4. Overweight.
5. Excessive nutrition with a predominance of fatty foods.
6. Low calorie diets.
7. Lipid metabolism disorder.
8. Hormonal disorders.
9. Taking medications (fibrates, hormonal contraceptives, octreotide).
10. Chronic bowel and pancreatic diseases.
11. Anatomical changes in the biliary system.
12. Chronic inflammatory diseases of the biliary tract.
13. Functional biliary disorders.
14. Endocrinological pathology (diabetes mellitus, hypothyroidism).

If 2 or more points from this list are true for you,
then you are at risk.

Don’t take risks.

Visit a gastroenterologist for an initial examination.

Why do you need a doctor’s examination?

The first stages of gallstone disease are often not accompanied by pronounced symptoms or are asymptomatic for 10-15 years. The patient feels great and does not suspect that he already needs the help of a specialist.

Ignoring this, you lose the chance to suppress the disease with small forces and without serious consequences for the body.

Revealing violations of the composition of bile (the presence of thick bile in the gallbladder) in this period perfectly lends itself to treatment and prevents the formation of stones, and therefore minimizes the risk of surgical intervention in the future!

To treat complications and an advanced stage is longer, more difficult and more expensive.

Stages of cholelithiasis

I Stage – initial or pre-stone

At this stage, it is possible to reveal thick heterogeneous bile in the gallbladder, the formation of biliary sludge, the presence of putty bile, a combination of putty bile with microliths.

If you skip treatment at this stage,

begins to form gallstones.

If you start treatment

It becomes possible to normalize the rheological properties of bile. You can prevent the process of stone formation and the further development of the disease.

Patients with diagnosed stage I are shown a consultation with a gastroenterologist-hepatologist:

• to determine treatment tactics
• to control the properties of bile, functions of the gallbladder and biliary system

Stage II – the formation of gallstones

At this stage in during the examination, the presence of gallstones is revealed:

• in the gallbladder, in the common bile duct, in the hepatic ducts
• by the number of calculi: single, multiple
• in composition: cholesterol, pigmented, mixed

The clinical picture is determined – in which the form of the disease manifests itself:

• latent (latent) course of the disease
• painful form with typical biliary colic
• dyspeptic form (the patient complains of a feeling of heaviness or a feeling of fullness in the right hypochondrium)
• gallstone disease proceeds under the mask oh other diseases

If you skip treatment at this stage,

further surgical intervention will become inevitable.

If you start treatment

It becomes possible to dissolve cholesterol stones without resorting to surgery. Complications can be prevented.

Patients are shown a consultation with a gastroenterologist-hepatologist to prescribe treatment.

If indicated, the gastroenterologist-hepatologist will appoint a joint consultation with the surgeon to determine further treatment tactics.

Stage III – chronic recurrent calculous cholecystitis

With frequent exacerbations of the disease, a joint consultation with a surgeon and a gastroenterologist-hepatologist is indicated to resolve the issue of surgical treatment and special preparation for the operation.

IV Stage – complications

A joint consultation of a surgeon and a gastroenterologist-hepatologist is indicated.

Symptoms

Very often, especially in the initial stages, gallstone disease does not make itself felt in any way and does not disturb the patient. In more than half of patients, stones in the gallbladder are discovered by chance during examination for other diseases.

Symptoms usually appear at more advanced and dangerous stages of the disease.Therefore, if you observe any of the following, you are advised to consult a gastroenterologist
.

Minimal manifestations of cholelithiasis:

• heaviness in the abdomen (heaviness in the right hypochondrium)
• belching
• nausea
• constipation
• flatulence

Cholelithiasis develops slowly over the years. Her symptoms gradually increase. For several years, you may feel heaviness in the right hypochondrium after eating (especially when eating fatty, fried meat, smoked, salted, pickled foods, as well as wine).In the future, nausea, vomiting and a sharp sharp cramping pain in the right hypochondrium – hepatic colic can join the unpleasant sensations.

If you observe a similar situation in yourself – do not put your health at risk and do not expect complications – contact a gastroenterologist
.

Serious manifestations of gallstone disease

This can be severe pain in the upper abdomen, accompanied by nausea and vomiting that does not bring relief (biliary or hepatic colic).

To the above symptoms may be added: jaundice (mucous membranes and skin are stained yellow), itching, a change in urine color to a darker one, lightening of feces (blockage of the common bile duct by a stone is the most common complication of biliary colic)

If you experience these symptoms, it is possible to assume with a high probability: gallstone disease at an advanced stage.

The described complications require surgical intervention, because lead to death.

Unfortunately, some of the negative consequences of the disease will last a lifetime – even if you receive the highest quality medical care. After surgery to remove the gallbladder (cholecystectomy), about half of the patients continue to experience pain, nausea, and other unpleasant symptoms. This condition is called postcholecystectomy syndrome (PCES), and it is the task of a gastroenterologist and an ultrasound diagnostician to find the cause of its development. To solve this problem, an ultrasound method is used – dynamic echo-choledochography (ultrasound of the bile ducts).

Do not postpone your visit to your gastroenterologist.

Take care of your health today!

Complications of gallstone disease

Patients often know that they have stones in their gallbladder. However, if the stones do not show any symptoms, or these symptoms appear rarely and do not affect the quality of life, patients prefer not to pay attention to it.

If you do not pay attention to this, the very first attack of biliary colic can lead to very serious complications:

• Obstructive jaundice – stones from the gallbladder enter the ducts and prevent the flow of bile into the duodenum.It is accompanied by sharp, excruciating pain in the upper abdomen, yellowing of the eyes and skin, darkening of urine, lightening of feces. This condition is dangerous because there is stagnation of bile in the system of intrahepatic and extrahepatic bile ducts. Against this background, the liver is affected, and its cells begin to collapse (hepatitis develops). If the stagnation of bile continues for a long time, then this leads to impaired liver function and subsequently to liver failure.
• Choledocholithiasis – the formation of stones in the bile ducts or their entry into the ducts from the gallbladder. A common complication, accompanied by increased pain, nausea, vomiting, which does not bring relief.

Biliary colic is accompanied by the following condition:

• Biliary pancreatitis. The pancreatic duct, through which the enzymes are secreted, connects to the common bile duct and together, through one opening (large duodenal papilla), flow into the duodenum.The ingress of stones into the common bile duct below the level of the confluence of the pancreatic duct is accompanied by inflammation of the pancreas.
• Stenosing papillitis. This is a cicatricial narrowing of the large duodenal papilla, which most often occurs against the background of its trauma by small stones passing through it. The development of such a complication is accompanied by severe symptoms: frequent pain attacks, possible development of jaundice, pancreatitis, inflammation of the gallbladder and bile ducts.
• Cholangitis. This is an inflammation of the common bile duct. At the same time, intoxication and fever are added to all the above symptoms.
• Cholecystitis. Inflammation of the gallbladder. The most common complication. It is accompanied by acute pain, nausea, vomiting, fever, intoxication

Other complications

When is it necessary to be examined?

1. For chronic diseases of the gastrointestinal tract.
2. If one of your immediate family members suffers from cholelithiasis.
3. With overweight.
4. In case of rapid weight loss (for example, for the purpose of losing weight).
5. In case of improper nutrition (eating food 1-2 times a day, intake of insufficient amount of liquid, preference for fatty, fried, spicy, smoked, salty foods).
6. In case of lipid metabolism disorders (hypercholesterolemia, dyslipidemia).
7. With long-term use of fibrates, hormonal contraceptives.
8. For anatomical abnormalities in the biliary system.
9. For diabetes mellitus, thyroid diseases.
10. After pregnancy and childbirth.

Any of the listed factors is a reason to consult a gastroenterologist-hepatologist. Don’t expect complications.

Diagnosis of gallstones

The first stage of diagnostics:

Consultation of an experienced gastroenterologist-hepatologist who will listen carefully to you, find out the history of the disease, conduct an objective examination, and determine the amount of additional examination required.

Second stage of diagnostics:

Laboratory and instrumental studies:

• general blood and urine analysis
• biochemical blood test
• coprological study
• fibrogastroduodenoscopy

and the shape of the gallbladder, the thickness of its wall, the number of calculi and their size.

The third stage of diagnostics:

Based on the data obtained, the gastroenterologist will provide extended recommendations on diet, maintaining a healthy lifestyle, planned drug therapy, if necessary, refer to a surgeon for consultation.

Such diagnostics in our clinic helps to solve the patient’s questions:

• Determination of the stage of gallstone disease
• Diagnosis and treatment of concomitant diseases
• Based on the results of the study, recommendations will be formed on adherence to a diet, maintaining a correct lifestyle, and planned drug therapy, which will improve well-being and lead to recovery
• determination of indications for surgical treatment

Treatment of gallstone disease

Treatment tactics depend on the stage of the disease

The most effective method of treatment is treatment in the early stages, when the disease can be controlled as non-drug (regimen , diet) and medication.

In the later stages, there is a high risk of developing serious complications that can lead to disability or even death. At these stages, surgical treatment is inevitable.

In stage I of cholelithiasis, the following are shown:

Consultation and supervision of a gastroenterologist-hepatologist, within the framework of which you will receive prescriptions and recommendations:

• for an active lifestyle – physical education contributes to the outflow of bile, eliminating its stagnation, reducing hypercholesterolemia
• to normalize body weight
• to correct endocrine disorders (hypothyroidism, diabetes mellitus, estrogen metabolism disorders, etc.))
• to stimulate the synthesis and secretion of bile acids by the liver, normalize the physicochemical composition of bile.

In the II stage of cholelithiasis, the following are shown:

Consultation and supervision of a gastroenterologist-hepatologist, within which you will receive prescriptions and recommendations:

• for therapeutic nutrition
• for normalizing body weight, combating hypodynamia
• for correcting lipid exchange
• on medication dissolution of stones with the help of bile acid preparations

In the III stage of gallstone disease, the following are shown:

Consultation and supervision of a gastroenterologist-hepatologist, within which you will receive prescriptions and recommendations:

• on therapeutic nutrition and weight normalization body
• for the correction of lipid metabolism and drug dissolution of stones
• for the relief of an attack of biliary colic

Decision of the issue of surgical treatment – in the course of a joint consultation of a gastroenterologist-hepatologist and a surgeon.

Stage VI of cholelithiasis – surgical treatment

To prescribe surgical treatment, a joint consultation with a surgeon and a gastroenterologist-hepatologist is required. During this consultation, the tactics of such treatment will be developed and issues related to preparation for treatment will be resolved.

Indications for surgical treatment of patients with gallstones are:

• acute calculous cholecystitis
• stones of the common bile duct
• gangrene of the gallbladder
• intestinal obstruction
• chronic calculous cholecystitis with dysfunctional gallbladder

The operation is also indicated in cases where early clinical symptoms of calculous cholecystitis (colic, fever, absence of stable remission in the intervals between attacks) join.

Currently, the following types of treatment are used:

• open and laparoscopic cholecystectomy
• choledystolithotomy
• cholecystostomy
• papillosphincterotomy

The choice of treatment tactics is determined by the coordination of actions between the gastroenterologist and the hepatologist surgeon.

Stages of treatment in stage IV of gallstone disease

Non-surgical stage

A gastroenterologist takes care of the patient from the moment the very first asymptomatic signs of the disease are detected.

Why is the decision to remove the bladder made by the gastroenterologist together with the surgeon?

At the Polyclinic EXPERT, a joint consultation of a surgeon and a gastroenterologist is held and further tactics are jointly determined.

Only a gastroenterologist has complete information about the state of the patient’s gallbladder. When prescribing treatment (including the appointment for a surgical operation), such factors are taken into account as:

• clinical manifestations
• duration of the disease and its stage
• size of stones, their number, the factor of the presence of stones in the gallbladder ducts
• the number of biliary colic in the anamnesis, the presence of complications and concomitant pathology

After clarifying all the above factors, it is possible to determine the tactics of treating a particular patient.

Surgical stage

Removal of the gallbladder is performed in a planned or emergency manner.

Routine surgical treatment

It is carried out after appropriate preoperative preparation, relief (suspension) of complications of cholelithiasis with the help of conservative therapy. The purpose of preparation is to adapt the patient’s body to the upcoming operation (to remove inflammation in the gallbladder). In this case, the removal of the gallbladder will take place with minimal consequences for the patient (the risk of postoperative complications is greatly reduced).

On an emergency basis

Operations are performed in case of complications of gallstone disease, which, without urgent intervention, will lead to death. This type of intervention is considered the most traumatic for the body and recovery may take longer.

When deciding on a planned surgical treatment, a gastroenterologist conducts a stage of preoperative preparation.

Preparation minimizes the risks of complications and facilitates the course of surgical intervention, traumatic for the body.

Post-surgical stage

Patient support after surgery.

Periodic examinations are recommended, during which the gastroenterologist monitors the patient’s condition and the activity of the disease. This will allow the doctor to adjust the treatment in time when post-surgical complications appear.

Why do you need the help of a gastroenterologist at the postoperative stage?

First of all, a specialist:

• will stop the development of complications of the postoperative stage (by medication)
• will help the patient to adapt to life without a gallbladder
• will make an individual diet for the patient
• will give recommendations regarding the lifestyle
• with the help of planned diagnostics will be monitor the patient’s condition.In case of recurrence of complications, the gastroenterologist will prescribe appropriate treatment.

With a removed gallbladder, the patient needs
constant regular monitoring,
as this affects the quality of his life.

Without the help of a gastroenterologist or if his recommendations are not followed, the life of a patient with postcholecystectomy syndrome can turn into a hellish series of diarrhea and unbearable abdominal pain.

In order not to get into a wave of complications and next problems, these patients should not forget about the need for constant regular monitoring of a gastroenterologist.

If, after surgical treatment, symptoms of gallstones persist, then this is an alarming sign, in which it is necessary to consult a gastroenterologist as soon as possible. Most often this is due to the already developed complications of cholelithiasis and requires timely diagnosis and proper treatment.

If the surgery is performed on time (not for emergency indications, before serious complications develop), then there will be no discomfort. However, this does not mean that after the operation there is a cure for gallstone disease.Therefore, in order to prevent the re-formation of stones, only not in the gallbladder, but in the bile ducts, it is necessary to be observed by a gastroenterologist, undergo an annual examination, primarily an ultrasound examination of the bile ducts (dynamic echo-choledochography) and, if necessary, conduct courses therapy.

Consequences after removal of the gallbladder

Why do you need the help of a gastroenterologist at this stage?

Postcholecystectomy syndrome may develop after cholecystectomy (removal of the gallbladder).

Occurs in 10-30% of patients who have undergone surgery. This syndrome greatly affects the patient’s quality of life. For example, improper food intake provokes severe bouts of diarrhea and abdominal pain. People suffering from postcholecystectomy syndrome have to follow a strict diet and adjust their rhythm of life to it.

At this stage, the help of a gastroenterologist will greatly facilitate the patient’s life. However, compliance with all the doctor’s recommendations, in any case, requires enormous efforts from the patient
throughout his life.

More about postcholecystectomy syndrome

The development of postcholecystectomy syndrome is influenced by many factors, including the timeliness and quality of surgical treatment.

Postcholecystectomy syndrome includes functional disorders, organic lesions associated with a relapse of the disease or with concomitant diseases (chronic pancreatitis, peptic ulcer disease). Most often, it is manifested by persistent pain, sometimes nausea, bloating, belching, a bitter taste in the mouth, heartburn, diarrhea.

There is a very high risk of developing this syndrome in those who had a complicated course of cholelithiasis, and were operated on against the background of an inflammatory process on an emergency basis for health reasons. Moreover, the syndrome is organic in nature, and it is usually not easy to find an adequate therapy to eliminate disturbing symptoms. To find out the exact reason for the development of PCES, dynamic echo-choledochography (ultrasound of the bile ducts) is used as the start of the examination.

If the removal of the gallbladder occurs in a planned manner, after appropriate preoperative preparation, then the chance of developing postcholecystectomy syndrome is sharply reduced.And if disturbing symptoms arise, then most likely they will be functional in nature, proceed more favorably and, if all the recommendations of the gastroenterologist are followed, will not affect the well-being and quality of life.

Why is it recommended to treat gallstone disease at the EXPERT Polyclinic?

What you get by contacting us:

• effective and safe treatment
• modern diagnostic equipment
• gastroenterologists of the highest category, specializing in the treatment of this type of disease.
• Joint consultation with a surgeon and a gastroenterologist
• Individual treatment program, in accordance with the condition of the disease and the characteristics of your body

When treating gallstone disease, the curator of the Polyclinic EXPERT is ready to accompany you at all stages of treatment. Starting from the initial consultation, ending with the period of post-surgical intervention, you can always count on the help and support of a curator.

Prognosis

The prognosis for cholelithiasis depends on many factors, including possible complications.There are rare cases of spontaneous recovery, when an attack of biliary colic ends with the release of a small stone into the intestinal lumen. As a rule, the prognosis is favorable and depends on a timely visit to a gastroenterologist-hepatologist, adequate conservative therapy or the quality of surgical treatment.

Prevention and lifestyle recommendations

1. Compliance with the regime, diet: eating every 3-4 hours, exclude long periods of fasting, drink enough fluids per day.A dietitian doctor will help you draw up the correct nutrition program.
2. Avoid fatty and fried foods, smoked foods, strong alcohol.
3. Include dietary fiber in the diet.
4. Leading an active lifestyle, physical education.
5. Bring body mass index back to normal.
6. Do not lose weight quickly, do it gradually.
7. If possible, exclude the use of drugs that promote stone formation (oral contraceptives, antibiotics, fibrates).
8. If you have diabetes, try to keep it at the stage of compensation.

Diet Recommendations

1. Sugar is a source of endogenous cholesterol and should be avoided.
2. Increase the amount of protein balanced in amino acid composition.
3. Increase the consumption of vegetable proteins: oat and buckwheat groats, seaweed.
4. Accustom yourself to a regular diet of plant fiber.
5. Avoid the consumption of legumes, animal fats, coffee.
6. Neglecting breakfast increases the risk of developing gallstone disease.
7. Vitamins E and C reduce the likelihood of gallstone formation.

Unfortunately, in order to forget about gallstone disease at later stages, it is not enough just to follow the correct regimen and diet. Any doctor will tell you that “this is just an adjunctive therapy, not a primary treatment.”

If you have:

Nothing hurts.Accidentally revealed a deformity in the gallbladder

Deformation of the gallbladder often refers to anatomical features and can be asymptomatic for a long time. At the same time, there may be a violation of the outflow of bile from the gallbladder, oversaturation of bile with cholesterol, the formation of sediment, putty bile, the formation of biliary sludge, which is the most important condition for the formation of gallstones. Over time, complaints may appear:

• for intermittent discomfort or dull pain in the right hypochondrium
• bitterness in the mouth
• flatulence
• unstable stool with a tendency to diarrhea.

In this case, an active lifestyle, exercise, normalization of body weight is recommended. It is necessary to consult a gastroenterologist in order to select drug therapy (if necessary), recommendations for proper nutrition, and further monitoring.

Nothing hurts. Flakes, thick bile, biliary sludge in the gallbladder were accidentally detected

In about half of the patients, biliary sludge does not cause any symptoms and is detected only by ultrasound of the gallbladder.Many patients do not attach importance to this pathology and do not go to the doctor. Meanwhile, the long-term existence of biliary sludge in more than half of patients may be complicated by biliary pancreatitis, dysfunction or stenosis of the sphincter of Oddi, acute cholecystitis, cholangitis, and gallbladder shutdown. Gallstones form in 20%. To prevent the development of gallstone disease and complications, it is recommended to consult a gastroenterologist-hepatologist in a timely manner. As a result, the causes that contribute to the formation of biliary sludge and the development of complications will be identified and eliminated.

There are complaints. Revealed deformation of the gallbladder, flakes, thick bile, biliary sludge in the gallbladder

In case of complaints, it is often not enough to do with recommendations for lifestyle changes, moderate physical activity, normalization of body weight. It is necessary to consult a gastroenterologist in order to select drug therapy that will improve the excretion of bile from the gallbladder, relieve pain, prevent the formation of gallstones and the development of complications in the future, and, as a result, will avoid surgical treatment in advanced cases.

Stones have been identified for a long time, but nothing worries

Latent (asymptomatic) stone carriage requires long-term observation by a gastroenterologist-hepatologist:

• to determine the indications for chenotherapy – drug dissolution of calculi using bile acids (in the presence of cholesterol stones) 900
• for ultrasound, which will determine the size and shape of the gallbladder, the thickness of its wall, the number of calculi and their size
• to determine the dynamics of these indicators over time

If necessary, a joint consultation with a surgeon is carried out and indications for surgical treatment are determined.

There are complaints. Identified stones in the gallbladder

Immediately consult a gastroenterologist, at which the specialist will determine:

• indications for drug dissolution of stones
• will select therapy in order to stop the patient’s complaints
• will identify metabolic disorders underlying stone formation.

The success of conservative therapy of cholelithiasis is determined by strict adherence to recommendations, the correct selection of litholytic therapy.The effectiveness of treatment is monitored by a gastroenterologist-hepatologist using an ultrasound scan, which must be carried out during the entire course of treatment. After the end of the drug course of dissolution of calculi, in rare cases, a relapse of stone formation is possible. Therefore, for the prevention of relapse, the gastroenterologist forms supportive and preventive therapy.

Severity, discomfort, pain in the “spoon” and in the right hypochondrium

These complaints are rather nonspecific and can be present in diseases of the liver, pancreas, stomach, duodenum, gallbladder (including cholelithiasis).

If you are worried about the severity, discomfort, pain in the “spoon” and in the right hypochondrium, you need to seek help from a gastroenterologist-hepatologist who:

• will find out the history of the disease
• will conduct objective studies
• will determine the amount of additional examination required

There are stones, there was 1 colic

Mandatory supervision of a gastroenterologist-hepatologist:

• to prescribe the necessary treatment
• to control the situation and constant observation

This simple measure:

• reduces the risk of recurrent colic
• prevents the development diseases and complications

There are stones, there were 2 colic

Repeated biliary colic, recurrent course of the disease increases the risk of complications and the risk of death by almost 4 times.

In this case, compulsory observation of a gastroenterologist-hepatologist doctor together with a surgeon is shown:

• to determine treatment tactics
• , if necessary, to resolve the issue of surgical treatment

It is necessary to remove the gallbladder – what to do?

In preparation for elective cholecystectomy, a joint consultation of a gastroenterologist-hepatologist and a surgeon is required:

• to determine the presence of indications and contraindications for surgery
• , if necessary, to plan an additional examination

a number of instrumental and laboratory tests that are included in the standard of examination before surgery.

The gallbladder has already been removed. Do I need a doctor’s supervision, and which specialist to see?

The gallbladder is an important organ of the gastrointestinal tract. In its absence, the following are often observed:

• change in hormonal function
• change in concentration function
• disorders associated with changed conditions of food assimilation in the intestine.

This leads to impaired motility and secretory function of the stomach, ulcerative lesions of the stomach or duodenum, duodenitis, pancreatitis, intestinal lesions, impaired metabolism of fat-soluble vitamins, protein and carbohydrate metabolism, fat metabolism and calcium metabolism.

Patients who have undergone cholecystectomy (that is, surgical removal of the gallbladder) need constant supervision by a gastroenterologist-hepatologist.

In most cases, removal of the gallbladder does not relieve the patient of metabolic disorders underlying stone formation. The separated bile contains many cholesterol crystals, remains thick and viscous. After the operation, the pathological processes underlying the gallstone disease proceed under new conditions: due to the absence of the gallbladder, the physiological function performed by it is no longer possible, the motility of the biliary tract is impaired, the regulation of the processes of bile formation and biliary excretion is absent.

The loss of the physiological role of the gallbladder, namely the lack of concentration of bile in the interdigestive period and its release into the duodenum during meals, is accompanied by impaired excretion of bile and indigestion. A change in the chemical composition of bile and its chaotic entry into the duodenum disrupts the digestion and absorption of lipids, reduces the bactericidal properties of the intestinal contents, which leads to microbial seeding of the duodenum, weakening the growth of normal intestinal microflora.

In this regard, the patient may be disturbed by:

• nausea
• vomiting
• heartburn
• bitterness in the mouth
• flatulence
• unstable stools
• constipation
• frequent loose stools
• abdominal pain

Excessive growth in the intestine leads to disturbances in protein, carbohydrate and fat metabolism, calcium metabolism and fat-soluble vitamins. This leads:

• to frequent profuse diarrhea
• to a decrease in body weight
• to osteoporosis (disorders of bone mineralization)
• to vitamin deficiencies, which are manifested by loss of skin elasticity, fine wrinkles, peeling, depigmentation, dry skin, lip lesions (hyperemia , swelling, peeling, cracking and crusting, getting wet in the corners of the mouth), tongue damage (ulceration of the papillae, cracking), damage to the gums (loosening and bleeding, loosening of teeth fixation and loss of teeth)

At least once every 4 months – with such a frequency, it is recommended to regularly observe a gastroenterologist-hepatologist and conduct ultrasound of the bile ducts (dynamic echo-choledochography) after cholecystectomy in order to early diagnose possible complications.

A year after removal of the gallbladder, the previous symptoms appeared: pain in the right side, nausea, loose stools

In patients after removal of the gallbladder, the existing clinical manifestations can be associated with a variety of factors:

• change in the chemical composition of bile
• impaired excretion bile into the duodenum
• impaired motility of the biliary tract
• excessive growth of pathogenic microflora in the intestine
• impaired digestion of food, absorption of nutrients

echo-choledochography)

• subject examination
• complex treatment
• further long-term observation

Treatment histories

History No. 1

Patient T., 42 years old, turned to the EXPERT Clinic to a gastroenterologist with complaints of decreased appetite, nausea, bitterness in the mouth, heaviness and pain in the right hypochondrium after eating.

From the anamnesis of the disease it is known that after giving birth 15 years ago, she gained 23 kg in body weight, eats irregularly, loves sweet and fatty foods. For the last 3 years, he has been taking hormonal contraceptives. From the anamnesis of life it was possible to find out that the mother and grandmother of the patient suffer from cholelithiasis (cholelithiasis). Both were operated on.

When examining the patient, attention was drawn to grade 2 obesity, non-intense pain on palpation of the right hypochondrium, lining of the tongue. In the course of the consultation, an ultrasound scan of the abdominal organs was carried out, where it was established that a single cloud-like formation occupying 1/3 of the volume of the gallbladder with its compaction

Lifestyle after removal of the gallbladder / Blog / Clinic EXPERT

Frequently asked questions

Is disability after removal of the gallbladder?

According to the criteria established by the medical community, the absence of a gallbladder itself is not an indication for assigning disability, i.e.because it does not interfere with work and mental activity. In the event that the patient’s work is associated with heavy physical labor or high mental and emotional stress, he may be recommended to facilitate working conditions.

Disability after removal of cholecystectomy can be attributed if complications occur during or after surgery.

To obtain a disability group, you must apply for a medical and social examination (ITU).

Can the liver hurt after removing the gallbladder?

The liver itself does not hurt – there are no nerve endings in it that are responsible for feeling pain.If you are experiencing pain and discomfort in the right hypochondrium, this is probably the aftermath of gallbladder surgery, which should go away within a week.

If the symptoms persist, this may indicate the development of postcholecystectomy syndrome (PCES), with which it is recommended to consult a gastroenterologist.

Is it ok to have sex?

Sexual activity, like sports, is characterized by a wide range of possible physical and physiological stresses.After successful completion of postoperative recovery, patients can return to normal sex life. However, it should be remembered that certain positions during intercourse, involving lifting a partner or squeezing the abdominal area, should be used carefully and within reasonable limits.

Is it possible to carry a pregnancy after removing the gallbladder?

Planning a pregnancy should not be earlier than 3-6 months after a successful operation. During this period, the body will regain strength and it will become clear whether there are negative consequences after the intervention.

In any case, pregnancy, childbirth, hormonal changes are risk factors for the formation of new stones. During and after gestation, it is necessary to pay special attention to the nutrition of the expectant mother, it is advisable to be under the supervision of a gastroenterologist and a nutritionist, to do preventive ultrasound of the bile ducts.

Is it ok to lift weights?

This depends primarily on the type of operation performed. With less invasive laparoscopic gallbladder removal, the restrictions on weight lifting in the postoperative period are less significant: do not lift weights above 9-10 kg in the first 4-6 weeks.For open surgery to remove the gallbladder, the weight limit is 5-6 kg.

After the end of the recovery period, you can try to lift more significant weights, but you need to listen to your well-being. If you feel discomfort in the abdomen, then you should stop lifting weights and consult a doctor.

Is a cold immediately after surgery dangerous?

A common cold, acute respiratory infections or acute respiratory viral infections can affect any person, and the patient’s body after removal of the gallbladder is especially vulnerable, since his immunity is reduced in the first weeks after surgery and general anesthesia.That is why, for the prevention of colds, it is important to avoid hypothermia, drafts and follow the regimen prescribed by the doctor.

The danger is that some people may develop postoperative pneumonia after surgery. The symptoms of this disease in the initial stages resemble the common cold. If symptoms similar to a cold occur after the operation, but then the temperature rises significantly (above 38 ° C), you should immediately consult your doctor.

The same should be done in cases when the temperature of 37.1-38 ° C lasts for several days or colds symptoms gradually worsen.

Is it possible to take hot baths, go to the bathhouse and when?

An increase in body temperature in a hot bath or steam bath increases blood flow and inflammation, if any. You can wash in warm and hot water 3-4 weeks after removing the stitches – with care, not being exposed to high temperatures for longer than necessary.

You need to be careful:

• to warm up only until the first sweat
• to control your well-being
• prefer a wet bath to a dry sauna.

Can I smoke and drink alcohol after removing the gallbladder?

Try to give up cigarettes or at least reduce their number as much as possible. Nicotine is one of the factors in the formation of new stones in the bile ducts. In addition, immunity is weakened after any surgery, and the risk of complications becomes higher.To avoid postoperative pneumonia, smokers are advised to stop using nicotine products, including gum and nicotine patches, at least two weeks before surgery.

The same applies to the consumption of alcoholic beverages. Drinking alcohol during the postoperative recovery period can lead to an increased risk of complications such as diarrhea, increased liver enzymes in the blood, and slower recovery.

How does the lifestyle change after removal of the gallbladder?

The lifestyle does not change dramatically after the recovery period, therefore after 1 month, as well as after 2, 3, 4, 5, 6 months, after a year or two, the main thing is to adhere to the general recommendations.

Major changes after cholecystectomy focus on diet and exercise . They should be gentle and introduced gradually and carefully. In case of alarming manifestations, you should immediately consult your doctor. It is a good idea to keep a diary to track the body’s response to specific innovations.

It is important not to spur the body, but gradually and carefully introduce new elements into your routine that heal and strengthen the body in new realities. It is useful to actively practice the most gentle and harmonious sports that improve metabolism and reduce stress (yoga, Nordic walking, swimming). The digestive system is sensitive to stress levels, so it is important to avoid extreme emotional stress, master various methods of protection against overwork (autogenous training, breathing techniques) or seek help from a psychotherapist.

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 engaged in home self-medication.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 the 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 basic 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 constant 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.

Do you have symptoms of gallstone disease?

Only a doctor can accurately diagnose the disease.
Do not delay the consultation – call

+7 (495) 775-73-60

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 tension in the muscles of a person, this is very important if the area of ​​the gallbladder is being examined.

In the presence of a real disease, a specialist can notice yellowness on the skin of the xanthemum, 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 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 refers to 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 be tested, 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 automatically begins in the human body.These peculiar hard flakes, as shown by the results of the analysis, together with the development of the disease, turn into stones. 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 in 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 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 has no 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.

Doctors 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.

Reading

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, perform physical activity, 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;

90,035 a person with a genetic predisposition to gallstone disease needs to visit a doctor periodically.

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 work. If 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.

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.