Gallstones | Kaiser Permanente

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What are gallstones?

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

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

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

What causes them?

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

What are the symptoms?

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

How are they diagnosed?

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

How are gallstones treated?

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

How can you prevent them?

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

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

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Cause

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

What Increases Your Risk

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

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

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

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

Symptoms

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

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

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

What Happens

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

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

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

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

Learn more

When to Call

Call 911 or other emergency services immediately if you:

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

Call your doctor now if you have:

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

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

Watchful waiting

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

Check your symptoms

Exams and Tests

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

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

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

What a gallstone looks like on an abdominal ultrasound

Courtesy of Intermountain Medical Imaging, Boise, Idaho.

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

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Treatment Overview

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

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

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

Learn more

Self-Care

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

Surgery

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

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

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

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• Cholecystectomy: Before Your Surgery

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Common questions about gallstones – Mayo Clinic Health System

Speaking of Health

Friday, November 19, 2021

Topics in this Post

• Gastrointestinal Health

Pouring warm maple syrup over freshly cooked waffles is a great way to start the morning. But you may be familiar with the crystallization that can occur with maple syrup. Similarly, hardening, or crystalizing, in digestive fluid deposits can form in the gallbladder causing gallstones.

1. What is the purpose of the gallbladder?

The gallbladder is a small, pear-shaped organ below the liver on the right side of your abdomen. The gallbladder holds digestive fluid, called bile, that’s released into the small intestine, and that bile helps your body absorb fats, cholesterol and certain vitamins.

Of the several types of gallstones, the most common is the cholesterol gallstone, which develops due to too much cholesterol combining with bile. Cholesterol stones appear yellow in color.

The second type of gallstone is formed when bile contains too much bilirubin, a chemical produced when the body breaks down red blood cells, creating dark brown or black stones.

Rarer types of gallstones are calcium carbonate and fatty acid calcium stones.

2. Can I have gallstones if I don’t have symptoms?

Two-thirds of people with gallstones do not experience any symptoms. Learning gallstones are present may be an incidental finding on an ultrasound performed for another diagnostic reason.

Gallstones that don’t cause symptoms typically do not need treatment. Of people with gallstones, 15%‒25% may develop symptoms over the next 10‒15 years.

If gallstones lodge in a duct and cause a blockage, signs and symptoms can occur, and they will last from a few minutes to several hours.

Symptoms can include:

• Upper right quadrant pain in the abdomen
• Pain in the center of your abdomen, below the breastbone
• Back pain between the shoulders
• Pain in the right shoulder
• Nausea
• Vomiting

These symptoms may increase 20‒30 minutes after eating.

3. What causes gallstones?

Many factors lead to the formation of gallstones, including:

• Bile containing too much cholesterol or bilirubin
• Genetics
• Slow small bowel transit
• Bile becoming concentrated due to the gallbladder not emptying completely

4.

Are women more likely to develop gallstones?

Gallstones are more likely to develop in certain people. Women are twice as likely as men to experience gallstones.

Other factors may increase your risk of gallstones, including:

• Being over 40
• Being overweight
• Being pregnant
• Having diabetes
• Having a family history of gallstones
• Losing weight rapidly
• Eating a high-fat diet
• Having Crohn’s disease
• Having liver cirrhosis

5. If I have a gallbladder attack, will I need surgery?

People who experience symptoms from gallstones in the gallbladder typically require gallbladder removal surgery.

If the gallstones leave the gallbladder and block the bile duct ― a tube that connects the liver, gallbladder and small bowel ― a special endoscopy procedure, called endoscopic retrograde cholangiopancreatography, may be needed to remove the stones.

A right upper quadrant ultrasound can be performed to detect gallstones. An ultrasound detects stones better than a CT scan. An endoscopic ultrasound can detect even small stones in the bile duct and gallbladder. The presence of stones can be a reason to be evaluated by a gastroenterologist or surgeon for treatment. This may include removal of stones from the bile duct, placement of a stent or removal of the gallbladder ― called a cholecystectomy.

Gallstones also can still develop in the bile duct after a cholecystectomy.

You can reduce the risk of gallstones with simple steps:

• Don’t skip meals.
  Be consistent with meal times each day. Skipping meals or fasting increases the risk of gallstones.
• Lose weight slowly.
  Aim to lose 1 or 2 pounds a week if you want to lose weight. Rapid weight loss increases the risk of gallstones.
• Eat a high-fiber diet including healthy fats.
  High-fiber foods include a variety of fruits and vegetables. Fish and nuts contain unsaturated, healthy fats.
• Maintain a healthy weight.
  Work to maintain a healthy weight through exercise and good diet.

Talk with your health care provider about occasional or continuous symptoms that may be related to gallstones.

Sebastian Strobel, M.D., specializes in gastroenterology and hepatology in La Crosse, Wisconsin.

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How to treat cholelithiasis, treatment of cholelithiasis in the Kurgan region – April 22, 2022

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More than 600 gallbladder removal surgeries are performed every year in the surgical department of the Kurgan Regional Clinical Hospital. Most of them are modern laparoscopic operations. All patients from regions of the region with complicated forms of cholelithiasis are admitted to the same department. And most of these patients undergo low-traumatic interventions to remove stones from the bile ducts. Denis Seredkin, a surgeon of the surgical department of the Kurgan Regional Clinical Hospital, wrote his work in a scientific article in collaboration with the head of the endoscopic department Viktor Semenov. His 45.RU and asked about what cholelithiasis is, how often do they get sick and who risks their health?

Cholelithiasis (GSD) is a disease in which stones form in the organs of the biliary system (gall bladder, bile ducts). The main reason leading to the development of the disease is a violation of cholesterol metabolism in the body. And in the presence of additional factors – inflammation of the biliary tract, stagnation of bile, infection – there is an accumulation in the gallbladder of pathological products with the gradual formation of stones.

Sedentary lifestyle, starvation with sudden weight loss, hormonal disorders, malnutrition can provoke the disease. Persons with a hereditary predisposition, obesity, those taking hormonal drugs, those suffering from diabetes mellitus, and the elderly have a high risk of getting sick.

Denis Seredkin (on the right in the photo) spoke about cholelithiasis in the Trans-Urals and its treatment. GSD affects 10% of the population. Every 10 years, the number of patients with cholelithiasis doubles. More and more children are suffering from this disease. The disease is steadily getting younger. Women get sick 2-3 times more often than men. With age, the number of patients increases. At the age of 60-70 years, the incidence of cholelithiasis reaches 40 percent.

The number of various complications of cholelithiasis reaches 10–35%. These include: acute inflammation of the gallbladder (up to suppuration and gangrene), migration of stones from the gallbladder into the ducts with their blockage and the development of acute purulent inflammation of the ducts and obstructive jaundice, acute pancreatitis, peritonitis. Acute severe conditions develop that require emergency medical care.

At the very beginning, the disease may not manifest itself in any way. And it often becomes an accidental find. Very often, patients seek medical help for the first time with existing complications. Most often, the first sign of the disease is pain in the right hypochondrium with irradiation to the stomach, right shoulder blade, right shoulder, to the right neck, bitterness in the mouth. To diagnose cholelithiasis, a simple study is enough – ultrasound of the liver and gallbladder.

If medical assistance is not provided on time, life-threatening conditions may develop: peritonitis, sepsis, acute liver failure, and others, which almost always end in death. Recently, more and more often we see patients with the presence of a malignant neoplasm of the gallbladder against the background of long-term stone carrying. This is an extremely malignant flowing form of cancer, in which a radical cure is almost impossible.

Worldwide, the only treatment for uncomplicated gallstone disease is cholecystectomy (removal of the gallbladder with stones). Option three. The first is a traditional operation through an incision in the anterior abdominal wall about 15-20 cm long. This is the oldest method, it is gradually becoming history. The second is cholecystectomy from a mini-access: that is, a special apparatus is installed through an incision in the abdominal wall 4-5 cm long, which improves the removal of the gallbladder. And the third, the most modern low-traumatic method is laparoscopic cholecystectomy. The operation is performed using special tools and equipment. This allows the gallbladder to be removed through several punctures in the abdominal wall.

Unfortunately, there are currently no conservative methods for the treatment of cholelithiasis.

Introducing an apparatus called a duodenoscope. It is introduced into the duodenum through the oral cavity, esophagus and stomach, the places where the bile duct flows into the intestine are found, this very place of confluence is expanded (dissected with a special knife, expanded by inflating a special balloon) and stones are removed from the duct and eliminate its blockage. In general terms, this procedure is similar to the well-known FGDS for examining the stomach. The operation is performed under light anesthesia, without a single puncture or incision in the skin. It has much fewer complications than abdominal surgery. Easily tolerated by patients of any age. We treated a patient aged 96 years old, who was successfully operated on and discharged only thanks to this technique. She would definitely not have endured any other intervention due to her age and severe concomitant heart disease. On the second or third day, patients are discharged home.

To reduce the risk of gallstone disease, it is necessary first of all to lead a correct healthy lifestyle. This is a balanced diet with a strict restriction of fatty foods, light carbohydrates, various fast foods and the prevention of physical inactivity (you need to move more). It is worth undergoing a medical examination, in which it is possible to identify and eliminate violations in the functioning of the organs and systems of the body, leading to the development of cholelithiasis, in time, as well as to detect signs of an existing cholelithiasis in time and get a doctor’s consultation.

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  menu for the week, what is possible and impossible, the results and reviews of nutritionists

  What is possible with a diet table number 5

  All dishes with this diet are steamed, boiled, stewed and served only warm. Sometimes it is allowed to bake a dish, but without a greasy crust. Be sure to drink a lot and eat fractionally: in small portions 5-6 times a day.

  • Pureed vegetable, dairy and cereal soups without meat are allowed for the first course. As a main dish, various lean meats and fish, chopped into small pieces, minced meat, soufflé, which are steamed or boiled. Oils only as dressings for dishes.
  • You can eat dairy and sour-milk products with reduced fat content. Casseroles are made from cottage cheese. Eggs are limited, cooked soft-boiled or included in omelettes, you can eat no more than one yolk per day.
  • Bread must not be fresh, but yesterday’s, no more than twice a week you can bake pastries without oil and fat. Crackers, biscuits, dry biscuits are allowed. From cereals are recommended: buckwheat, oats, semolina, rice. As complex carbohydrates, durum wheat pasta can be used.
  • Vegetables are also boiled and baked and eaten fresh. Especially isolated are peas, carrots, beets, pumpkins, zucchini, tomatoes, potatoes and cauliflower, cucumbers. Fruits can be eaten non-acidic: apples, bananas, pears. Greens and spices are limited.
  • Jellies, casseroles, puddings, dried fruits, honey are allowed for dessert. Limited allowed: marshmallow, jam, marmalade. Herbal teas, weak coffee with milk, weak tea, juices, jelly and compotes are suitable as drinks.

  What not to do with a diet table No. 5

  • Spicy, fried, smoked foods are completely excluded in the diet, sour and salt are limited. You can not eat all the sauces: ketchup, mayonnaise, spicy seasonings.
  • Soda, alcohol, cocoa and black coffee are prohibited. Dishes should not be too hot or cold.
  • Do not cook soups with meat, fish and mushroom broths. Prohibited fatty meat and fish, offal, canned food, lard.
  • All fatty dairy products are excluded. Corn, barley and wheat porridge are not recommended. Fresh bread and pancakes, pancakes, products with cream are not allowed.
  • Chocolate and ice cream should be avoided, as well as acidic fruits such as cranberries or citrus fruits.
  • Mushrooms, garlic, radishes, green onions are excluded, greens are limited.

  Weekly menu for diet table No. 5

  Day 1

  Breakfast : steamed omelette with hard cheese, coffee with milk
  Second breakfast: baked apple, a little honey can be added
  Lunch: vegetable soup, low-fat meatloaf fruit compote
  Snack: croutons (without fillers), rosehip drink
  gin: buckwheat porridge, steam cutlets turkey, tea
  Before bed: kefir

  Good to know

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  Day 2

  Breakfast : low-fat cottage cheese with sour cream, oatmeal with milk and water, tea
  Second breakfast: a handful of dried fruits, an apple
  Lunch : beetroot, boiled chicken with white sauce, boiled rice, dried fruit compote
  Afternoon c: apple jelly
  Dinner : buckwheat, berry compote
  Bedtime : kefir

  Recipe for cereals nick

  1. Boil 200 g of buckwheat in plenty of water.
  2. Mash 200 g of cottage cheese, add a tablespoon of sugar, 100 ml of milk and one egg.
  3. Combine porridge and curd mass.
  4. Bake under foil until done.

  Day 3

  Breakfast : steamed carrot pancakes, coffee with milk
  Second breakfast: dry biscuits, dried fruit compote groats, baked vegetables, fish meatballs, compote
  Snack : fruit jelly
  Dinner : steamed chicken dumplings, boiled cauliflower, herbal tea
  Before bed : low fat yogurt

  Day 4

  9029 4 Breakfast : milk rice porridge, tea
  Second breakfast : dry biscuit, fruit compote
  Lunch: vermicelli soup, boiled chicken, vegetable puree, tea yano tea
  Before going to bed : banana

  Day 5

  Diet. Photo: Pixabay

  Breakfast: oatmeal with milk, tea
  Second breakfast: wheat toast with pureed cottage cheese
  Lunch : vegetable soup, stewed beef, tea
  Snack: lazy dumplings, compote
  Dinner: milk vermicelli soup, biscuit, tea
  Bedtime: acidophilus

  Day 6

  Breakfast: protein omelette with boiled green beans, tea
  Second breakfast : grated carrot salad with dried apricots
  Lunch: cereal soup, steamed fish cakes, steamed vegetables, compote, biscuits
  Snack : cottage cheese, baked apples
  9021 0 Dinner : meat soufflé, toast from rye bread, chamomile tea
  Before going to bed : kefir

  Soufflé recipe

  1. Pass 200 g of boiled beef twice through a meat grinder, mix with one yolk.
  2. Pour 100 ml of milk into the minced meat and mix.
  3. Whisk egg whites into foam, mix with minced meat.
  4. Steam cooking.

  Day 7

  Breakfast: low-fat cottage cheese with banana and honey, coffee with milk
  Lunch: borscht, stewed fish with vegetables, bread, tea
  Afternoon snack: 9 0211 milk pudding
  Dinner: boiled veal tongue, rice, herbal tea
  Before going to bed : fat-free kefir

  *This is an exemplary menu in which you can make your own changes, come up with your own recipes. The main thing is to adhere to the basic rules: eat fractionally, eat dishes only from permitted products.

  Benefits and disadvantages of diet table #5

  Table #5 is a therapeutic diet developed by the founder of diet therapy, Pevzner. The diet creates favorable conditions for the recovery of the body and helps to avoid exacerbations of diseases. Usually diet table number 5 is prescribed for cholecystitis, hepatitis and cholelithiasis.

  The diet is long-term and can be used for several months or even years. It is the basis of proper and rational nutrition, useful for every person.

  As a rule, those who adhere to this diet for a long time note its positive effect on well-being, but pay attention to some disadvantages. For example, that dishes from the menu of table No. 5 have to be prepared separately for themselves, since not all family members are willing to voluntarily switch to steamed-boiled and rather bland food. For the same reason, sometimes there is nothing to eat at a party or in a restaurant.

  Results

  The most important result that is achieved with this diet is the restoration of the functioning of the organs of the gastrointestinal tract and the improvement of well-being. But in addition to the therapeutic effect, this diet can be the most gentle way to lose weight, as it is balanced in terms of the ratio of substances and does not cause stress in the body. Extra pounds go away rather slowly, but the general condition of the body improves and then the weight does not return, as happens with extreme weight loss.

  It is important that a person who eats strictly within the framework of table No. 5 loses weight without starving. For every month with such a diet, from 3 to 6 kilograms go away.

  But since this diet is primarily therapeutic, it is not worth prescribing it to yourself, without consulting a doctor, just for the sake of losing weight. The fact is that “Table No. 5” obliges to reduce fat intake. With problems in the work of the biliary system, this is what you need. But in general, fats are necessary for our body, because. they perform many important functions. Their consumption can be reduced to a reasonable limit, but not eliminated completely.

  For weight loss, not only diet is important, but an integrated approach. Nutritionists warn that excessive and unreasonable food restrictions can provoke an eating disorder.