Can gallstones disappear on their own. Gallstones: Causes, Symptoms, and Treatment Options Explained
Can gallstones disappear on their own. What are the main types of gallstones. How are gallstones diagnosed and treated. What complications can arise from untreated gallstones. How can you prevent gallstone formation.
Understanding Gallstones: Formation and Types
Gallstones are solid masses that form in the gallbladder, a small organ located beneath the liver. These stones can vary in size, ranging from tiny grains of sand to golf ball-sized formations. The gallbladder’s primary function is to store and release bile, a fluid produced by the liver to aid in digestion. When certain substances in bile, such as cholesterol and bilirubin, accumulate excessively, they can crystallize and form gallstones.
There are two main types of gallstones:
- Cholesterol stones: These yellow-green stones account for approximately 80% of all gallstones. They form when there’s an excess of cholesterol in the bile that cannot be dissolved.
- Pigment stones: Smaller and darker in color, these stones are composed of bilirubin, a substance produced when the body breaks down red blood cells.
Do gallstones always cause symptoms? Not necessarily. Many people with gallstones remain asymptomatic for years. However, when these stones block a bile duct, they can cause severe pain and require immediate medical attention.
Recognizing Gallstone Symptoms: When to Seek Help
While some individuals may have gallstones without experiencing any symptoms, others may encounter various signs that indicate the presence of these formations. Common symptoms of gallstones include:
- Sudden, intense pain in the upper right abdomen or center of the abdomen
- Pain that radiates to the right shoulder or between the shoulder blades
- Nausea or vomiting
- Fever or chills
- Jaundice (yellowing of the skin and eyes)
- Clay-colored stools
When should you seek immediate medical attention for gallstone symptoms? If you experience severe abdominal pain lasting more than a few hours, high fever with chills, or yellowing of your skin and eyes, it’s crucial to consult a healthcare professional promptly. These symptoms may indicate a serious infection or inflammation that requires urgent treatment.
Gallstone Causes and Risk Factors: Who’s Most Susceptible?
The exact causes of gallstone formation are not fully understood, but several factors contribute to their development:
- Excess cholesterol in bile: When the liver produces more cholesterol than the bile can dissolve, the excess can form into crystals and eventually stones.
- High levels of bilirubin: Certain conditions like liver cirrhosis, infections, or blood disorders can lead to increased bilirubin production, promoting stone formation.
- Incomplete gallbladder emptying: If the gallbladder doesn’t empty completely, bile can become overly concentrated, increasing the risk of stone formation.
Are certain individuals more prone to developing gallstones? Yes, several risk factors increase the likelihood of gallstone formation:
- Being female, especially those who are pregnant, use hormone replacement therapy, or take birth control pills
- Being over 40 years old
- Being overweight or obese
- Consuming a diet high in fat and cholesterol but low in fiber
- Rapid weight loss or fasting
- Family history of gallstones
- Certain medical conditions like diabetes or sickle cell anemia
Understanding these risk factors can help individuals take proactive steps to reduce their chances of developing gallstones.
Diagnosing Gallstones: Advanced Imaging Techniques
Accurate diagnosis of gallstones is crucial for proper treatment. Healthcare providers employ various diagnostic tools and techniques to identify and assess gallstones:
- Blood tests: These can detect signs of infection, inflammation, or bile duct blockage.
- Ultrasound: This non-invasive imaging technique uses sound waves to create images of the gallbladder and surrounding structures.
- CT scan: Specialized X-rays provide detailed cross-sectional images of the abdomen, including the gallbladder.
- Magnetic Resonance Cholangiopancreatography (MRCP): This advanced MRI technique produces detailed images of the bile and pancreatic ducts.
- Cholescintigraphy (HIDA scan): A radioactive tracer is used to evaluate gallbladder function and detect any blockages.
- Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure combines endoscopy and X-rays to examine the bile ducts and can also be used for stone removal.
- Endoscopic ultrasound: A combination of endoscopy and ultrasound provides high-resolution images of the gallbladder and surrounding tissues.
How do these diagnostic methods help in treatment planning? By providing detailed information about the size, number, and location of gallstones, these techniques enable healthcare providers to determine the most appropriate treatment approach for each patient.
Treatment Options for Gallstones: From Medication to Surgery
The treatment of gallstones depends on the severity of symptoms and the individual’s overall health. Here are the main approaches to managing gallstones:
Watchful Waiting
For asymptomatic gallstones, a “wait and see” approach may be recommended. Regular monitoring ensures that any developments are caught early.
Medications
In some cases, medications like ursodeoxycholic acid (Ursodiol) may be prescribed to dissolve small cholesterol stones. However, this approach can take months or years and is not always effective.
Surgical Interventions
For symptomatic gallstones, surgical removal of the gallbladder (cholecystectomy) is often the preferred treatment. Two main surgical approaches are used:
- Laparoscopic cholecystectomy: A minimally invasive procedure using small incisions and a camera-guided instrument to remove the gallbladder.
- Open cholecystectomy: A traditional surgery involving a larger incision to remove the gallbladder, typically reserved for more complex cases.
Can you live without a gallbladder? Yes, the body can adapt to the absence of a gallbladder, with the liver taking over the function of releasing bile directly into the small intestine.
ERCP for Bile Duct Stones
For gallstones that have migrated into the bile ducts, Endoscopic Retrograde Cholangiopancreatography (ERCP) may be used to remove the stones before or during gallbladder surgery.
What factors determine the choice of treatment? The size and number of gallstones, their location, the severity of symptoms, and the patient’s overall health all play a role in determining the most appropriate treatment approach.
Complications of Untreated Gallstones: Understanding the Risks
While some gallstones may remain asymptomatic, untreated symptomatic gallstones can lead to serious complications:
- Acute cholecystitis: Inflammation of the gallbladder due to blockage, causing severe pain and fever.
- Choledocholithiasis: Stones lodged in the common bile duct, potentially leading to jaundice and liver damage.
- Pancreatitis: Inflammation of the pancreas caused by a gallstone blocking the pancreatic duct.
- Cholangitis: Infection of the bile ducts, which can be life-threatening if left untreated.
- Gallbladder cancer: Although rare, long-standing gallstone disease may increase the risk of gallbladder cancer.
How quickly can gallstone complications develop? While some complications may develop gradually, others, such as acute cholecystitis or cholangitis, can occur suddenly and require immediate medical attention.
Preventing Gallstones: Lifestyle Modifications for Reduced Risk
While not all gallstones can be prevented, certain lifestyle changes can help reduce the risk of their formation:
- Maintain a healthy weight: Obesity increases the risk of gallstones, so maintaining a healthy BMI is crucial.
- Gradual weight loss: Rapid weight loss can increase the risk of gallstones. Aim for slow, steady weight loss of 1-2 pounds per week.
- Balanced diet: Consume a diet rich in fiber, fruits, vegetables, and whole grains while limiting high-fat and high-cholesterol foods.
- Regular exercise: Engaging in regular physical activity can help maintain a healthy weight and reduce the risk of gallstone formation.
- Stay hydrated: Drinking plenty of water throughout the day can help keep bile from becoming too concentrated.
- Limit alcohol consumption: Excessive alcohol intake can increase the risk of gallstone formation.
Can dietary supplements help prevent gallstones? Some studies suggest that vitamin C, coffee, and moderate alcohol consumption may have protective effects against gallstone formation, but more research is needed to confirm these findings.
Living with Gallstones: Management and Long-term Outlook
For individuals diagnosed with gallstones, understanding how to manage the condition and what to expect in the long term is crucial:
Dietary Considerations
While there’s no specific “gallstone diet,” some dietary modifications may help manage symptoms:
- Reduce fat intake, especially saturated and trans fats
- Increase fiber consumption
- Eat smaller, more frequent meals to reduce the demand on the gallbladder
- Stay hydrated to help maintain proper bile flow
Monitoring and Follow-up
Regular check-ups with a healthcare provider are essential for individuals with gallstones, even if they’re asymptomatic. This allows for early detection of any changes or complications.
Pain Management
For those experiencing gallstone pain, over-the-counter pain relievers like ibuprofen or acetaminophen may provide temporary relief. However, persistent or severe pain should be evaluated by a medical professional.
Post-surgery Adjustments
After gallbladder removal, most individuals can return to their normal diet and activities. However, some may experience temporary digestive changes, such as diarrhea or bloating, which usually resolve over time.
What is the long-term prognosis for individuals with gallstones? For those who undergo gallbladder removal, the prognosis is generally excellent, with most people experiencing complete resolution of symptoms. However, a small percentage may develop new stones in the bile ducts, requiring additional treatment.
In conclusion, understanding gallstones – their causes, symptoms, and treatment options – is crucial for anyone at risk or currently dealing with this condition. By recognizing the signs early, seeking appropriate medical care, and making necessary lifestyle changes, individuals can effectively manage gallstones and minimize their impact on overall health and well-being. Remember, while gallstones can be a challenging health issue, with proper care and management, most people can lead normal, healthy lives free from gallstone-related complications.
Picture, Symptoms, Types, Causes, Risks, Treatments
What Are Gallstones?
Gallstones are pieces of solid material that form in your gallbladder, a small organ under your liver. If you have them, you might hear your doctor say you have cholelithiasis.
Your gallbladder stores and releases bile, a fluid made in your liver, to help in digestion. Bile also carries wastes like cholesterol and bilirubin, which your body makes when it breaks down red blood cells. These things can form gallstones.
Gallstones can range from the size of a grain of sand to that of a golf ball. You might not know that you have them until they block a bile duct, causing pain that needs treatment right away.
Gallstone Types
The two main kinds of gallstones are:
- Cholesterol stones. These are usually yellow-green. They’re the most common, making up 80% of gallstones.
- Pigment stones. These are smaller and darker. They’re made of bilirubin. .
Signs and Symptoms of Gallstones
Symptoms may include:
See your doctor or go to the hospital if you have signs of a serious infection or inflammation:
Causes of Gallstones
Doctors aren’t sure exactly what causes gallstones, but they might happen when:
- There’s too much cholesterol in your bile. Your body needs bile for digestion. It usually dissolves cholesterol. But when it can’t do that, the extra cholesterol might form stones.
- There’s too much bilirubin in your bile. Conditions like cirrhosis, infections, and blood disorders can cause your liver to make too much bilirubin.
- Your gallbladder doesn’t empty all the way. This can make your bile very concentrated.
Gallstone Risk Factors
You’re more likely to get gallstones if you:
Gallstone Diagnosis
Your doctor will do a physical exam and might order tests including:
Blood tests. These check for signs of infection or blockage, and rule out other conditions.
Ultrasound. This makes images of the inside of your body.
CT scan. Specialized X-rays let your doctor see inside your body, including your gallbladder.
Magnetic resonance cholangiopancreatography(MRCP). This test uses a magnetic field and pulses of radio wave energy to make pictures of the inside of your body, including your liver and gallbladder.
Cholescintigraphy (HIDA scan). This test can check whether your gallbladder squeezes correctly. Your doctor injects a harmless radioactive material that makes its way to the organ. A technician can then watch its movement.
Endoscopic retrograde cholangiopancreatography (ERCP). Your doctor runs a tube called an endoscope through your mouth down to your small intestine. They inject a dye so they can see your bile ducts on a camera in the endoscope. They can often take out any gallstones that have moved into the ducts.
Endoscopic ultrasound. This test combines ultrasound and endoscopy to look for gallstones.
Gallstone Treatment
You don’t need treatment if you don’t have any symptoms. Some small gallstones can pass through your body on their own.
Most people with gallstones have their gallbladders taken out. You can still digest food without it. Your doctor will use one of two procedures.
Laparoscopic cholecystectomy. This is the most common surgery for gallstones. Your doctor passes a narrow tube called a laparoscope into your belly through a small cut. It holds instruments, a light, and a camera. They take out your gallbladder through another small cut. You’ll usually go home the same day.
Open cholecystectomy. Your doctor makes bigger cuts in your belly to remove your gallbladder. You’ll stay in the hospital for a few days afterward.
If gallstones are in your bile ducts, your doctor may use ERCP to find and remove them before or during surgery.
If you have another medical condition and your doctor thinks you shouldn’t have surgery, they might give you medication instead. Chenodiol (Chenodol) and ursodiol (Actigall, Urso 250, Urso Forte) dissolve cholesterol stones. They can cause mild diarrhea.
You may have to take the medicine for years to totally dissolve the stones, and they may come back after you stop taking it.
Complications of Gallstones
Gallstones can cause serious problems, including:
- Gallbladder inflammation (acute cholecystitis). This happens when a stone blocks your gallbladder so it can’t empty. It causes constant pain and fever. Your gallbladder might burst, or rupture, if you don’t get treatment right away.
- Blocked bile ducts. This can cause fever, chills, and yellowing of your skin and eyes (jaundice). If a stone blocks the duct to your pancreas, that organ may become inflamed (pancreatitis).
- Infected bile ducts (acute cholangitis). A blocked duct is more likely to get infected. If the bacteria spread to your bloodstream, they can cause a dangerous condition called sepsis.
- Gallbladder cancer. It’s rare, but gallstones raise your risk of this kind of cancer.
Preventing Gallstones
Some lifestyle changes might lower your risk of gallstones.
- Eat a healthy diet that’s high in fiber and good fats, like fish oil and olive oil. Avoid refined carbs, sugar, and unhealthy fats.
- Get regular exercise. Aim for at least 30 minutes, 5 days a week.
- Avoid diets that make you lose a lot of weight in a short time.
- If you’re a woman at high risk of gallstones (for example, because of your family history or another health condition), talk to your doctor about whether you should avoid the use of hormonal birth control.
Learn to identify Gallstones | Ada
What are gallstones?
Gallstones, also known as symptomatic cholelithiasis, are hard, crystal-like deposits that can form in the gallbladder below the liver. They can range in size from as small as grains of sand to as large as golf balls – although small stones are much more common. In most cases, the stones remain in the gallbladder and do not cause any discomfort.
However, inflammation of the gallbladder wall can occur. This is referred to as cholecystitis. If a gallstone emerges from the gallbladder, it can block the bile duct – thus forcing the bile to overflow from the liver into the intestine. This condition is called choledocholithiasis.
The main symptom of symptomatic gallstones is pain in the upper right or middle part of the abdomen, directly below the ribcage. Usually, the diagnosis can be made quickly if a doctor collects a person’s medical history (anamnesis) and physical examination, as well as laboratory tests, and ultrasound. Treatment depends on the individual case. The overall prognosis is excellent.,,
If you think that you might have gallstones, you can try using the Ada app to find out more about your symptoms.
What are the causes of gallstones?
Gallstones develop when there is an imbalance in the composition of bile. Bile is formed in the liver, stored in the gallbladder, and finally released into the intestine. When someone eats a high-fat meal, the bile is needed to bind the fats from the food.
The majority of gallstones are made mostly of cholesterol and are called cholesterol stones. In these cases, the amount of cholesterol within the bile is too high and causes the formation of a solid stone.
Less commonly, there are also gallstones made up of bilirubin, a breakdown product of red blood cells, and also gallstones caused by an imbalance of bile salts, lecithin, or calcium carbonate.,,
The most important risk factors for the development of gallstones are:
What are the symptoms of gallstones?
In the majority of cases, gallstones do not cause any symptoms or problems. Symptoms typically occur when gallstones cause gallbladder or bile duct blockages. In these cases, the following symptoms may occur:,,
- remitting pain in the upper right part of the abdomen
- fever or chills
- nausea and vomiting
- itchiness
- yellowing of the eyes or skin (jaundice)
- light-colored stools
- dark urine.
If these symptoms occur, you should seek medical assistance as they may be signs of an infection or inflammation of the gallbladder, liver, or pancreas.
Where is the pain located?
The main symptom of gallstones is pain in the upper right or middle part of the abdomen, directly below the ribcage. This pain can occur suddenly and can spread to the arm, right shoulder, back, or chest. Some people experience the pain as sharp and stinging, while for others it can be a deep pain. This is also known as colic or colic-like pain. It is often triggered by a heavy meal and can wake a person up at night.,,,,
The pain is sometimes confused with a heart attack. Gallstone pain usually lasts between half an hour and a few hours. The pain attacks often come in relapses and subside as the stone moves and the blockage dissolves. In some cases, the pain can subside just a few minutes after.,,,,
If you think that you might have gallstones, you can try using the Ada app to find out more about your symptoms.
What is the diagnosis for gallstones?
A doctor will first make an anamnesis, in which the symptoms and the medical history will be inquired. The doctor will then carry out an extensive physical examination. The doctor can press on the upper right part of the abdomen and ask the person to take a deep breath during the examination. Pain may indicate an inflammation of the gallbladder.
After that, some tests are usually carried out to confirm the diagnosis. It is important to rule out other diseases that can sometimes cause similar symptoms, such as appendicitis, gastritis, and kidney stones.,
Diagnostic tests for suspected gallstones may include:,,,,
Blood test
- This is done in order to:
- see if there are any signs of infection or inflammation of the bile ducts, gallbladder, pancreas, or liver .
- check the function of the liver.
Abdominal ultrasound
- a rapid, non-invasive examination using sound waves to confirm the presence of gallstones in the gallbladder
- This is the most commonly used examination method for suspected gallstones.
- Inflammation of the gallbladder can also be detected in this way.
Endosonography
- This is also a procedure that makes use of the advantages of ultrasound technology.
- The device consists of a flexible tube at the end of which an ultrasound probe is attached.
- The examiner first inserts the tube into the mouth and then pushes it forward into the abdomen so that an ultrasound image can be obtained at close range.
- The diagnosis can thus be confirmed.
Endoscopic retrograde cholangiopancreaticography (ERCP)
- This is the preferred method if a stone is suspected to block the bile duct.
- This examination method uses an endoscope.
- The examiner moves the endoscope through the person’s throat and esophagus into the stomach and upper intestines.
- In addition, the examiner can accurately visualize the bile duct using contrast media and if possible, remove the stone in the same session.
CT examination
- This is an imaging procedure in which X-rays are used in several layers in order to:
- confirm the presence of gallstones in the bile system.
- check for possible complications, such as blocked bile ducts and pancreatitis.
MRI examination
- An imaging procedure that uses a strong magnetic field to produce a detailed, three-dimensional image of the body.
Good to know: Gallstones can also be discovered by chance if you are examined for other complaints or as part of a general health check. As long as the gallstones do not cause symptoms, in this case also known as silent gallstones, treatment is usually not recommended. However, a doctor can inform you about symptoms that you should be aware of from that point on.,
How are gallstones treated?
In general, gallstones are usually only treated if they cause discomfort. Only roughly every fourth person who has gallstones without symptoms will develop symptoms within 10 years.,,
If there are complaints, a few general measures are carried out first:
- temporary fasting of food or decreasing intake of fatty foods
- administration of medications that relieve the body’s spasmodic tensions against the blockade caused by the stone
- administration of painkillers.
The following steps depend on the exact location of the gallstone and the problems caused.
Surgery to remove gallstones
The surgical removal of the gallbladder, called a cholecystectomy, is the preferred treatment for symptomatic cholelithiasis – i.e. when gallstones are present and lead to discomfort. It is a common procedure that is considered the most effective way to eliminate symptoms in the long term and to prevent possible complications from gallstones.,
There are two types of gallbladder surgery
Laparoscopic cholecystectomy:
- This is a type of keyhole surgery in which the gallbladder is removed through a small incision in the abdomen.
- In some cases, a person can go home on the same day.
- In other cases, you will need to stay in hospital for a few days of monitoring.
Open cholecystectomy:
- This is an older type of surgery that requires a larger incision in the abdomen to remove the gallbladder.
- This may be necessary if laparoscopy is not advisable or complications occur.
- The recovery time is longer with this type of surgery.
After a gallbladder surgery
You can lead a normal and healthy life without a gallbladder. After the removal of the gallbladder, the bile flows directly from the liver into the intestine via the connecting bile duct, without being temporarily stored in the gallbladder as before. The bile continues to support digestion as usual. In some cases, mild diarrhea or digestive disorders may occur temporarily. The risk of complications from a cholecystectomy is considered low.,,
Endoscopic retrograde cholangiopancreatography (ERCP)
This procedure is the preferred treatment option for bile duct blockage. The examiner moves the endoscope into the abdominal cavity. From there, the examiner can accurately visualize the bile duct using contrast media and if possible, remove the stone in the same session. If there are further gallstones in the gallbladder, surgery is often recommended.,,
Non-surgical treatment options
Non-surgical treatments are usually only recommended if surgery is not possible, e.g. if a different state of health makes surgery non-recommendable. Treatment options may include the following:
Medications containing bile acid: This is an attempt to increase the solubility of bile and thus dissolve gallstones. The treatment period is at least six months. A recurrence of gallstones is common.
Extracorporeal shock wave lithotripsy (ESWL): X-rays that emit shock waves to break gallstones into smaller pieces. Afterwards, medication must be taken to dissolve and excrete the debris. This procedure is rarely used today for gallstone treatment.,,
Good to know: Unfortunately, gallstones usually do not dissolve on their own. It is sometimes possible to dissolve cholesterol stones with certain medications. However, this can take a long time and often does not work. Also the nowadays rarely used method of extracorporeal shock wave lithotripsy, in which gallstones are shattered into smaller pieces (see above), can contribute to the excretion of the stones. But even if the gallstones disappear by these methods, it is likely that new stones will form over time.,,,
What is the prognosis for gallstones?
Most gallstones do not cause any symptoms and don’t require treatment. Whenever symptoms occur, treatment is necessary. However, the overall prognosis is excellent and most people fully recover.
What are the complications of gallstones?
The majority of people with gallstones have no symptoms whatsoever. In these cases, usually no treatment is necessary. Even if symptoms occur, there are low-risk treatment methods available today, which makes the prognosis extremely favorable.
In individual cases, or if no treatment is given for existing complaints, the following complications may occur:,,,
- cholecystitis
- inflammation of the gallbladder
- pancreatitis
- inflammation of the pancreas
- injury and/or infection of the bile ducts
- i.e. the liver, gallbladder and bile ducts
- Inflammation of the bile ducts is referred to as cholangitis.
- intestinal obstruction.
These complications often require emergency treatment. As already mentioned above, medical attention should be sought immediately for the following symptoms:,
- severe, persistent pain in the abdomen
- fever
- chills
- yellowing of the skin or eye whites (jaundice).
Gallstones FAQs
Q: Can gallstones go away without surgery?
A: Unfortunately, gallstones do not usually dissolve on their own. It is sometimes possible to dissolve certain types of gallstones with certain medications. However, this can take a long time and often does not work. Also, the current, yet rarely used method of extracorporeal shock wave lithotripsy, in which gallstones are shattered into smaller pieces, can contribute to the excretion of the stones. But, even if the gallstones disappear by these methods, it is likely that new stones will form over time.,,,
Q: Are gallstones dangerous?
A: In the majority of cases, gallstones do not cause any symptoms or problems. But, you should seek medical attention immediately if the following symptoms are present: severe, persistent pain in the abdomen, fever, chills, or yellowing of the skin or eye whites (jaundice).
Even if symptoms do occur, there are low-risk treatment methods available today, which makes the prognosis extremely favorable. ,
In individual cases, or if no treatment is given for existing complaints, the following complications may occur: cholecystitis (inflammation of the gallbladder) pancreatitis (inflammation of the pancreas), injury and/or infection of the bile ducts, or intestinal obstruction.,,,
Q: Can you pass gallstones naturally?
A: Usually gallstones form in the gallbladder and remain there since it’s very unlikely that they will dissolve. If they pass, there are two things that can happen. Either they get stuck in the duct that connects the gallbladder to the intestine, known as the common bile duct, which leads to symptoms, such as pain. Or if they are small enough and do not get stuck in the duct, then they may cause some temporary pain. However, they will eventually reach the intestine and will be expelled.
Cholecystitis | Johns Hopkins Medicine
What is cholecystitis?
Cholecystitis (pronounced ko-luh-sis-TIE-tis) is a redness and swelling (inflammation) of the gallbladder. It happens when a digestive juice called bile gets trapped in your gallbladder.
The gallbladder is a small organ under your liver. It stores bile which is made in the liver.
Normally bile drains out of your gallbladder and into your small intestine. If the bile is blocked, it builds up in your gallbladder. This causes inflammation and can cause infection.
Cholecystitis can be sudden (acute) or long-term (chronic).
What causes cholecystitis?
Cholecystitis happens when a digestive juice called bile gets trapped in your gallbladder.
In most cases, this happens because lumps of solid material (gallstones) are blocking a tube that drains bile from the gallbladder.
When gallstones block this tube, bile builds up in your gallbladder. This causes irritation and pressure in the gallbladder. It can cause swelling and infection.
The gallbladder stores bile. Gallstones are formed in your gallbladder. They are made from bile.
Other causes of cholecystitis include:
- Bacterial infection in the bile duct system. The bile duct system is the drainage system that carries bile from your liver and gallbladder into the first part of your small intestine (the duodenum).
- Tumors of the pancreas or liver. A tumor can stop bile from draining out of your gallbladder.
- Reduced blood supply to the gallbladder. This may happen if you have diabetes.
- Gallbladder sludge. This is a thick material that can’t be absorbed by bile in your gallbladder. The sludge builds up in your gallbladder. It happens mainly to pregnant women or to people who have had a very fast weight loss.
Cholecystitis can happen suddenly (acute) or it can be long-term (chronic).
What are the symptoms of cholecystitis?
In most cases, an attack of cholecystitis lasts 2 to 3 days. Each person’s symptoms may vary. Symptoms may include:
- Intense, sudden pain in the upper right part of your belly
- Pain (often worse with deep breaths) that spreads to your back or below the right shoulder blade
- Nausea
- Vomiting
- Fever
- Yellowing of the skin and eyes (jaundice)
- Loose, light-colored bowel movements
- Belly bloating
The symptoms of cholecystitis may look like other health problems. Always see your healthcare provider to be sure.
How is cholecystitis diagnosed?
Your healthcare provider will look at your past health and give you a physical exam.
You may also have some blood tests including:
- Complete blood count (CBC). This test measures your white blood cell count. You may have a high white blood cell count if you have an infection.
- Liver function tests. A group of special blood tests that can tell if your liver is working properly.
You may also have imaging tests, including:
- Ultrasound (also called sonography). This test creates images of your internal organs on a computer screen using high-frequency sound waves. It is used to see the liver and gallbladder and check blood flow through different vessels.
- Belly X-ray. This test makes pictures of internal tissues, bones, and organs using invisible electromagnetic energy beams.
- CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. It is more detailed than a regular X-ray.
- HIDA scan (cholescintigraphy or hepatobiliary scintigraphy). This scan checks for any abnormal movements (contractions) of your gallbladder. It also checks for blocked bile ducts. A radioactive chemical or tracer is shot (injected) into your vein. The amount of radiation is very small. It is not harmful. It collects in your liver and flows into your gallbladder. A special scanner watches the tracer move through your organs. You will take medicine to make your gallbladder contract.
- PTC (percutaneous transhepatic cholangiography). A thin needle is put through your skin and into the bile duct in your liver. A dye is then shot (injected) through the needle. The dye lets your bile ducts be seen clearly on the X-rays. A blocked duct will show up on the X-rays.
- ERCP (endoscopic retrograde cholangiopancreatography. This is used to find and treat problems in your liver, gallbladder, bile ducts, and pancreas. It uses X-ray and a long, flexible tube (endoscope) with a light and camera at one end. The tube is put into your mouth and throat. It goes down your food pipe (esophagus), through your stomach, and into the first part of your small intestine (the duodenum). It then goes into your bile ducts. The inside of these organs can be seen on a video screen. A dye is put into your bile ducts through the tube. The dye lets the bile ducts be seen clearly on the X-rays.
How is cholecystitis treated?
You will likely be admitted to a hospital to rest your gallbladder. You may need surgery to remove your gallbladder.
In the hospital your treatment may include:
- Taking bacteria-fighting medicines (antibiotics) to fight the infection
- Taking fluids and pain medicines by IV (through a vein or intravenously)
- Keeping your stomach empty until your symptoms ease
Your symptoms may get better with this treatment.
But if your cholecystitis is caused by gallstones in your gallbladder, your gallbladder will need to be removed. Gallbladder removal (called cholecystectomy) is a common surgery. Your body will work well without your gallbladder. It is not essential for a healthy life.
You may have surgery done right away. If you are too sick to have surgery, a small tube may be put through your skin and into your gallbladder. This will drain the bile and ease your symptoms until you can have surgery.
Other treatment options may include:
- Oral dissolution therapy. Medicines made from bile acid are used to dissolve the stones
- Medicines. These are used to prevent gallstones from forming
- Low-fat diet. When you are allowed to eat food again
What are the complications of cholecystitis?
In some cases cholecystitis can cause other problems including:
- Infection and pus buildup in your gallbladder
- Tissue death in your gallbladder (gangrene)
- Bile duct injury that can affect your liver
- Infection and inflammation of your pancreas (pancreatitis)
- Infection and inflammation of the lining of your belly (peritonitis)
If your gallbladder has not been removed and you have more attacks of cholecystitis, you may develop long-term (chronic) cholecystitis.
Chronic cholecystitis may not cause any symptoms. But it can damage the walls of your gallbladder. The walls can become scarred and get thicker. Your gallbladder will start to get smaller. Over time, it will be less able to store and release bile. You will need surgery to remove your gallbladder.
When should I call my healthcare provider?
Call your healthcare provider right away if:
- You have severe belly pain that won’t go away
- Your cholecystitis symptoms come back after treatment
Key points about cholecystitis
- Cholecystitis is a redness and swelling (inflammation) of the gallbladder.
- It happens when bile becomes trapped and builds up in the gallbladder.
- In most cases this happens when solid lumps (gallstones) block the tube that drains bile from the gallbladder.
- In most cases you will be admitted to a hospital.
- Your gallbladder may need to be removed.
Next steps
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
Your gallstones may vanish without a surgery too!
In some cases you may not have to face the doctor’s knife to get stones out of your gallbladder.
Read on to know more.
Written by Aishwarya Vaidya | Updated : July 17, 2018 5:46 PM IST
Just beneath your liver, towards the right sight of your abdomen, a small pear-shaped organ is located which is known as a gallbladder. Sometimes, tiny stones start colonising this organ of your body. They are known as gallstones–the hardened deposits of a digestive fluid called bile. What are gallstones?
A study by the Nigerian Journal of Surgery stated: “Gallstones are becoming increasingly common; they are seen in all age groups, but the incidence increases with age, and about a quarter of women over 60 years will develop them. In most cases, they do not cause symptoms, and only 10% and 20% will eventually become symptomatic within 5 years and 20 years of diagnosis. Thus the average risk of developing the symptomatic disease is low, and approaches 2.0-2.6% per year.” The symptoms include vomiting or nausea, sudden pain in the right side of your abdomen and your right shoulder.
Non-surgical treatment
Though gallstones do not go away on their own, and require surgical intervention in most cases, there are times when non-surgical treatments can work wonders too. A study named Non-surgical Management of Gallstones in the journal Progress in Liver Diseases stated: “For patients in good general health who are willing to undergo surgery, removal of the gallbladder is the treatment of choice. However, there are some patients in whom a nonsurgical procedure ought to be considered.” According to the observations of the study, patients with a patent cystic duct and a functioning gallbladder, and symptomatic stones that are transparent to X-rays, can be scheduled for non-surgical treatment. Floating stones also clear away in most cases with oral dissolution therapy or direct contact dissolution. So, if you don’t wish to opt for a surgery or if you are unable to do so, then, your doctor may suggest some non-surgical ways to treat your gallbladder issue. Below listed are some noninvasive treatments.
- Oral bile acid pills: By thinning the bile, these medicines can dissolve the gallstones. The gallstones can be dissolved by the chemicals in the pills namely ursodeoxycholic or chenodiol.
- Contact dissolution therapy: To dissolve the gallstones, a solvent called as methyl tertiary-butyl ether (MTBE) is injected into the gallbladder.
- Percutaneous Cholecystectomy: To withdraw fluid from the gallbladder a needle is used and then a catheter is inserted to drain the fluid through the skin. For a few weeks, the catheter is left in that place and then, the gallbladder is removed surgically. This procedure is ideal for candidates who cannot undergo surgery right away.
A word of caution: Avoid self-medication or using any over the counter products. Seek your doctor’s help before doing so. Herbal remedies for gallstones
Image Source: Shutterstock
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Causes, Treatment, and When to See a Doctor
Your gallbladder is a pear-shaped organ located in your right upper abdomen, just under your ribcage. Gallbladder pain is more likely to happen after you have eaten a fatty meal, but it can also happen on an empty stomach in the middle of the night.
The pain is often in the right upper belly, under the ribs, but the pain may spread (“radiate”) to the lower chest or your right shoulder blade, leading some people to worry they are having a heart attack. Unlike pain from gas, gallbladder pain is typically not relieved by changing position, burping, or passing gas. Heartburn is not a symptom of gallbladder problems, although a person may feel nauseated and vomit.
Given the location of the gallbladder, what seems like gallbladder pain may actually be pain related to issues other than gallbladder disease, such as those related to your heart, muscles, and other organs within your digestive system. This is why it’s important to have your pain evaluated by a medical professional.
Verywell / Alexandra Gordon
Causes
The following health problems are all potential sources of gallbladder pain:
Gallstones
The most common cause of “gallbladder pain” is gallstones (also called “cholelithiasis”), which are hard particles that form due to either an imbalance of the substances that make up bile (the fluid that the gallbladder secretes to aid in the digestion of food) or the gallbladder not emptying as it should. These particles can be quite small or grow to the size of a golf ball.
Typically, the formation of gallstones happens very slowly. A person may develop one large stone, multiple small stones, or a mix of the two. It is entirely possible to have gallstones and not have any symptoms. Such stones are considered benign because they do not interfere with the functioning of your digestive system.
Pain occurs, though, when a gallstone blocks one of the ducts in the biliary tract—the part of your body that contains your gallbladder and your bile ducts. The pain may ease when the gallstone moves and the bile duct is no longer blocked.
Serious complications can arise from having gallstones. The gallbladder, common bile duct, or the pancreas may become inflamed and infected, posing a great risk to your health. Rarely, gangrene or rupture of the gallbladder can occur, or a gallstone may cause a bowel obstruction.
Biliary Sludge
Besides gallstones, biliary sludge (thickened bile salts) may also form in the gallbladder. This sludge blocks healthy bile emptying out of the gallbladder, potentially causing similar symptoms and complications as gallstones.
Cholecystitis
Gallbladder inflammation (called “cholecystitis”) most commonly develops as a result of gallstones. Less commonly, cholecystitis develops without gallstones (called “acalculous cholecystitis”).
Acute Cholecystitis
When a gallstone becomes stuck within the gallbladder, inflammation ensues, causing sudden and sometimes severe abdominal pain (called “biliary colic”) along with nausea, vomiting, fever, and a loss of appetite. Biliary colic describes a dull, cramping pain in the upper-right part of the abdomen.
Acalculous Cholecystitis
Acalculous cholecystitis causes the same symptoms as acute cholecystitis, although a gallstone is not the culprit. While the precise cause is not clear, experts suspect poor bile and blood flow within the gallbladder may cause this condition to develop. Acalculous cholecystitis is mostly seen in people who are severely ill, like those on mechanical ventilation or those with a major infection or severe burn injury.
Acute Cholangitis
Acute cholangitis occurs from a bacterial infection in the common bile duct, often as a result of an obstructing gallstone, or sometimes from a bile duct stricture or cancer of the gallbladder, bile duct, pancreas, or duodenum (first part of the small intestine). Symptoms of acute cholangitis may include upper-right-sided abdominal pain, fever, and jaundice. In more severe cases, a person may also develop low blood pressure and confusion, which can be signs of life-threatening sepsis.
Gallbladder Rupture
Rarely, your gallbladder may rupture or burst open as a result of gallbladder inflammation (cholecystitis). Even rarer, an injury like a motor vehicle accident or sports contact injury may result in gallbladder rupture, causing sudden and severe, sharp pain in the upper-right part of your abdomen.
Choledocholithiasis
Choledocholithiasis is where gallstones block the common bile duct, restricting the flow of bile from the liver to the intestine. The resulting rise in pressure can cause an increase in liver enzymes and also jaundice.
Functional Gallbladder Disease/Biliary Dyskinesia
Functional gallbladder disease (FGBD), sometimes referred to as “chronic acalculous gallbladder dysfunction” or “biliary dyskinesia,” is the technical name for gallbladder disease without the presence of any gallstones. It includes dysfunction of the sphincter of Oddi, the muscular sphincter that helps to control gallbladder emptying. Symptoms may come on suddenly or occur chronically.
Biliary dyskinesia is a gallbladder syndrome that occurs when your gallbladder is not emptying properly. Due to improper drainage of bile, gallbladder pain and other symptoms, such as nausea and vomiting, may result.
Biliary dyskinesia is usually only identified after other causes of pain (like gallstones) have been ruled out.
Most of the treatment recommendations have been written to address people with gallbladder hypokinesia (underfunction), but there is a growing body of research about people with hyperkinesia, whose gallbladders empty too much.
Current research indicates that both hypokinesia and hyperkinesia of the gallbladder may benefit from gallbladder removal (cholecystectomy).
Gallbladder Cancer
Gallbladder cancer is rare and is often not diagnosed until it is fairly advanced. Besides gallbladder pain, a person with gallbladder cancer may be jaundiced and experience nausea, vomiting, and weight loss.
Because of its vague symptoms, gallbladder cancer is often found late. Gallbladder cancer that is diagnosed late can have a poor prognosis.
When to See a Doctor
If you are experiencing gallbladder pain, you should inform your physician as soon as possible, even if your symptoms have gone away. Your doctor will want to make sure that you are not experiencing a problem that will put you at risk for a more severe disease in the future.
You should get immediate medical attention if you experience any of the following symptoms:
- Severe, intense pain that prevents you from getting comfortable
- Pain that increases when you take a breath
- Pain that lasts for more than five hours
- Yellow skin or yellow around the whites of your eyes (called jaundice)
- Fever and chills
- Rapid heartbeat
- Persistent vomiting
- Persistent lack of appetite or unexplained weight loss
- Cola or tea-colored urine
- Clay-colored stools
Diagnosis
Getting to the bottom of your gallbladder pain entails a medical history, physical exam, blood tests, and imaging tests.
Medical History
During your visit, your provider will ask you several questions about your discomfort. For example, they will ask you to pinpoint as best as you can exactly where you feel the pain on your belly. Your doctor may also inquire whether your gallbladder pain occurs with eating fatty meals or whether you have any other symptoms like fever, nausea, or vomiting.
Physical Examination
During your physical exam, your doctor will focus on your abdomen, specifically the right upper part where your gallbladder is located. In addition to examining the area for skin changes, swelling, tenderness, and guarding (tensing of the abdominal wall), they will likely press on your gallbladder to see if it is tender (a technique called “Murphy’s sign”).
During this maneuver, your doctor will have you take a deep breath in, while they press on your gallbladder to see if any pain is elicited. If so, this indicates an inflamed gallbladder (a “positive” Murphy’s sign).
Blood Tests
When evaluating gallbladder pain, your medical provider will usually order blood tests, including a complete blood count (CBC), a complete metabolic panel, a PT/PTT (blood clotting tests), and liver function tests.
Your provider may also order other tests to rule out other causes of your pain.
Imaging
In order to confirm that your pain is a result of a gallbladder disease, your doctor will want to visualize your gallbladder. The first test, and sometimes the only test needed, is an ultrasound. Ultrasounds are non-invasive and painless. Sometimes, you will be sent to a radiology department for your ultrasound, but some doctors’ offices have the ability to perform the ultrasound there.
While trying to determine your diagnosis, your doctor may also order the following imaging tests:
- Hepatobiliary iminodiacetic acid (HIDA) scan: By injecting you with a small amount of a radioactive substance, doctors are able to see how the substance moves through your body, including your gallbladder, bile ducts and your liver. This can actually help your doctors to see how your gallbladder is emptying in real time.
- Computed tomography (CT) scan (“CAT” scan): Multiple x-rays will be taken, often using a swallowed or IV contrast medium to help picture quality. A computer then puts these multiple images together into a three-dimensional image.
- Magnetic resonance cholangiopancreatography (MRCP): As a special type of magnetic resonance imaging (MRI), this test uses strong magnets to take detailed pictures of your common bile duct and surrounding structures.
- Endoscopic retrograde cholangiopancreatography (ERCP): For an ERCP, you swallow a tube with a light and a camera attached, while you are sedated. The camera allows doctors to look for any problems, and attached tools can sometimes allow them to take care of the problem that day, like removing stones or widening a narrow bile duct.
Differential Diagnoses
While it is reasonable to think that pain in the right upper abdomen is related to the gallbladder, keep in mind that the liver is also located in this area. Therefore, liver disease, such as hepatitis, may be what is actually causing your presumed gallbladder pain.
Some of the diagnoses that your provider may explore include:
Treatment
The treatment of gallbladder pain depends on the precise cause.
“Watch and Wait” Approach
For people with asymptomatic gallstones, a “watch and wait” approach is taken, meaning surgery to remove their gallbladder is only done if and when their gallstones begin causing symptoms.
Only about 50% of people with asymptomatic gallstones will go on to develop symptoms, whereas surgery does carry some risks. A low-fat diet can be beneficial in preventing gallstone formation, as 80% or more of gallstones are made of cholesterol.
Medications
Medications are rarely used to treat gallstones, but your doctor may recommend a medication like a nonsteroidal anti-inflammatory (NSAID) to ease your gallbladder pain.
Antibiotics may be given if a person develops a gallbladder or biliary tract infection, which is a complication of gallstone disease.
Bile acid pills are sometimes given to people with minimal symptoms and a well-functioning gallbladder. The medications ursodeoxycholic acid and ursodiol help to dissolve the cholesterol type of gallstones in two-thirds of patients within two to three months, but the stones may not disappear entirely.
Surgery/Procedures
There are two surgical ways to remove the gallbladder:
- Open cholecystectomy: The gallbladder is removed through a large cut in the abdomen. This is sometimes the only option for ruptured gallbladders or surgery where extensive exploration may be needed, as in cancer.
- Laparoscopic cholecystectomy: The surgeon uses long, thin instruments to remove the gallbladder through a much smaller cut in the abdomen. This is the most common gallbladder surgery.
An endoscopic retrograde choloangiopancreatogprahy (ERCP) is a procedure performed by a gastroenterologist. It can be used to both visualize and remove the problem, and it is most commonly used to relieve an obstructed bile duct.
Prevention
Focusing on a healthy lifestyle is your best chance to prevent gallstones and, thus, gallbladder pain.
Bear in mind, these strategies do more than keep your gallbladder healthy—they also keep your heart healthy:
- Visit your primary care physician for periodic checkups.
- Exercise for at least 30 minutes, 5 days per week.
- Eat a healthy diet rich in vegetables, fruits, low-fat dairy products, whole grains, legumes, and spices.
- Keep your weight low, but try to avoid rapid weight loss.
- Avoid foods high in saturated fat and cholesterol.
- If you are on a cholesterol medication or hormone replacement therapy, speak with your doctor to find out if these medications have increased your risk for the development of gallstones.
Frequently Asked Questions
What can I do about gallbladder pain during pregnancy?
You may have to make dietary changes, including consuming plenty of fruits, vegetables, and whole grains, and limiting carbohydrates and saturated fats, to control gallstones in pregnancy. If surgery is necessary, it is generally safest during the second trimester, but the doctor may have you wait until after your baby is born.
Why do I still have pain in the area after my gallbladder was removed?
About 5% to 40% of people will experience postcholecystectomy syndrome after gallbladder removal. It can cause abdominal symptoms similar to the pain felt before the gallbladder was removed. In addition, people may experience nausea, vomiting, gas, bloating, and diarrhea.
What are the best and worst foods to eat for the gallbladder?
The best foods for a healthy gallbladder are lean meats, fish, plant-based foods, lower sodium foods, fruits, vegetables, fiber, whole grains, and low-fat dairy. High intake of saturated fats, sugar, sodium, refined carbohydrates, red meat, fried foods, and full-fat dairy products may eventually lead to gallbladder problems or exacerbate existing gallbladder conditions.
A Word From Verywell
While gaining knowledge about your gallbladder pain is a good proactive step, be sure to get checked out by a doctor. A thorough assessment and prompt treatment of your pain is the best way to prevent complications and get back to feeling your best.
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Gallstones and gallbladder disease Information | Mount Sinai
More than 20 million Americans have gallstones, and approximately 1 million are diagnosed each year. However, only 1% to 3% of the population complains of symptoms during the course of a year, and fewer than one-half of these people have symptoms that return.
Risk Factors in Women
Women at all ages are much more likely than men to develop gallstones. Gallstones occur in nearly 25% of women in the United States by age 60, and as many as 50% by age 75. In most cases, they have no symptoms. In general, women are probably at increased risk because estrogen stimulates the liver to remove more cholesterol from blood and divert it into the bile.
Pregnancy
Pregnancy increases the risk for gallstones, and pregnant women with stones are more likely to develop symptoms than women who are not pregnant. Surgery should be delayed until after delivery if possible. In fact, gallstones may disappear after delivery. If surgery is necessary, laparoscopy is the safest approach.
Hormone Replacement Therapy
Several large studies have shown that the use of hormone replacement therapy (HRT) doubles or triples the risk for gallstones, hospitalization for gallbladder disease, or gallbladder surgery. Estrogen raises triglycerides, a fatty substance that increases the risk for cholesterol stones. How the hormones are delivered may make a difference, however. Women who use a patch or gel form of HRT face less risk than those who take a pill. HRT may also be a less-than-attractive option for women because studies have shown it has negative effects on the heart and increases the risk for breast cancer.
Risk Factors in Men
About 20% of men have gallstones by the time they reach age 75. Because most cases do not have symptoms, however, the rates may be underestimated in older men. One study of nursing home residents reported that 66% of the women and 51% of the men had gallstones. Men who have their gallbladder removed are more likely to have severe disease and surgical complications than women.
Risks in Children
Gallstone disease is relatively rare in children. When gallstones do occur in this age group, they are more likely to be pigment stones. The following conditions may put children at higher risk:
- Spinal injury
- History of abdominal surgery
- Sickle-cell anemia
- Impaired immune system
- Receiving nutrition through a vein (intravenous)
Ethnicity
The risk of gallstone and gallbladder disease in the United States is highest in certain tribes of Native Americans, it is higher in Hispanic Americans than in whites, and lowest in black Americans. People of Asian descent who develop gallstones are most likely to have the brown pigment type.
Native North and South Americans, such as Pima Indians in the United States and native populations in Chile and Peru, are especially prone to developing gallstones. Pima women have a 70% chance of developing gallstones during their lives, and a majority of native Indian females in Chile and Peru develop gallstones. These populations also have a high incidence of gallbladder cancer. In Chilean women, gallbladder cancer is the most common cause of cancer death, ahead of breast, lung, and cervical cancer.
Genetics
Having a family member or close relative with gallstones may increase the risk. Up to 33% of cases of painful gallstones may be related to genetic factors.
A mutation in the gene ABCG8 significantly increases a person’s risk of developing a certain type of gallstones. A single gene, however, does not explain the majority of cases, so multiple genes and environmental factors play a complex role.
Defects in transport proteins involved in biliary lipid secretion appear to predispose certain people to gallstone disease, but this alone may not be sufficient to create gallstones.
Diet
Cholesterol gallstones are more prevalent in people who consume Western diets of high amounts of saturated fats and cholesterol, protein, and refined sugars, and low amounts of fiber as well as a high total calorie count.
Diabetes
People with diabetes are at higher risk for gallstones and have a higher-than-average risk for acalculous gallbladder disease (without stones). Gallbladder disease may progress more rapidly in patients with diabetes, who tend to have worse infections.
Obesity and Weight Changes
Obesity
Being overweight is a significant risk factor for gallstones. In such cases, the liver over-produces cholesterol, which is delivered into the bile and causes it to become supersaturated.
Weight Cycling
Rapid weight loss or cycling (dieting and then putting weight back on) further increases cholesterol production in the liver and an increased risk for gallstones.
- The risk for gallstones is as high as 12% after 8 to 16 weeks of restricted-calorie diets.
- The risk is more than 33% within 12 to 18 months after gastric bypass surgery.
About 30% of gallstone cases in these situations have symptoms. The risk for gallstones is highest in the following dieters:
- Those who lose more than 24% of their body weight
- Those who lose more than 1.5 kg (3.3 lb.) a week
- Those on very low-fat, low-calorie diets
Men are also at increased risk of developing gallstones when their weight fluctuates. The risk increases proportionately with dramatic weight changes as well as with frequent weight cycling.
Bariatric Surgery
Patients who have either Roux-en-Y or laparoscopic banding bariatric surgery are at increased risk for gallstones. For this reason, many centers request that patients undergo cholecystectomy before their bariatric procedure. However, doctors are now questioning this practice.
Metabolic Syndrome
Metabolic syndrome is a cluster of conditions that includes obesity (especially belly fat), low HDL (good) cholesterol, high triglycerides, high blood pressure, and high blood sugar. Research suggests that metabolic syndrome is a risk factor for gallstones.
Low HDL Cholesterol, High Triglycerides and Their Treatment
Although gallstones are formed from the supersaturation of cholesterol in the bile, high total cholesterol levels themselves are not necessarily associated with gallstones. Gallstone formation is associated with low levels of HDL (good) cholesterol and high triglyceride levels. Some evidence suggests that high levels of triglycerides may impair the emptying actions of the gallbladder.
Unfortunately, fibrates (drugs that may be used to correct these abnormalities) increase the risk for gallstones by boosting the amount of cholesterol secreted into the bile. These medications include gemfibrozil (Lopid) and fenofibrate (Tricor). Other cholesterol-lowering drugs do not have this problem or may even decrease the risk for gallstones, which is the case for statins.
Other Risk Factors
Prolonged Intravenous Feeding
Prolonged intravenous feeding reduces the flow of bile and increases the risk for gallstones. Up to 40% of patients on home intravenous nutrition develop gallstones within 3 to 4 months, and the risk may be higher in patients on total intravenous nutrition.
Crohn Disease
Crohn disease, an inflammatory bowel disorder, leads to poor reabsorption of bile salts from the digestive tract and substantially increases the risk for gallbladder disease. Patients over age 60 and those who have had numerous bowel operations (particularly in the region where the small and large bowel meet) are at especially high risk.
Cirrhosis
Cirrhosis poses a major risk for gallstones, particularly pigment gallstones.
Organ Transplantation
Bone marrow or solid organ transplantation increases the risk of gallstones. The complications can be so severe that some organ transplant centers require the patient’s gallbladder to be removed before the transplant is performed.
Medications
The following drugs may increase the risk for gallstones:
- The somatostatin analog octreotide (Sandostatin).
- Fibrates, a type of lipid-lowering agents.
- Estrogen, whether administered as an oral contraceptive to premenopausal women or as hormone replacement therapy to postmenopausal women.
- Thiazide diuretics.
- The antibiotic ceftriaxone.
Blood Disorders
Chronic hemolytic anemia, including sickle cell anemia, increases the risk for pigment gallstones.
Spinal Cord Injury
People with spinal cord injury have a higher prevalence of gallstones and a higher rate of complications from gallstone disease.
Heme
High consumption of heme iron, the type of iron found in meat and seafood, has been shown to lead to gallstone formation in men. Gallstones are not associated with diets high in non-heme iron foods such as beans, lentils, and enriched grains.
90,000 Gallstones – Should I Operate?
28.11.2018
The formation of stones in the gallbladder is the main symptom of cholelithiasis (GSD). In Russia and Europe, this disease is recorded in 10-15% of the population. The source of development of stones is cholesterol, salts and other components of bile, which is formed in the liver and then accumulates in the gallbladder. The formation of gallstones is facilitated by stagnation of bile, inflammation in the wall of the gallbladder and ducts, hormonal and metabolic disorders.Sometimes gallstones may not manifest themselves, but more often they cause pain and other concerns. The greatest danger is posed by complications of gallstone disease.
Why is cholelithiasis dangerous?
– The presence of stones in the gallbladder constantly maintains inflammation in its wall. In the presence of provoking factors – the intake of fatty foods, alcohol, physical activity – the inflammation is exacerbated, and an attack of acute cholecystitis develops, which may require emergency surgery.It is impossible to completely cure chronic cholecystitis in the presence of gallstones.
– The contraction of the gallbladder after a meal can lead to the wedging of a stone into the excretory duct of the bladder, as a result of which the gallbladder becomes clogged and creates a “disabled gallbladder” effect.
– Small stones can slip from the gallbladder into the bile ducts, causing jaundice and acute pancreatitis. These diseases require urgent surgical treatment and to this day often lead to death.
– Large stones can cause a pressure ulcer in the wall of the gallbladder. In this case, a fistula usually develops between the gallbladder and the intestine. The constant reflux of intestinal contents into the gallbladder and bile ducts leads to the development of severe inflammation in them.
– With a prolonged course of calculous cholecystitis, chronic pancreatitis inevitably develops. In this case, even the elimination of cholecystitis (removal of the gallbladder) does not give a complete recovery, since pancreatitis continues to cause pain and other complaints.
– Prolonged trauma to the wall of the gallbladder by stones in it can lead to the development of gallbladder cancer.
Methods for the treatment of gallstone disease?
The main method of treatment of gallstone disease is surgical. The methods of dissolving and crushing gallstones did not justify themselves due to low efficiency, a large number of complications, and high cost of treatment.
For over 100 years, the main operation used for cholecystectomy has been the removal of the gallbladder.It makes no sense to remove stones alone, as the cause of the disease is that the diseased gallbladder forms stones, and not stones cause gallbladder disease.
Previously, the gallbladder was removed through a large incision in the abdominal wall. Now the “gold standard” in the treatment of cholelithiasis is laparoscopic cholecystectomy, performed through small punctures. The operation takes about an hour. Postoperative hospital stay – 1-2 days. After surgery, it is recommended to limit excessive physical activity and follow a diet for 1-2 months.
Today, laparoscopic cholecystectomy is a fairly safe operation. The complication rate does not exceed 0.1-0.3%, which is lower than with open surgery.
What to do in case of detection of ZhKD?
Don’t expect complications! The first step on the road to recovery is to call us and come for a consultation with a surgeon. A specialist in our multidisciplinary clinic will determine the need for surgical treatment and answer all your questions.
Today, only one list of life-threatening complications of cholelithiasis dictates the need for urgent treatment of this disease. The recommendation “do not remove stones if they don’t bother you” should be recognized as hopelessly outdated.
Find out more about the possibilities of the Center for Minimally Invasive Surgery at the Reaviz multidisciplinary clinic.
Cholelithiasis – a “disease of civilization”
Every malfunction in the body is always an unpleasant surprise for a person.One of them is gallstones. Their presence indicates the development of gallstone disease. According to statistics, every tenth person knows firsthand what kind of disease it is. Usually middle-aged and elderly people suffer from it, but recently the disease has become much younger. Scientists call it “the disease of civilization”, because it is the modern way of life: unhealthy diet, stress, snacks on the go, bad ecology negatively affect the gallbladder.
How are stones formed?
With gallstone disease, bile stagnation occurs, and its components begin to precipitate and crystallize.So stones or, in medical terms, calculi are formed in the gallbladder. They can be several or one, the size of a grain of sand or the size of a pigeon’s egg.
Why is this happening?
There are several reasons for the development of the disease. One of them is eating cholesterol-rich foods. Also, the formation of stones can be promoted by prolonged use of medications that provoke thickening of bile, gastrointestinal diseases, and a sedentary lifestyle. Rare meals (1-2 times a day) is another important cause of the development of the disease.Genetic factors also play a role in stone formation. If your parents were sick with this disease, unfortunately, you are at risk, because it is inherited.
At first, the disease is almost asymptomatic, for a long time the stones do not manifest themselves in any way. Most patients are unaware of the presence of stones in the gallbladder and learn about them only on an ultrasound scan. The first signs appear only after a few years, when stones begin to interfere with the normal outflow of bile.
What to look for?
One of the symptoms of cholelithiasis is pain in the right hypochondrium. As the specialists of the department of surgeons of the Zaporozhye regional hospital note, the most indicative manifestation is an attack of biliary colic, which occurs due to the movement of a stone along the biliary tract. A person who has stones in the gallbladder in parallel may still suffer from pancreatitis, ulcers, gastritis. In addition, when the gallbladder contracts, stones can close its duct and cause severe pain in the right hypochondrium, which can be accompanied by nausea, vomiting and fever up to 38-38.5 ° C.
Gallstone disease can lead to the development of life-threatening conditions, for example, obstructive jaundice, rupture of the bile duct. In such cases, urgent hospitalization in the surgery department of the regional hospital is necessary, since if there is a stone in the gallbladder, it can get into the common duct, get stuck in it, disrupt the work of the pancreas, lead to pancreatitis and even death.
“It is very important to remember that the stones from the bladder cannot disappear by themselves, they must be removed, – Taras Gavrilenko, head of the department of surgery of the Zaporozhye regional hospital, comments on the situation. – But sometimes patients are in no hurry to see a doctor and try to remove the stones on their own, starting the disease and provoking the development of severe complications. We strongly recommend that in the presence of the above symptoms, immediately contact a specialized department, where qualified medical care will be provided. ”
Advantages of treatment in the department of surgery
For the treatment of gallstone disease in the department, laparoscopy of the gallbladder is successfully used .This is the most gentle and least traumatic intervention, which is carried out using modern equipment from leading world manufacturers. With such operations, healing occurs much faster and the maximum cosmetic effect is achieved. The use of disposable consumables allows you to completely eliminate the risk of infection during the operation. The experience of the hospital’s surgeons allows patients to fully recover and return to their usual lifestyle in the shortest possible time.
To improve the quality of medical services, the surgeons of the Zaporozhye Regional Hospital closely cooperate with the Department of Hospital Surgery of the Zaporizhzhya State Medical University under the guidance of Professor, Dr. med. n. Alexandra Nikonenko.
“The specialists of the department are constantly improving their qualifications, regularly attending medical congresses, symposia and conferences in Ukraine and abroad. In addition, surgeons use the most modern developments and techniques with the sole purpose of restoring the quality of life to patients.For this, the Zaporozhye regional hospital has everything possible: a staffed staff of highly qualified surgeons, modern equipment, a powerful diagnostic base, “- sums up Igor Shishka, chief physician of the Zaporozhye regional hospital.
Cholelithiasis
Gallstone disease
Gallstones is a condition in which you have gallstones.The gallbladder is an organ located just below the liver. The gallbladder acts as a storehouse for bile. Bile, a thick green liquid, is synthesized in the liver. Bile travels through the bile ducts and enters the intestines when you eat. Bile helps in the digestion of fats and other substances. Many people have gallstones but don’t know it. Abdominal pain occurs if stones in the gallbladder begin to block the duct of the gallbladder, and sometimes the common bile duct (common bile duct), in this case obstructive jaundice develops against the background of severe pain.
What is the cause of gallstone disease?
Problems with how bile is produced and excreted from the gallbladder can lead to gallstone disease. Bile is a balanced mixture of water, cholesterol, bile salts and bilirubin (yellow pigment). The stones can be from a variety of bile materials. Cholesterol stones form when bile contains too much cholesterol and not enough bile salts. It is believed that liver diseases such as hepatitis and blood anemia can lead to the formation of pigment stones.Gallstones can form when bile stagnates in the gallbladder.
Risk of gallstone disease:
- Overweight.
- Certain medications such as estrogen, antibiotics, and medications to lower cholesterol levels.
- Diabetes or small bowel surgery.
- Fasting or rapid weight loss.
- The presence of another family member with gallstone disease (genetic predisposition).
- Pregnancy.
What are the signs and symptoms of gallstone disease?
The most common symptom of gallstone disease is pain in the right upper abdomen. This is usually just below the right half of the ribcage. Pain can also be transmitted to the right shoulder and between the shoulder blades. There may also be nausea and vomiting. These symptoms may go away on their own to recur later, especially after eating fatty foods.
Other signs and symptoms may include:
- Jaundice (yellowing of the skin or whites of the eyes).
- Bloated feeling when there is too much gas in the stomach.
- Colorless (gray) cal.
- Dark urine.
How is the diagnosis made?
You may need the following tests:
- Biochemical blood test.
- Abdominal ultrasound: An abdominal ultrasound is a test done to see the liver and gallbladder on a monitor screen.
Surgical treatment of gallstone disease.
Surgical treatment: Surgery is often necessary to treat gallstone disease. This can be done in any of the following ways:
Open cholecystectomy: Open cholecystectomy is an operation to remove the gallbladder through an incision in the abdominal wall, usually a median one, previously performed from an incision in the right hypochondrium.
Laparoscopic cholecystectomy: A laparoscope is used for this procedure.A laparoscope is a thin optical tube connected to a video camera. Small incisions in the abdomen, for the introduction of 5-10mm surgical instruments, allow the patient to easily recover from surgery
90,000 Is the kink of the gallbladder bad?
The gallbladder looks like a pear. It accumulates bile in itself, which is produced by the liver. From here, bile is delivered to the duodenum and participates in the next stage of digestion.
It happens that a child is brought in for an ultrasound of the abdominal cavity, and the conclusion is made that the gallbladder is bent.
It’s worth fearing ⁉️
⠀
Kink of the gallbladder in children is a congenital or acquired anomaly. It can be found anywhere on the organ.
It cannot be straightened, straightened, straightened. The kink can disappear and reappear. It depends on the position of the body during the ultrasound and on where the bend is.It can also be fixed.
The causes of inflection are varied. Influenced by heredity and genetic disorders, bad habits, lack of diet, etc.
If the bend of the gallbladder has become an accidental finding on ultrasound, the child has no complaints and does not bother with anything, then treatment is not prescribed. We recommend that you observe and undergo an ultrasound scan once a year.
The kink itself does not hurt. But if inflammation or other pathologies of the gallbladder join, then there will be:
- Pain in the abdomen, in the right hypochondrium.
- Nausea after eating, vomiting.
- Stool disorder.
In this case, you need to consult a gastroenterologist, find the real cause of the complaints and start treatment.
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If the child has a pronounced kink, then this can impede the normal flow of bile. She stagnates. In the future, this can lead to inflammation, the formation of gallbladder stones.
To prevent bile stagnation:
- Observe the diet.No fatty, fried, unhealthy foods, long intervals between meals.
- Get regular physical activity.
- Undergo an ultrasound scan routinely.
- If you have a complaint, go to the doctor.
In our center you can ask for help, for yourself or your child, to a gastroenterologist, as well as do an ultrasound of the abdominal organs. The procedure allows the physician to obtain information about: liver, spleen, kidneys, pancreas, gallbladder, bile ducts, blood and lymph vessels.
Medakom Medical Center. We are trusted with invaluable children!
see also
See also
90,000 Kink of the gallbladder: is it worth fearing, should it be treated?
When leaving the ultrasound diagnostic room, many patients are unpleasantly surprised. The kink of the gallbladder, which they did not even know about, suddenly appears before them as an incomprehensible and unexpected problem.So there was an explanation for the chronic severity and pain in the right hypochondrium, the frequent feeling of bitterness in the mouth. About “how to treat it”, “where did it come from” and “is it worth it to be afraid” gastroenterologist Olga Yuryevna Zharinova tells.
Anomaly in the shape of the gallbladder is a fairly common congenital defect that does not need special correction. Naturally, the bend provokes stagnation of bile with the formation of an inhomogeneous sediment in the future.In turn, it can be transformed into flakes, and they into stones. Stagnant bile is a favorable environment for the development of pathogenic microflora, which causes inflammation of the walls of the gallbladder (according to the description of ultrasound – thickening of the walls and their hyperechogenicity) – cholecystitis. Its chronic form disrupts the work of the pancreas and digestion in the intestines.
It is certainly possible to live with an inflection of the gallbladder. Moreover, you will feel great if you follow a few simple rules:
- Compliance with a diet (limit the use of fatty, fried and salty foods, eat fractionally – five to six times a day in small portions).However, this does not mean a lifelong rejection of festive tables and various delicacies. Moderation in food is the main rule.
- Tubage (tubage is a cleansing procedure in which the biliary tract is washed, the bile stagnation that provokes the formation of stones is eliminated).
Tubage technique
You will need : mineral water, solution of magnesia, sorbitol, choleretic herbs.
Contraindications : period of menstruation and the week before it begins.
Technique for performing : in the evening open a bottle of mineral water with choleretic properties (“Essentuki” (No. 4.17), “Arzani”, “Smirnovskaya”, “Jermuk”). The gas needs to come out of it. In the morning on an empty stomach, drink 200-250 ml of mineral water at room temperature. You can add 5 grams of magnesium sulfate or sorbitol to it – this contributes to a more vigorous release of the gallbladder. After 15-20 minutes, take the same amount of water again. After taking it, you should lie down with a heating pad in the area of the right hypochondrium on the right side and stay in this position for 1.5-2 hours.
To carry out a tyubage only with magnesia sulfate, in the evening, dilute 1 tablespoon of magnesia powder in 1 glass of hot water and leave until morning. Preheat the solution to a temperature of 40 degrees Celsius, drink it in the morning on an empty stomach. Then put a heating pad on the area of the right hypochondrium and lie with it on the right side for 1.5-2 hours.
Assessment of the correctness of the tyubage: if after the procedure there was a bowel movement and the stool was rather dark, with a greenish tinge, then there was a clear admixture of bile in it, i.e.That is, the process was efficient.
This procedure is recommended to be carried out once every two to three weeks.
For women with an inflection of the gallbladder, it is very useful to sign up for belly dancing. The work of the abdominal muscles during exercise promotes the correct outflow of bile and prevents its stagnation. It also improves the blood supply to the abdominal and pelvic organs. As a result, you will have a toned belly, an attractive waist, and correct, regular bowel movements, which contributes to clear and beautiful skin.
For men , the specialist recommends walking more often, doing exercises and attending sports events, a swimming pool, a sauna.
Control ultrasound of the organs of the hepato-biliary system (GBS) should be performed 2 times a year. If you follow all the recommendations, bile stagnation, despite the presence of an inflection, will be minimal or absent altogether. The quality of your life will be at its best!
Our doctor advises to visit a gastroenterologist every six months, having with you the data of the last ultrasound of the GBS.
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