Stone

Gale stones: Gallstones – Symptoms and causes

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Treatment, Definition, Risk Factors & Symptoms

Overview

Do You Have Gallstone Pain?

What are gallstones?

Gallstones are stone-like objects that develop in the gallbladder or bile ducts (the pipe-like system within the liver). Gallstones can range dramatically in size, from tiny grains of sand to golf ball-sized objects. Interestingly, small stones can often cause the most trouble. These are stones that can leave the gallbladder and get stuck. Larger stones tend to remain quietly in the gallbladder. It is important to know that many people who have gallstones are never bothered by them and may not know the stones are even there. In these cases, no treatment is needed.

What are gallstones made of?

Gallstones are made up of hardened materials in your body. Typically, there are two types:

  • Cholesterol: Made up of fatty substances in the blood, cholesterol is found throughout the body. These are the most common type of gallstones.
  • Pigment Stones (mainly made of bilirubin): This substance is created when red blood cells break down in the liver. Too much bilirubin can actually leak into the bloodstream and cause the skin and eyes to turn yellow (jaundice).

Gallstones that are made up of cholesterol tend to be greenish in color. It is more common to have gallstones made of cholesterol than other types of stone.

Where do gallstones develop?

Gallstones are most commonly found in the gallbladder, as cholesterol stones. Gallstones can also travel from the gallbladder to the common bile duct, which is the largest of the ducts (pipes) in the liver.

Common bile duct stones are much less common than gallstones. Stones that find their way into the common bile duct can create more serious medical situations than just gallstones that remain in the gallbladder. Common bile duct stones can block the common bile duct, resulting in a serious infection called cholangitis. These stones can also cause pancreatitis, a painful condition caused by inflammation of the pancreas. Stones in the common bile duct can be removed without surgery by using a scope. Removal of the gallbladder requires surgery, which is typically done laparoscopically (a minimally invasive surgical procedure).

Gallstones are stone-like objects that develop in the gallbladder.

What is the gallbladder?

The gallbladder is a small organ tucked up under the liver, on the right side of your body. It is shaped like a swollen pea pod. The gallbladder’s job is to store and dispense bile—a fluid that helps digest fats in the food you eat. Similarly to a pea pod, the gallbladder is green. This is due to the bile inside the gallbladder. Bile is a mixture of cholesterol, bilirubin, bile salts and lecithin.

The gallbladder is connected to other parts of the digestive system through a series of ducts, or tunnels. These ducts help to carry bile and aid in the entire process of breaking down food. Ultimately, the bile finds its way into the common bile duct, where it passes through a special sphincter (a valve made of muscle), into the small intestine. Once there, the bile can mix directly with food that’s waiting to be digested. The common bile duct then empties bile into the duodenum, the first portion of the very lengthy small intestine.

Not all bile travels directly from the liver into the duodenum. Another portion of bile moves from the liver into the gallbladder through a special duct called the cystic duct. The gallbladder stores bile, which is available to be used for digestion on very short notice. If a fatty meal is eaten, then the gallbladder is signaled to contract and to squeeze some stored bile into the common bile duct where it’s passed into the small intestine to mix with food. All bile ends up in the small intestine, where it helps digest food.

What is bile and what is it used for?

Produced in the liver, bile is a combination of cholesterol, bilirubin, bile salts and lecithin. This solution helps break down fat during the digestion process. Bile is either released directly to the small intestine from the hepatic duct (coming straight from the liver) or from the bile ducts after being stored in the gallbladder. The entire system of ducts is called the biliary system. Bile is an important part of digestion and exits the body with your feces.

Symptoms and Causes

Why do gallstones develop?

Gallstones can develop for several reasons, including:

  • Forming when there is a critical concentration of cholesterol or bilirubin in the bile.
  • Developing if the gallbladder is lazy and does not completely empty itself of bile.
  • Occurring in people with other conditions, like:
  • During pregnancy.
  • When you rapidly lose weight.

What are the symptoms of gallstones?

The symptoms of gallstones can vary based on the size of the gallstone. Most gallstones do not cause any symptoms at all. These gallstones are known as silent stones and require no treatment. When the gallstones cause symptoms, they may include:

  • Pain in the upper mid abdomen or upper right abdomen.
  • Associated pain in the right shoulder.
  • Chest pain.
  • Nausea and vomiting.
  • Repeated similar episodes.
  • Jaundice (a yellow tint to the skin and eyes).

Pain is the main symptom most people experience with gallstones. This pain is steady and can last from around 15 minutes to several hours. The episodes, which can be severe, generally subside after one to three hours or so. People who have these painful attacks, while uncomfortable, are not in any medical jeopardy. Gallstones can cause acute cholecystitis, which is a more serious condition when the gallbladder is actually inflamed. This happens if a stone blocks off the cystic duct, which increases the pressure within the gallbladder. This condition may require antibiotics, hospitalization and even urgent surgery. Stones that pass out of the gallbladder and into the common bile duct can cause a complete blockage of the duct with jaundice, infection and pancreatitis. You may feel pain in several places, including:

  • Upper part of the abdomen, on the right side.
  • Between the shoulder blades.
  • Under the right shoulder.

When people experience pain with gallstones, it is sometimes referred to as a gallbladder attack or biliary colic.There are two special conditions that could mimic gallstone symptoms. First, some gallbladders contain a thick sludge, which has not formed into actual stones. Sometimes sludge is felt to cause symptoms similar to actual gallstone pain. Secondly, there is an uncommon condition called acalculous cholecystitis, when the gallbladder becomes inflamed, but no stones are present. This is generally treated by surgical removal of the gallbladder.

Who is at risk for gallstones?

You may have an increased risk for developing gallstones if you:

  • Are a woman.
  • Are over the age of 40.
  • Have a family history of gallstones (members of your family have had gallstones).
  • Are overweight.
  • Have lost a large amount of weight over a short amount of time.
  • Have diabetes.
  • Have Crohn’s disease.
  • Eat a diet that is high in fat and cholesterol.
  • Take drugs that lower cholesterol.
  • Take various medicines including oral contraceptives.
  • Have certain blood disorders.
  • Are of Native American or Mexican descent.

Does my diet or weight place me at risk for gallstones?

People who are overweight or planning to lose weight –either through a planned diet program or a surgery—are actually at an increased risk of developing gallstones. The risk is higher for several reasons.

  • People who are overweight may have diets that are high in cholesterol. Your bile has cholesterol in it already, but if your diet has excessive amounts of cholesterol, there is a higher chance it will collect in your bile and create a cholesterol gallstone.
  • Rapid weight loss is also a concern. The gallbladder is a part of the digestive process. It holds bile to the side like a storage tank. Then the gallbladder releases the bile through the ducts and into the intestine to help break down food. If you go on a diet plan that significantly reduces your calorie intake or you have a weight loss surgery, your liver secretes extra cholesterol into the bile. The gallbladder can sometimes be ‘lazy’ and not able to contract vigorously, which also leads to gallstone formation. Patients who are undergoing a gastric bypass or other surgical procedure that will lead to rapid weight loss are at risk of gallstone formation. For this reason, surgeons may remove the gallbladder prophylactically (a preventive measure) at the time of the weight loss surgery.

If you are considering a weight loss program or surgery, it is important to discuss your risks with a doctor. This could be especially important if you have had stones in the past. It is common for gallstones to happen more than once.

Can children get gallstones?

Gallstones can happen to both children and adults. It is most common to see gallstones in middle-aged adults. However, adults are not the only ones who experience gallstones. One challenge with gallstones in children is identifying symptoms. Young children may have difficulty expressing where the pain is located. If you child has any unusual symptoms or abdominal pain, call your doctor.

Diagnosis and Tests

How are gallstones diagnosed?

The most commonly used test to detect gallstones is an ultrasound. Ultrasound is a painless and accurate procedure that transmits high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photographic images of the internal structures of the body. While no test is 100%, this is a very accurate test for diagnosing gallstones. There are other radiology tests that are sometimes used, but ultrasound is the main tool for diagnosing gallbladder disease.

In general, ultrasound does not visualize the common bile duct well. Though stones in this duct aren’t as common, they can happen. If they are suspected, the following tests may be done:

  • Endoscopic retrograde cholangiopancreatography (ERCP): This is both a test and a possible treatment for common bile duct stones. When used as a test, an endoscope — a flexible tube with a light and a camera attached — is inserted into the patient’s mouth, down the throat, and into the stomach and small intestine. A dye is injected to allow the bile ducts to stand out. If there are gallstones in the bile duct, they can be removed by the endoscope. This scope cannot remove stones contained within the gallbladder.

    Endoscopic retrograde cholangiopancreatography (ERCP) can diagnose and sometimes treat gallstones.
  • Magnetic resonance cholangiopancreatography (MRCP): In MRCP, the bile ducts are examined with magnetic resonance imaging (MRI), a test that uses a large magnet, radio waves, and a computer to produce very clear images of parts of the body. Unlike ERCP, MRCP can only diagnose common bile duct stones. It cannot remove them. However, MRCP’s advantage over ERCP is that it is the safer alternative, so often physicians will opt for MRCP initially.
  • Endoscopic ultrasound (EUS): This procedure combines endoscopy with ultrasound (there’s a probe at the tip of the scope). Like ERCP, this scope is passed through the mouth and advanced to the common bile duct and gallbladder region. It visualizes the common bile duct well. Similar to MRCP, gallstones are identified but not removed during this procedure. If common bile duct stones are demonstrated by EUS (or MRCP), then an ERCP will generally follow to remove them.

    Endoscopic ultrasound passes through the mouth to the common bile duct and gall bladder.

Management and Treatment

Incision locations for a laproscopic cholecystectomy

How are gallstones treated?

Silent stones are not treated and should be left alone. Most people who have gallstones are in this category.If you have symptoms, such as pain, you will probably need to be treated. The most common treatment for gallstones is to remove the gallbladder surgically. Removal of the gallbladder is called a cholecystectomy. In the majority of cases (90%), this surgery can be performed laparoscopically, a minimally invasive technique that results in less post-operative pain and a faster recovery than conventional cholecystectomy.Gallstones that are found in the bile ducts may need to be removed even if there are no symptoms. This procedure is commonly done with the endoscopic retrograde cholangiopancreatography (ERCP) procedure.

What is a laparoscopic cholecystectomy?

Laparoscopic cholecystectomy is known as a minimally invasive procedure because it uses several small incisions instead of one large one. A laparoscope is a narrow tube with a camera. This surgical tool is inserted through one incision. The camera allows your doctor to see your gallbladder on a TV screen. Your gallbladder is then removed through another small incision.

What happens if a laparoscopic cholecystectomy does not work or if there are complications during surgery?

If the patient has certain complications associated with gallstones, the surgeon may need to remove the gallbladder with an open cholecystectomy. This surgery involves an incision in the abdomen and requires a longer hospital stay (three to five days). Medical issues that could lead to open cholecystectomy include:

  • Having severe inflammation of the gallbladder.
  • Experiencing difficulties during an attempted laparoscopic surgery.
  • Having severe cardiac and respiratory issues.
  • Having a late term pregnancy.
  • Experiencing major scarring from a previous surgery.
  • Having a bleeding disorder or liver disease.
  • Having suspected gallbladder cancer, a very rare condition.

What is an endoscopic retrograde cholangiopancreatography (ERCP) procedure?

An endoscopic retrograde cholangiopancreatography (ERCP) procedure is another minimally invasive option for removing gallstones. The endoscope is a tube-like tool. Your doctor will need to move it throughout your digestive system during the treatment. The path the endoscope travels is:

  • In the mouth.
  • Down the throat.
  • Through the stomach.
  • Into the duodenum (beginning of the small intestine) where the common bile duct empties its bile.

Once there, the endoscope is used to remove any blockages in the bile duct.

Can I digest food without a gallbladder?

You don’t need a gallbladder in order to digest food properly. If your gallbladder is removed, bile will flow directly from your liver through the hepatic duct and the common bile duct to the small intestine. After the surgery, you may experience some softer stools, which generally resolve over time.

Are there any non-surgical treatments for gallstones?

In most cases where gallstones need treatment, your healthcare provider will use a minimally invasive technique to remove the stone. There are medications that can be used to dissolve the stones. However, as minimally invasive methods have advanced, these drugs haven’t been used as often. Dissolving medications can take months—or possibly even years—to get rid of the gallstones. By contrast, a procedure resolves the issue quickly. Using these medications to treat gallstones could be an option if you are unable to have surgery because of another condition. Talk to your doctor about all treatment options and which one is the best fit for you.

What are the complications of gallstones?

There are several complications of a gallstone attack, including:

Gallstones can also cause the gallbladder or bile ducts to become infected. A blockage in the common bile duct can cause jaundice (yellowing of your skin or eyes) or can irritate the pancreas.

Prevention

Can gallstones be prevented?

Gallstones cannot be prevented. However, you can decrease your risk factors by following healthy lifestyle tips. It is important to maintain a healthy weight through exercise and a balanced diet. Talking to your doctor about weight loss and cholesterol management is also a big part of preventing gallstones.

What foods should I avoid if I have had gallstones in the past?

Many gallstones are formed from cholesterol. Though you cannot prevent gallstones, you can try and limit the amount of fatty foods in your diet. Several tips for limiting cholesterol in your diet include:

  • Eating less meat.
  • Adding fish.
  • Limiting the amount of fried foods.
  • Adding more whole grains.
  • Choosing low-fat dairy products (cheese, milk).
  • Adding fresh vegetables and fruit.

Can I have gallstones more than once?

Yes. If you have experienced a gallstone attack once, it is more likely that you will have them again. The multiple attack nature of gallstones is why your doctor may suggest removing the gallbladder.

Outlook / Prognosis

When can I return to my normal activities after having gallstones?

If you have a gallstone that does not require treatment (silent stone) you can continue on with your normal activities right away. If you have a minimally-invasive procedure, you will need a short amount of time to recover before starting your activities again. Two major advantages of minimally-invasive procedures include a much faster recovery time and less pain. Larger, open surgeries traditionally mean more time in the hospital and a longer recovery at home. Speak with your doctor about a realistic plan for your recovery.

Living With

When should I call my doctor?

If you are experiencing pain in your abdomen, call your doctor, especially if the pain increases over time and is associated with fever, nausea or vomiting. Abdominal pain has many causes and your doctor will evaluate your symptoms carefully in order to make the correct diagnosis. If your symptoms are severe, then you may be directed to an emergency department for immediate evaluation.Are gallstones fatal?Gallstones themselves are not fatal. However, they can cause many complications that could be fatal. Fortunately, this is a rare event. If a large stone blocks your bile ducts after leaving the gallbladder, there could be a build-up of bile in the gallbladder and ducts, causing severe pain and an infection within the ducts. This is an urgent medical situation that needs prompt treatment, such as an emergency endoscopic retrograde cholangiopancreatography (ERCP). Of course, all medical procedures—such as ERCP and cholecystectomy—have risks.

How quickly will I recover from gallstones?

If gallstones cause symptoms, then you may need surgery. If you have a laparoscopic cholecystectomy (minimally invasive procedure to remove the gallbladder) without any complications, you may be home within 24 hours. If there are complicating factors—swelling of the gallbladder, infection, a blocked duct or other medical conditions may need to have an open surgery. If that happens, your hospital stay could be about three to five days.

Treatment, Definition, Risk Factors & Symptoms

Overview

Do You Have Gallstone Pain?

What are gallstones?

Gallstones are stone-like objects that develop in the gallbladder or bile ducts (the pipe-like system within the liver). Gallstones can range dramatically in size, from tiny grains of sand to golf ball-sized objects. Interestingly, small stones can often cause the most trouble. These are stones that can leave the gallbladder and get stuck. Larger stones tend to remain quietly in the gallbladder. It is important to know that many people who have gallstones are never bothered by them and may not know the stones are even there. In these cases, no treatment is needed.

What are gallstones made of?

Gallstones are made up of hardened materials in your body. Typically, there are two types:

  • Cholesterol: Made up of fatty substances in the blood, cholesterol is found throughout the body. These are the most common type of gallstones.
  • Pigment Stones (mainly made of bilirubin): This substance is created when red blood cells break down in the liver. Too much bilirubin can actually leak into the bloodstream and cause the skin and eyes to turn yellow (jaundice).

Gallstones that are made up of cholesterol tend to be greenish in color. It is more common to have gallstones made of cholesterol than other types of stone.

Where do gallstones develop?

Gallstones are most commonly found in the gallbladder, as cholesterol stones. Gallstones can also travel from the gallbladder to the common bile duct, which is the largest of the ducts (pipes) in the liver.

Common bile duct stones are much less common than gallstones. Stones that find their way into the common bile duct can create more serious medical situations than just gallstones that remain in the gallbladder. Common bile duct stones can block the common bile duct, resulting in a serious infection called cholangitis. These stones can also cause pancreatitis, a painful condition caused by inflammation of the pancreas. Stones in the common bile duct can be removed without surgery by using a scope. Removal of the gallbladder requires surgery, which is typically done laparoscopically (a minimally invasive surgical procedure).

Gallstones are stone-like objects that develop in the gallbladder.

What is the gallbladder?

The gallbladder is a small organ tucked up under the liver, on the right side of your body. It is shaped like a swollen pea pod. The gallbladder’s job is to store and dispense bile—a fluid that helps digest fats in the food you eat. Similarly to a pea pod, the gallbladder is green. This is due to the bile inside the gallbladder. Bile is a mixture of cholesterol, bilirubin, bile salts and lecithin.

The gallbladder is connected to other parts of the digestive system through a series of ducts, or tunnels. These ducts help to carry bile and aid in the entire process of breaking down food. Ultimately, the bile finds its way into the common bile duct, where it passes through a special sphincter (a valve made of muscle), into the small intestine. Once there, the bile can mix directly with food that’s waiting to be digested. The common bile duct then empties bile into the duodenum, the first portion of the very lengthy small intestine.

Not all bile travels directly from the liver into the duodenum. Another portion of bile moves from the liver into the gallbladder through a special duct called the cystic duct. The gallbladder stores bile, which is available to be used for digestion on very short notice. If a fatty meal is eaten, then the gallbladder is signaled to contract and to squeeze some stored bile into the common bile duct where it’s passed into the small intestine to mix with food. All bile ends up in the small intestine, where it helps digest food.

What is bile and what is it used for?

Produced in the liver, bile is a combination of cholesterol, bilirubin, bile salts and lecithin. This solution helps break down fat during the digestion process. Bile is either released directly to the small intestine from the hepatic duct (coming straight from the liver) or from the bile ducts after being stored in the gallbladder. The entire system of ducts is called the biliary system. Bile is an important part of digestion and exits the body with your feces.

Symptoms and Causes

Why do gallstones develop?

Gallstones can develop for several reasons, including:

  • Forming when there is a critical concentration of cholesterol or bilirubin in the bile.
  • Developing if the gallbladder is lazy and does not completely empty itself of bile.
  • Occurring in people with other conditions, like:
  • During pregnancy.
  • When you rapidly lose weight.

What are the symptoms of gallstones?

The symptoms of gallstones can vary based on the size of the gallstone. Most gallstones do not cause any symptoms at all. These gallstones are known as silent stones and require no treatment.When the gallstones cause symptoms, they may include:

  • Pain in the upper mid abdomen or upper right abdomen.
  • Associated pain in the right shoulder.
  • Chest pain.
  • Nausea and vomiting.
  • Repeated similar episodes.
  • Jaundice (a yellow tint to the skin and eyes).

Pain is the main symptom most people experience with gallstones. This pain is steady and can last from around 15 minutes to several hours. The episodes, which can be severe, generally subside after one to three hours or so. People who have these painful attacks, while uncomfortable, are not in any medical jeopardy. Gallstones can cause acute cholecystitis, which is a more serious condition when the gallbladder is actually inflamed. This happens if a stone blocks off the cystic duct, which increases the pressure within the gallbladder. This condition may require antibiotics, hospitalization and even urgent surgery. Stones that pass out of the gallbladder and into the common bile duct can cause a complete blockage of the duct with jaundice, infection and pancreatitis.You may feel pain in several places, including:

  • Upper part of the abdomen, on the right side.
  • Between the shoulder blades.
  • Under the right shoulder.

When people experience pain with gallstones, it is sometimes referred to as a gallbladder attack or biliary colic.There are two special conditions that could mimic gallstone symptoms. First, some gallbladders contain a thick sludge, which has not formed into actual stones. Sometimes sludge is felt to cause symptoms similar to actual gallstone pain. Secondly, there is an uncommon condition called acalculous cholecystitis, when the gallbladder becomes inflamed, but no stones are present. This is generally treated by surgical removal of the gallbladder.

Who is at risk for gallstones?

You may have an increased risk for developing gallstones if you:

  • Are a woman.
  • Are over the age of 40.
  • Have a family history of gallstones (members of your family have had gallstones).
  • Are overweight.
  • Have lost a large amount of weight over a short amount of time.
  • Have diabetes.
  • Have Crohn’s disease.
  • Eat a diet that is high in fat and cholesterol.
  • Take drugs that lower cholesterol.
  • Take various medicines including oral contraceptives.
  • Have certain blood disorders.
  • Are of Native American or Mexican descent.

Does my diet or weight place me at risk for gallstones?

People who are overweight or planning to lose weight –either through a planned diet program or a surgery—are actually at an increased risk of developing gallstones. The risk is higher for several reasons.

  • People who are overweight may have diets that are high in cholesterol. Your bile has cholesterol in it already, but if your diet has excessive amounts of cholesterol, there is a higher chance it will collect in your bile and create a cholesterol gallstone.
  • Rapid weight loss is also a concern. The gallbladder is a part of the digestive process. It holds bile to the side like a storage tank. Then the gallbladder releases the bile through the ducts and into the intestine to help break down food. If you go on a diet plan that significantly reduces your calorie intake or you have a weight loss surgery, your liver secretes extra cholesterol into the bile. The gallbladder can sometimes be ‘lazy’ and not able to contract vigorously, which also leads to gallstone formation. Patients who are undergoing a gastric bypass or other surgical procedure that will lead to rapid weight loss are at risk of gallstone formation. For this reason, surgeons may remove the gallbladder prophylactically (a preventive measure) at the time of the weight loss surgery.

If you are considering a weight loss program or surgery, it is important to discuss your risks with a doctor. This could be especially important if you have had stones in the past. It is common for gallstones to happen more than once.

Can children get gallstones?

Gallstones can happen to both children and adults. It is most common to see gallstones in middle-aged adults. However, adults are not the only ones who experience gallstones. One challenge with gallstones in children is identifying symptoms. Young children may have difficulty expressing where the pain is located. If you child has any unusual symptoms or abdominal pain, call your doctor.

Diagnosis and Tests

How are gallstones diagnosed?

The most commonly used test to detect gallstones is an ultrasound. Ultrasound is a painless and accurate procedure that transmits high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photographic images of the internal structures of the body. While no test is 100%, this is a very accurate test for diagnosing gallstones. There are other radiology tests that are sometimes used, but ultrasound is the main tool for diagnosing gallbladder disease.

In general, ultrasound does not visualize the common bile duct well. Though stones in this duct aren’t as common, they can happen. If they are suspected, the following tests may be done:

  • Endoscopic retrograde cholangiopancreatography (ERCP): This is both a test and a possible treatment for common bile duct stones. When used as a test, an endoscope — a flexible tube with a light and a camera attached — is inserted into the patient’s mouth, down the throat, and into the stomach and small intestine. A dye is injected to allow the bile ducts to stand out. If there are gallstones in the bile duct, they can be removed by the endoscope. This scope cannot remove stones contained within the gallbladder.

    Endoscopic retrograde cholangiopancreatography (ERCP) can diagnose and sometimes treat gallstones.
  • Magnetic resonance cholangiopancreatography (MRCP): In MRCP, the bile ducts are examined with magnetic resonance imaging (MRI), a test that uses a large magnet, radio waves, and a computer to produce very clear images of parts of the body. Unlike ERCP, MRCP can only diagnose common bile duct stones. It cannot remove them. However, MRCP’s advantage over ERCP is that it is the safer alternative, so often physicians will opt for MRCP initially.
  • Endoscopic ultrasound (EUS): This procedure combines endoscopy with ultrasound (there’s a probe at the tip of the scope). Like ERCP, this scope is passed through the mouth and advanced to the common bile duct and gallbladder region. It visualizes the common bile duct well. Similar to MRCP, gallstones are identified but not removed during this procedure. If common bile duct stones are demonstrated by EUS (or MRCP), then an ERCP will generally follow to remove them.

    Endoscopic ultrasound passes through the mouth to the common bile duct and gall bladder.

Management and Treatment

Incision locations for a laproscopic cholecystectomy

How are gallstones treated?

Silent stones are not treated and should be left alone. Most people who have gallstones are in this category.If you have symptoms, such as pain, you will probably need to be treated. The most common treatment for gallstones is to remove the gallbladder surgically. Removal of the gallbladder is called a cholecystectomy. In the majority of cases (90%), this surgery can be performed laparoscopically, a minimally invasive technique that results in less post-operative pain and a faster recovery than conventional cholecystectomy.Gallstones that are found in the bile ducts may need to be removed even if there are no symptoms. This procedure is commonly done with the endoscopic retrograde cholangiopancreatography (ERCP) procedure.

What is a laparoscopic cholecystectomy?

Laparoscopic cholecystectomy is known as a minimally invasive procedure because it uses several small incisions instead of one large one. A laparoscope is a narrow tube with a camera. This surgical tool is inserted through one incision. The camera allows your doctor to see your gallbladder on a TV screen. Your gallbladder is then removed through another small incision.

What happens if a laparoscopic cholecystectomy does not work or if there are complications during surgery?

If the patient has certain complications associated with gallstones, the surgeon may need to remove the gallbladder with an open cholecystectomy. This surgery involves an incision in the abdomen and requires a longer hospital stay (three to five days). Medical issues that could lead to open cholecystectomy include:

  • Having severe inflammation of the gallbladder.
  • Experiencing difficulties during an attempted laparoscopic surgery.
  • Having severe cardiac and respiratory issues.
  • Having a late term pregnancy.
  • Experiencing major scarring from a previous surgery.
  • Having a bleeding disorder or liver disease.
  • Having suspected gallbladder cancer, a very rare condition.

What is an endoscopic retrograde cholangiopancreatography (ERCP) procedure?

An endoscopic retrograde cholangiopancreatography (ERCP) procedure is another minimally invasive option for removing gallstones. The endoscope is a tube-like tool. Your doctor will need to move it throughout your digestive system during the treatment. The path the endoscope travels is:

  • In the mouth.
  • Down the throat.
  • Through the stomach.
  • Into the duodenum (beginning of the small intestine) where the common bile duct empties its bile.

Once there, the endoscope is used to remove any blockages in the bile duct.

Can I digest food without a gallbladder?

You don’t need a gallbladder in order to digest food properly. If your gallbladder is removed, bile will flow directly from your liver through the hepatic duct and the common bile duct to the small intestine. After the surgery, you may experience some softer stools, which generally resolve over time.

Are there any non-surgical treatments for gallstones?

In most cases where gallstones need treatment, your healthcare provider will use a minimally invasive technique to remove the stone. There are medications that can be used to dissolve the stones. However, as minimally invasive methods have advanced, these drugs haven’t been used as often. Dissolving medications can take months—or possibly even years—to get rid of the gallstones. By contrast, a procedure resolves the issue quickly. Using these medications to treat gallstones could be an option if you are unable to have surgery because of another condition. Talk to your doctor about all treatment options and which one is the best fit for you.

What are the complications of gallstones?

There are several complications of a gallstone attack, including:

Gallstones can also cause the gallbladder or bile ducts to become infected. A blockage in the common bile duct can cause jaundice (yellowing of your skin or eyes) or can irritate the pancreas.

Prevention

Can gallstones be prevented?

Gallstones cannot be prevented. However, you can decrease your risk factors by following healthy lifestyle tips. It is important to maintain a healthy weight through exercise and a balanced diet. Talking to your doctor about weight loss and cholesterol management is also a big part of preventing gallstones.

What foods should I avoid if I have had gallstones in the past?

Many gallstones are formed from cholesterol. Though you cannot prevent gallstones, you can try and limit the amount of fatty foods in your diet. Several tips for limiting cholesterol in your diet include:

  • Eating less meat.
  • Adding fish.
  • Limiting the amount of fried foods.
  • Adding more whole grains.
  • Choosing low-fat dairy products (cheese, milk).
  • Adding fresh vegetables and fruit.

Can I have gallstones more than once?

Yes. If you have experienced a gallstone attack once, it is more likely that you will have them again. The multiple attack nature of gallstones is why your doctor may suggest removing the gallbladder.

Outlook / Prognosis

When can I return to my normal activities after having gallstones?

If you have a gallstone that does not require treatment (silent stone) you can continue on with your normal activities right away. If you have a minimally-invasive procedure, you will need a short amount of time to recover before starting your activities again. Two major advantages of minimally-invasive procedures include a much faster recovery time and less pain. Larger, open surgeries traditionally mean more time in the hospital and a longer recovery at home. Speak with your doctor about a realistic plan for your recovery.

Living With

When should I call my doctor?

If you are experiencing pain in your abdomen, call your doctor, especially if the pain increases over time and is associated with fever, nausea or vomiting. Abdominal pain has many causes and your doctor will evaluate your symptoms carefully in order to make the correct diagnosis. If your symptoms are severe, then you may be directed to an emergency department for immediate evaluation.Are gallstones fatal?Gallstones themselves are not fatal. However, they can cause many complications that could be fatal. Fortunately, this is a rare event. If a large stone blocks your bile ducts after leaving the gallbladder, there could be a build-up of bile in the gallbladder and ducts, causing severe pain and an infection within the ducts. This is an urgent medical situation that needs prompt treatment, such as an emergency endoscopic retrograde cholangiopancreatography (ERCP). Of course, all medical procedures—such as ERCP and cholecystectomy—have risks.

How quickly will I recover from gallstones?

If gallstones cause symptoms, then you may need surgery. If you have a laparoscopic cholecystectomy (minimally invasive procedure to remove the gallbladder) without any complications, you may be home within 24 hours. If there are complicating factors—swelling of the gallbladder, infection, a blocked duct or other medical conditions may need to have an open surgery. If that happens, your hospital stay could be about three to five days.

Definition & Facts for Gallstones

In this section:

What are gallstones?

Gallstones are hard, pebble-like pieces of material, usually made of cholesterol or bilirubin, that form in your gallbladder. Gallstones can range in size from a grain of sand to a golf ball. The gallbladder can make one large gallstone, hundreds of tiny stones, or both small and large stones.

When gallstones block the bile ducts of your biliary tract, the gallstones can cause sudden pain in your upper right abdomen. This pain is called a gallbladder attack, or biliary colic. If your symptoms continue and they’re left untreated, gallstones can cause serious complications.

However, most gallstones don’t cause blockages and are painless, also called “silent” gallstones. Silent gallstones usually don’t need medical treatment.

Types of gallstones

The two main types of gallstones are

  • cholesterol stones
  • pigment stones

Cholesterol stones are usually yellow-green in color and are made of mostly hardened cholesterol. In some countries, cholesterol stones make up about 75 percent of gallstones.1

Pigment stones are dark in color and are made of bilirubin. Some people have a mix of both kinds of stones.

Gallstones can range in size from a grain of sand to a golf ball.

Do gallstones have another name?

Cholelithiasis is the name doctors sometimes call gallstones.

What is the biliary tract?

Your biliary tract, which is made up of your gallbladder and bile ducts, helps with digestion by releasing bile.

The gallbladder is a small, pear-shaped organ that stores bile and is located in your upper right abdomen, below your liver.

The bile ducts of your biliary tract include the hepatic ducts, common bile duct, and cystic duct. Bile ducts also carry waste and digestive juices from the liver and pancreas to the duodenum.

Your liver produces bile, which is mostly made of cholesterol, bile salts, and bilirubin. Your gallbladder stores the bile until it’s needed. When you eat, your body signals your gallbladder to empty bile into your duodenum to mix with food. The bile ducts carry the bile from your gallbladder to the duodenum.

Your biliary tract, which is made up of your gallbladder and bile ducts, helps with digestion by releasing bile.

How common are gallstones?

Gallstones are very common, affecting 10 to 15 percent of the U.S. population, which is almost 25 million people. About a quarter of the nearly 1 million people diagnosed with gallstones each year will need to be treated, usually with surgery.2

Who is more likely to develop gallstones?

Certain groups of people have a higher risk of developing gallstones than others.3

  • Women are more likely to develop gallstones than men. Women who have extra estrogen in their body due to pregnancy, hormone replacement therapy, or birth control pills may be more likely to produce gallstones.
  • Older people are more likely to develop gallstones. As you age, the chance that you’ll develop gallstones becomes higher.
  • People with a family history of gallstones have a higher risk.
  • American Indians have genes that raise the amount of cholesterol in their bile, and have the highest rate of gallstones in the United States.
  • Mexican Americans are also at higher risk of developing gallstones.

American Indians have genetic factors that make them more likely to develop gallstones.

People with certain health conditions

You are more likely to develop gallstones if you have one of the following health conditions:

People with diet- and weight-related health concerns

You are more likely to develop gallstones if you

Learn more about dieting and gallstones.

What are the complications of gallstones?

Complications of gallstones can include

  • inflammation of the gallbladder
  • severe damage to or infection of the gallbladder, bile ducts, or liver
  • gallstone pancreatitis, which is inflammation of the pancreas due to a gallstone blockage

Many people do not have symptoms of gallstones until they have complications.

If left untreated, gallstones can be deadly. Treatment for gallstones usually involves gallstone surgery.

References

[1] Portincasa P, Wang DQ-H. Gallstones. In: Podolsky, DK, Camilleri M, Fitz JG, Kalloo, AN, Shanahan F, Wang, TC, eds. Yamada’s Textbook of Gastroenterology. Volume 2. 6th edition. Hoboken, NJ: Wiley-Blackwell; 2015:1808–1834.

[2] Gallstones. American Gastroenterological Association website. http://www.gastro.org/patient-care/conditions-diseases/gallstones. Accessed November 27, 2017.

[3] Portincasa P, Wang DQ-H. Gallstones. In: Podolsky, DK, Camilleri M, Fitz JG, Kalloo, AN, Shanahan F, Wang, TC, eds. Yamada’s Textbook of Gastroenterology. Volume 2. 6th edition. Hoboken, NJ: Wiley-Blackwell; 2015:1808–1834.

Gallstones | Symptoms, Causes and Treatment

What are gallstones?

Gallstones occur when bile, which is normally fluid, forms stones. Gallstones commonly contain lumps of fatty (cholesterol-like) material that has solidified and hardened. Sometimes bile pigments or calcium deposits form gallstones. Sometimes just a few small stones are formed; sometimes a great many. Occasionally, just one large stone is formed.

Human gallstones

George Chernilevsky, CC BY-SA 4.0, via Wikimedia Commons

By George Chernilevsky, CC BY-SA 4.0, via Wikimedia Commons

About one in three women, and one in six men, form gallstones at some stage in their lives. Gallstones become more common with increasing age. The risk of forming gallstones increases with pregnancy, obesity, rapid weight loss, having a close relative with gallstones, and diabetes, and if you take certain medicines such as the contraceptive pill.

You can find out more about the gallbladder and bile in the Further Reading section at the end of this leaflet.

Summer crunch salad

Crunchy summer salad of green beans, juicy tomatoes, sliced mushrooms, fresh herbs, and parmesan…

Symptoms of gallstones

Commonly they cause no problems

Most people with gallstones do not know they have them. It is common to have stones in the gallbladder that cause no symptoms. Gallstones are often found when the tummy (abdomen) is scanned or X-rayed for other reasons.

Possible problems

About one out of three people with gallstones develop symptoms or problems. Symptoms are more likely to develop in smokers and women who have had a lot of children. Symptoms include:

  • Biliary colic. This is a severe pain in the upper abdomen. The pain is usually worst to the right-hand side, just below the ribs. It is caused by a stone that becomes stuck in the cystic duct. This is the small tube that takes bile from the gallbladder to the bile duct. The gallbladder then squeezes (contracts) hard to dislodge the stone and this causes pain. The pain eases and goes if the gallstone is pushed out into the bile duct (and then usually out into the gut), or if it falls back into the gallbladder.

    Pain from biliary colic can last just a few minutes but, more commonly, lasts for several hours. A severe pain may only happen once in your lifetime, or it may flare up from time to time. Sometimes less severe but niggly pains occur now and then, particularly after a fatty meal when the gallbladder contracts most.

  • Inflammation of the gallbladder. This is called cholecystitis. This can lead to infection in the gallbladder. Symptoms usually develop quickly and include abdominal pain, high temperature (fever) and being generally unwell. You will normally be admitted to hospital and have your gallbladder removed soon if you develop this problem. See the separate leaflet called Cholecystitis which provides more details.
  • Jaundice. This is an uncommon complication of gallstones. It occurs if a gallstone comes out of the gallbladder but gets stuck in the bile duct. Bile then cannot pass into the gut and so seeps into the bloodstream. This causes yellowing of your skin or the whites of the eyes (jaundice). The stone may eventually be passed into the gut. However, it is common to need an operation to remove a gallstone which has become stuck in the bile duct. (Note: there are many other causes of jaundice apart from gallstones.) See the separate leaflet called Jaundice which provides more details.

Blockage illustration

BruceBlaus, CC BY-SA 4.0, via Wikimedia Commons

By BruceBlaus, CC BY-SA 4.0, via Wikimedia Commons

  • Pancreatitis. This is an inflammation of the pancreas. The pancreas makes a fluid rich in enzymes (chemicals which digest food):
  • Other complications. These occasionally occur, such as severe infection of the bile duct, obstruction of the bowel and other uncommon gut problems.

How are gallstones diagnosed?

In many cases your symptoms, combined with tenderness in the upper right side of your tummy (abdomen), will alert the doctor that this is likely to be gallstones. However, tests are sometimes needed to rule out other conditions such as stomach ulcers, irritable bowel syndrome and tumours. An ultrasound scan and blood tests are the most common investigations done. Other investigations including different types of scans may sometimes be required.

Gallstones treatment

No treatment is needed in most cases

It is often best to leave gallstones alone if they cause few or no symptoms. If symptoms are problematic after fatty food, it makes sense to avoid that type of food. For more details, see the leaflet called Gallstones diet sheet. 

Medication

Once gallstones start giving symptoms, surgery is the best treatment. However, you may be given painkillers and antibiotic medication through a drip if the gallbladder becomes infected. Surgery is performed once the infection settles down – usually a week later.

Taking a medicine called ursodeoxycholic acid may sometimes dissolve small stones. This may take years of treatment, is not usually successful and is therefore not commonly used. However, it may be used to prevent gallstones developing when there is a high risk of them forming. For example, it may be used in people who lose weight rapidly following surgery for obesity. 

Surgery

An operation to remove the gallbladder is the usual treatment if you have troublesome symptoms caused by gallstones. Different techniques to remove the gallbladder may be recommended depending on its site, size and other factors.

  • Keyhole surgery is now the most common way to remove a gallbladder. The medical term for this operation is laparoscopic cholecystectomy. It is called keyhole surgery, as only small cuts are needed in the tummy (abdomen) with small scars remaining afterwards. The operation is done with the aid of a special telescope that is pushed into the abdomen through one small cut. This allows the surgeon to see the gallbladder. Instruments pushed through another small cut are used to cut out and remove the gallbladder. Keyhole surgery is not suitable for all people.
  • Some people with gallstones need a traditional operation to remove the gallbladder. This is called cholecystectomy. In this operation a larger cut is needed to get at the gallbladder.
  • Other surgical procedures may be needed if a stone becomes stuck in the bile duct.

Editor’s note

Dr Sarah Jarvis, 5th July 2021

Laser treatment to break up bile duct stones
A procedure called laser lithotripsy can be used to break up stones in the bile duct. This is usually carried out under general anaesthetic using endoscopy – a flexible telescope inserted through the mouth. A laser fibre is inserted gently through the flexible telescope and used to break the stones into smaller pieces, which can be more easily removed.

The National Institute for Health and Care Excellence (NICE) has looked at the evidence for this treatment. They recommend that it should only be considered for difficult-to-treat bile duct stones, with special arrangements for monitoring. This is because it has been found to be effective, but at the moment there is limited evidence about its long-term safety.

You can find out more about this procedure, and NICE’s recommendations, from the further reading section at the end of this leaflet.

After a gallbladder is removed

You do not need a gallbladder to digest food. Bile still flows from the liver to the gut once the gallbladder is removed. However, there is no longer any storage area for bile between meals. The flow of bile is therefore constant, without the surges of bile that occur from a gallbladder when you eat a meal.

You can usually eat a normal diet without any problems after your gallbladder is removed, although some patients are advised to eat a low-fat diet. Up to half of people who have had their gallbladder removed have some mild tummy (abdominal) pain or bloating from time to time. This may be more noticeable after eating a fatty meal. Some people notice an increase in the frequency of passing stools (faeces) after their gallbladder is removed. This is like mild diarrhoea. It can be treated by antidiarrhoeal medication if it becomes troublesome.

Post-cholecystectomy syndrome

Whilst it is unusual to have problems following gallbladder removal, some patients develop problems including tummy (abdominal) pain, yellowing of their skin or the whites of the eyes (jaundice) or indigestion symptoms.

Understanding the gallbladder and bile

Bile is a fluid made in the liver. Bile contains various substances, including bile pigments, bile salts, cholesterol and lecithin. Bile is passed into tiny tubes called bile ducts. The bile ducts join together (like the branches of a tree) to form the main bile duct. Bile constantly drips down the bile ducts, into the main bile duct and then into the gut.

The gallbladder lies under the liver on the right side of the upper tummy (abdomen). It is like a pouch which comes off the main bile duct and fills with bile. It is a ‘reservoir’ which stores bile. The gallbladder squeezes (contracts) when we eat. This empties the stored bile back into the main bile duct. The bile passes along the remainder of the bile duct into the first part of the gut, known as the duodenum.

Bile helps to digest food, particularly fatty foods.

Gallstones in Women – American College of Gastroenterology

Since 80% of persons with gallstones have no symptoms, it is important to realize that tests for gallstones are only needed when symptoms are present. Your doctor will know which of the following tests would be best for you.

Abdominal Ultrasound: this is the safest, simplest and most readily available test to diagnose gallstones. Sonar waves from a probe are passed over the abdomen to visualize the gallbladder and detect the presence of stones. This test is not an x-ray and can be safely performed during pregnancy.

OCG (Oral Cholecystogram): this is an x-ray test. Iodine pills are given and an x-ray taken the following day. This test should not be performed during pregnancy.

CT Scan (computerized tomography): this test uses x-rays which are not safe during pregnancy. This test is not very accurate for diagnosing gallstones.

Nuclear Scan (HIDA, DISIDA): This test involves injection of a tiny amount of radioactive tracer into the blood, which quickly accumulates in the liver and gallbladder and can be seen with a special camera. This is a very accurate and safe test during an acute attack, but generally is not recommended during pregnancy.

ERCP (Endoscopic Retrograde Cholangiopancreatogram): This is a very important x-ray test that is used only in special cases. It is generally not done during pregnancy. Sometimes, the ERCP test is the only way to diagnose gallstones or stones that have migrated into the bile duct. This procedure may be used to remove gallstones that have migrated into the bile duct and sometimes avoid the need for surgery.

Infection of the bile ducts is called cholangitis. This is a very serious medical illness, characterized by abdominal pain, fever, yellowing of the eyes and skin (jaundice), and even infection in the blood stream. When cholangitis occurs, the ERCP test is usually done on an emergency basis to remove obstructing stones and drain the infection.

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  • Department of Surgery – Gallstones

    What are gallstones?

    Gallstones are hard particles that develop in the gallbladder. The gallbladder is a small, pear-shaped organ located in the upper right abdomen—the area between the chest and hips—below the liver. 

    Gallstones can range in size from a grain of sand to a golf ball. The gallbladder can develop a single large gallstone, hundreds of tiny stones, or both small and large stones. Gallstones can cause sudden pain in the upper right abdomen. This pain, called a gallbladder attack or biliary colic, occurs when gallstones block the ducts of the biliary tract.

    By BruceBlaus (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)], via Wikimedia Commons

    What is the biliary tract?

    The biliary tract consists of the gallbladder and the bile ducts. The bile ducts carry bile and other digestive enzymes from the liver and pancreas to the duodenum—the first part of the small intestine. 

    The liver produces bile—a fluid that carries toxins and waste products out of the body and helps the body digest fats and the fat-soluble vitamins A, D, E, and K. Bile mostly consists of cholesterol, bile salts, and bilirubin. Bilirubin, a reddish-yellow substance, forms when hemoglobin from red blood cells breaks down. Most bilirubin is excreted through bile. 

    The bile ducts of the biliary tract include the hepatic ducts, the common bile duct, the pancreatic duct, and the cystic duct. The gallbladder stores bile. Eating signals the gallbladder to contract and empty bile through the cystic duct and common bile duct into the duodenum to mix with food.

    [Top]

    What causes gallstones?

    Imbalances in the substances that make up bile cause gallstones. Gallstones may form if bile contains too much cholesterol, too much bilirubin, or not enough bile salts. Scientists do not fully understand why these imbalances occur. Gallstones also may form if the gallbladder does not empty completely or often enough. 

    The two types of gallstones are cholesterol and pigment stones:

    • Cholesterol stones, usually yellow-green in color, consist primarily of hardened cholesterol. In the United States, more than 80 percent of gallstones are cholesterol stones.1
    • Pigment stones, dark in color, are made of bilirubin.

    [Top]

    Who is at risk for gallstones?

    Certain people have a higher risk of developing gallstones than others:2

    • Women are more likely to develop gallstones than men. Extra estrogen can increase cholesterol levels in bile and decrease gallbladder contractions, which may cause gallstones to form. Women may have extra estrogen due to pregnancy, hormone replacement therapy, or birth control pills. 
    • People over age 40 are more likely to develop gallstones than younger people. 
    • People with a family history of gallstones have a higher risk. 
    • American Indians have genetic factors that increase the amount of cholesterol in their bile. In fact, American Indians have the highest rate of gallstones in the United States—almost 65 percent of women and 30 percent of men have gallstones. 
    • Mexican Americans are at higher risk of developing gallstones. 

    Other factors that affect a person’s risk of gallstones include2

    • Obesity. People who are obese, especially women, have increased risk of developing gallstones. Obesity increases the amount of cholesterol in bile, which can cause stone formation. 
    • Rapid weight loss. As the body breaks down fat during prolonged fasting and rapid weight loss, the liver secretes extra cholesterol into bile. Rapid weight loss can also prevent the gallbladder from emptying properly. Low-calorie diets and bariatric surgery—surgery that limits the amount of food a person can eat or digest—lead to rapid weight loss and increased risk of gallstones. 
    • Diet. Research suggests diets high in calories and refined carbohydrates and low in fiber increase the risk of gallstones. Refined carbohydrates are grains processed to remove bran and germ, which contain nutrients and fiber. Examples of refined carbohydrates include white bread and white rice. 
    • Certain intestinal diseases. Diseases that affect normal absorption of nutrients, such as Crohn’s disease, are associated with gallstones. 
    • Metabolic syndrome, diabetes, and insulin resistance. These conditions increase the risk of gallstones. Metabolic syndrome also increases the risk of gallstone complications. Metabolic syndrome is a group of traits and medical conditions linked to being overweight or obese that puts people at risk for heart disease and type 2 diabetes.

    More information about these conditions is provided in the NIDDK health topic, Insulin Resistance and Prediabetes.

    Pigment stones tend to develop in people who have 

    • cirrhosis—a condition in which the liver slowly deteriorates and malfunctions due to chronic, or long lasting, injury 
    • infections in the bile ducts 
    • severe hemolytic anemias—conditions in which red blood cells are continuously broken down, such as sickle cell anemia 

    [Top]

    What are the symptoms and complications of gallstones? 

    Many people with gallstones do not have symptoms. Gallstones that do not cause symptoms are called asymptomatic, or silent, gallstones. Silent gallstones do not interfere with the function of the gallbladder, liver, or pancreas. 

    If gallstones block the bile ducts, pressure increases in the gallbladder, causing a gallbladder attack. The pain usually lasts from 1 to several hours.1 Gallbladder attacks often follow heavy meals, and they usually occur in the evening or during the night. 

    Gallbladder attacks usually stop when gallstones move and no longer block the bile ducts. However, if any of the bile ducts remain blocked for more than a few hours, complications can occur. Complications include inflammation, or swelling, of the gallbladder and severe damage or infection of the gallbladder, bile ducts, or liver. 

    A gallstone that becomes lodged in the common bile duct near the duodenum and blocks the pancreatic duct can cause gallstone pancreatitis—inflammation of the pancreas. 

    Left untreated, blockages of the bile ducts or pancreatic duct can be fatal. 

    [Top]

    When should a person talk with a health care provider about gallstones? 

    People who think they have had a gallbladder attack should notify their health care provider. Although these attacks usually resolve as gallstones move, complications can develop if the bile ducts remain blocked. 

    People with any of the following symptoms during or after a gallbladder attack should see a health care provider immediately: 

    • abdominal pain lasting more than 5 hours 
    • nausea and vomiting 
    • fever—even a low-grade fever—or chills
    • yellowish color of the skin or whites of the eyes, called jaundice 
    • tea-colored urine and light-colored stools

    These symptoms may be signs of serious infection or inflammation of the gallbladder, liver, or pancreas. 

    [Top]

    How are gallstones diagnosed?

    A health care provider will usually order an ultrasound exam to diagnose gallstones. Other imaging tests may also be used. 

    • Ultrasound exam. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. A specially trained technician performs the procedure in a health care provider’s office, outpatient center, or hospital, and a radiologist—a doctor who specializes in medical imaging—interprets the images. Anesthesia is not needed. If gallstones are present, they will be visible in the image. Ultrasound is the most accurate method to detect gallstones.
    • Computerized tomography (CT) scan. A CT scan is an x ray that produces pictures of the body. A CT scan may include the injection of a special dye, called contrast medium. CT scans use a combination of x rays and computer technology to create three-dimensional (3-D) images. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. An x-ray technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Anesthesia is not needed. CT scans can show gallstones or complications, such as infection and blockage of the gallbladder or bile ducts. However, CT scans can miss gallstones that are present.
    • Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed pictures of the body’s internal organs and soft tissues without using x rays. A specially trained technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Anesthesia is not needed, though people with a fear of confined spaces may receive light sedation. An MRI may include the injection of contrast medium. With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some newer machines allow the person to lie in a more open space. MRIs can show gallstones in the ducts of the biliary system.
    • Cholescintigraphy. Cholescintigraphy—also called a hydroxyl iminodiacetic acid scan, HIDA scan, or hepatobiliary scan—uses an unharmful radioactive material to produce pictures of the biliary system. In cholescintigraphy, the person lies on an exam table and a health care provider injects a small amount of unharmful radioactive material into a vein in the person’s arm. The health care provider may also inject a substance that causes the gallbladder to contract. A special camera takes pictures of the radioactive material as it moves through the biliary system. A specially trained technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Anesthesia is not needed. Cholescintigraphy is used to diagnose abnormal contractions of the gallbladder or obstruction of the bile ducts. 
    • Endoscopic retrograde cholangiopancreatography (ERCP). ERCP uses an x ray to look into the bile and pancreatic ducts. After lightly sedating the person, the health care provider inserts an endoscope—a small, flexible tube with a light and a camera on the end—through the mouth into the duodenum and bile ducts. The endoscope is connected to a computer and video monitor. The health care provider injects contrast medium through the tube into the bile ducts, which makes the ducts show up on the monitor. The health care provider performs the procedure in an outpatient center or hospital. ERCP helps the health care provider locate the affected bile duct and the gallstone. The stone is captured in a tiny basket attached to the endoscope and removed. This test is more invasive than other tests and is used selectively. 

    Health care providers also use blood tests to look for signs of infection or inflammation of the bile ducts, gallbladder, pancreas, or liver. A blood test involves drawing blood at a health care provider’s office or commercial facility and sending the sample to a lab for analysis. 

    Gallstone symptoms may be similar to those of other conditions, such as appendicitis, ulcers, pancreatitis, and gastroesophageal reflux disease. 

    Sometimes, silent gallstones are found when a person does not have any symptoms. For example, a health care provider may notice gallstones when performing ultrasound for a different reason. 

    [Top]

    How are gallstones treated?

    If gallstones are not causing symptoms, treatment is usually not needed. However, if a person has a gallbladder attack or other symptoms, a health care provider will usually recommend treatment. A person may be referred to a gastroenterologist—a doctor who specializes in digestive diseases—for treatment. If a person has had one gallbladder attack, more episodes will likely follow. 

    The usual treatment for gallstones is surgery to remove the gallbladder. If a person cannot undergo surgery, nonsurgical treatments may be used to dissolve cholesterol gallstones. A health care provider may use ERCP to remove stones in people who cannot undergo surgery or to remove stones from the common bile duct in people who are about to have gallbladder removal surgery.

    Surgery 

    Surgery to remove the gallbladder, called cholecystectomy, is one of the most common operations performed on adults in the United States. 

    The gallbladder is not an essential organ, which means a person can live normally without a gallbladder. Once the gallbladder is removed, bile flows out of the liver through the hepatic and common bile ducts and directly into the duodenum, instead of being stored in the gallbladder. 

    Surgeons perform two types of cholecystectomy: 

    • Laparoscopic cholecystectomy. In a laparoscopic cholecystectomy, the surgeon makes several tiny incisions in the abdomen and inserts a laparoscope—a thin tube with a tiny video camera attached. The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of organs and tissues. While watching the monitor, the surgeon uses instruments to carefully separate the gallbladder from the liver, bile ducts, and other structures. Then the surgeon removes the gallbladder through one of the small incisions. Patients usually receive general anesthesia. 

      Most cholecystectomies are performed with laparoscopy. Many laparoscopic cholecystectomies are performed on an outpatient basis, meaning the person is able to go home the same day. Normal physical activity can usually be resumed in about a week.3

    • Open cholecystectomy. An open cholecystectomy is performed when the gallbladder is severely inflamed, infected, or scarred from other operations. In most of these cases, open cholecystectomy is planned from the start. However, a surgeon may perform an open cholecystectomy when problems occur during a laparoscopic cholecystectomy. In these cases, the surgeon must switch to open cholecystectomy as a safety measure for the patient. 

      To perform an open cholecystectomy, the surgeon creates an incision about 4 to 6 inches long in the abdomen to remove the gallbladder.4 Patients usually receive general anesthesia. Recovery from open cholecystectomy may require some people to stay in the hospital for up to a week. Normal physical activity can usually be resumed after about a month.3

    A small number of people have softer and more frequent stools after gallbladder removal because bile flows into the duodenum more often. Changes in bowel habits are usually temporary; however, they should be discussed with a health care provider. 

    Though complications from gallbladder surgery are rare, the most common complication is injury to the bile ducts. An injured common bile duct can leak bile and cause a painful and possibly dangerous infection. One or more additional operations may be needed to repair the bile ducts. Bile duct injuries occur in less than 1 percent of cholecystectomies.5

    Nonsurgical Treatments for Cholesterol Gallstones

    Nonsurgical treatments are used only in special situations, such as when a person with cholesterol stones has a serious medical condition that prevents surgery. Gallstones often recur within 5 years after nonsurgical treatment.6

    Two types of nonsurgical treatments can be used to dissolve cholesterol gallstones:

    • Oral dissolution therapy. Ursodiol (Actigall) and chenodiol (Chenix) are medications that contain bile acids that can dissolve gallstones. These medications are most effective in dissolving small cholesterol stones. Months or years of treatment may be needed to dissolve all stones. 
    • Shock wave lithotripsy. A machine called a lithotripter is used to crush the gallstone. The lithotripter generates shock waves that pass through the person’s body to break the gallstone into smaller pieces. This procedure is used only rarely and may be used along with ursodiol. 

    [Top]

    Eating, Diet, and Nutrition

    Factors related to eating, diet, and nutrition that increase the risk of gallstones include

    • obesity 
    • rapid weight loss 
    • diets high in calories and refined carbohydrates and low in fiber 

    People can decrease their risk of gallstones by maintaining a healthy weight through proper diet and nutrition. 

    Ursodiol can help prevent gallstones in people who rapidly lose weight through low-calorie diets or bariatric surgery. People should talk with their health care provider or dietitian about what diet is right for them. 

    [Top]

    Points to Remember

    • Gallstones are hard particles that develop in the gallbladder.
    • Imbalances in the substances that make up bile cause gallstones. Gallstones may form if bile contains too much cholesterol, too much bilirubin, or not enough bile salts. Scientists do not fully understand why these imbalances occur. 
    • Women, people over age 40, people with a family history of gallstones, American Indians, and Mexican Americans have a higher risk of developing gallstones. 
    • Many people with gallstones do not have symptoms. Gallstones that do not cause symptoms are called asymptomatic, or silent, gallstones.
    • If gallstones block the bile ducts, pressure increases in the gallbladder, causing a gallbladder attack.
    • Gallbladder attacks often follow heavy meals, and they usually occur in the evening or during the night.
    • Gallstone symptoms may be similar to those of other conditions. 
    • If gallstones are not causing symptoms, treatment is usually not needed. However, if a person has a gallbladder attack or other symptoms, a health care provider will usually recommend treatment. 
    • The usual treatment for gallstones is surgery to remove the gallbladder. If a person cannot undergo surgery, nonsurgical treatments may be used to dissolve cholesterol gallstones. A health care provider may use endoscopic retrograde cholangiopancreatography (ERCP) to remove stones in people who cannot undergo surgery or to remove stones from the common bile duct in people who are about to have gallbladder removal surgery. 
    • The gallbladder is not an essential organ, which means a person can live normally without a gallbladder. Once the gallbladder is removed, bile flows out of the liver through the hepatic and common bile ducts and directly into the duodenum, instead of being stored in the gallbladder. 

    [Top]

    References

    [Top]

    Clinical Trials

    The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. 

    What are clinical trials, and are they right for you?
    Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for youExternal NIH Link. 

    What clinical trials are open?
    Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.govExternal Link Disclaimer. 

    This information may contain content about medications and, when taken as prescribed, the conditions they treat. When prepared, this content included the most current information available. For updates or for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888-INFO-FDA (1-888-463-6332) or visit www.fda.govExternal Link Disclaimer. Consult your health care provider for more information.

    The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, the omission does not mean or imply that the product is unsatisfactory. 

    [Top]


    This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

    The NIDDK would like to thank:
    Michael G. Sarr, M.D., Mayo Clinic

    This information is not copyrighted. The NIDDK encourages people to share this content freely.


    [Top]

    November 2013

    How to set up a tent – Knowledge Library

    How to set up a tent – Knowledge library – Sportmaster online store

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    The tent is the second home for the tourist. In order for this house to serve for a long time and remain comfortable and beautiful, it must be properly looked after.

    Setting up the tent

    Setting up a tent is, on the one hand, very simple, but on the other, it requires compliance with certain rules:

    Place for a tent

    Place for tent is better to choose a shady place, as ultraviolet light destroys the nylon fiber that is part of the tent fabric.The protective layer, which covers the fabric of the awning, also does not like “tanning”.

    In wooded areas, the best option is to set up your tent under the trees, but you need to make sure they are secure. It is best not to pitch your tent under dry and broken trees, as they can fall during strong winds.

    In the mountains and steppes, in open space, it is unlikely that it will be possible to find a shady area.

    The tent area should be carefully free of bumps, twigs, stones and other debris that could damage the floor fabric.

    It is also recommended to free the entrance area from things when the tent is already set up. Things can be placed compactly under the awning or in the corners of the tent itself.

    Assembling the tent

    When assembling the frame, parts of fastening must fit snugly against each other to avoid their detachment and deformation, for example, in strong wind gusts. If sand gets into the junction of the arcs, it should be cleaned so that the segments can easily dock with each other.

    It is important not to pull the tent too far with the pegs, so as not to damage the seams connecting the tent parts.

    Base should be straightened, stretching it evenly and avoiding strong distortions and kinks of the fabric.

    The outer awning should not come into contact with the tent itself, then the air gap between them will prevent condensation from leaking inside.

    Storm braces and their fixation

    Guys keep the outer tent of the tent in place against sudden gusts of wind and other spontaneous influences, giving the tent additional stability.

    Guys are usually supplied with new tents along with a set of pegs, as well as special buckles (with two or three holes), which regulate the length and tension of the guards.

    To attach a guy to the awning you need:

    Pass it through the special eyelet on the outer surface of the awning. The easiest way to do this is to make a small, fixed-length loop at the end of a guy, using, for example, a “conductor knot” or any other reliable knot you know.

    The end of the loop is threaded into the eyelet, after which the free end of the brace is threaded through the loop.

    This method of fastening allows, if necessary, to easily and quickly remove the brace from the awning without undoing the knot.

    It is convenient to use a sliding loop to put the guy-rope on the peg, which is made using a buckle from the set supplied with the tent. By moving the buckle, you can adjust the tension of the guy line without moving the peg.

    If there is no buckle, you can use the following tensioning method:

    Make a sliding loop at the free end using, for example, a “half-grip knot”;

    Place the loop over the peg and tighten tightly; (to adjust the tension, the peg is moved together with the guyed over it)

    It should be remembered that with any method of stretching, the braces are adjusted diagonally in pairs (front left – back right, center front – center back, etc.).

    a

    . In no case should they be pulled in a row, moving in a circle

    b

    , so as not to move and / or distort the already installed bottom of the tent.

    Taking off the tent for further transportation, guy lines or:

    Detach from the awning and put it in a bag together with pegs.

    Remove from the pegs and leave on the awning (so that freely dangling braces do not interfere with folding the awning).

    Each guy can be beautifully coiled, securing the coil with a marking unit.

    The fire should not be set too close to the tent so that sparks do not damage the fabric. In general, for its safety, smoking inside the “house” and lighting the tent with lighted matches is strongly discouraged.

    Tent wash

    After the hike, it is better to just clean the tent well of debris and dirt and ventilate it thoroughly.

    If very dirty places appear, you can moisten them with soapy water without using washing powder and wipe them with a cloth.

    It is necessary to renew the protective covering of the fabric from time to time. For this, there are special water-repellent impregnations and aerosols.

    It is recommended to clean the tent flat.

    Drying and storage

    Before packing for storage, the tent must be well dried to prevent mold.

    Store the tent in a dry place, not in the sun, in a slightly opened cover.

    Altai Center for Hydrometeorology and Environmental Monitoring

    Altai Territory

    m.Barnaul

    8 October

    9 October

    10 October

    8 October

    9 October

    10 October

    Temperature -1, + 4 gr, with clarification up to -6 gr.

    Temperature -1, + 4 gr.

    Temperature -2, + 3 gr.

    Temperature 0, + 2 gr.

    Temperature + 1, + 3 gr.

    Temperature 0, + 2 gr.

    In some areas, light rain, in places with sleet.

    Light rains in the east, with sleet in places.

    Mostly rainless.

    Light rain, sleet at times.

    Mostly rainless.

    Mostly no precipitation

    Southwest wind, 4-9 m / s, in places gusts up to 14 m / s.

    Southwest wind, 4-9 m / s, in places gusts up to 14 m / s.

    Southwest wind 6-11 m / s, in places gusts up to 16 m / s.

    Southwest wind, 4-9 m / s.

    South-west wind, 4-9 m / s.

    South-west wind, 6-11 m / s.

    Temperature + 5, + 10 gr.

    Temperature + 7, + 12 degrees, in some places in the south up to +17 degrees.

    Temperature + 8, + 13 gr.

    Temperature + 5, + 7 gr.

    Temperature + 10, + 12 gr.

    Temperature + 8, + 10 gr.

    Light rain in some areas, with sleet in the morning.

    Mostly rainless.

    Light rain in some areas.

    Light rain in the early afternoon, sleet in the morning.

    Mostly rainless.

    Light rain at the end of the day.

    Southwest wind, 4-9 m / s, in places gusts up to 14 m / s.

    Southwest wind, 7-12 m / s, in places gusts up to 18 m / s.

    South-west wind with a transition to north-west, 6-11 m / s, in places gusts up to 16 m / s.

    South-west wind, 4-9 m / s.

    South-west wind, 7-12 m / s.

    South-west wind with a transition to north-west, 6-11 m / s.

    90,000 In Primorye, a storm warning was issued due to the approach of a typhoon

    https://ria.ru/201/15588.html

    A storm warning was issued in Primorye due to the approach of a typhoon

    In Primorye, a storm warning was issued due to the approach of a typhoon – RIA Novosti, 03.03.2020

    In Primorye, a storm warning was issued due to the approach of typhoon

    Rescuers issued a warning about the approach of typhoon Tapa, which on September 23 will bring heavy rains to the southeastern and eastern regions of Primorye, according to … RIA Novosti, 03.03.2020

    2019-09-20T13: 18

    2019-09-20T13: 18

    2020-03-03T16: 16

    accidents

    Ministry of Emergency Situations of Russia (Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters)

    Primorsky Krai

    Russia

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    VLADIVOSTOK, 20 Sep – RIA Novosti. Rescuers have issued a warning about the approach of Typhoon Tapa, which on September 23 will bring downpours in the southeastern and eastern regions of Primorye, according to the regional chief executive of the Russian Emergencies Ministry. Earlier, forecasters reported that Typhoon Tapa would pass over the Sea of ​​Japan on September 23-24. On the night of September 23, the typhoon will pass over the south of the Korean Peninsula and then move northeast to the island of Hokkaido.In the afternoon of September 23, it will begin to influence the weather in Primorye. “On the day of September 23 and at night on September 24, in the southeastern and eastern regions of the region in the Artyomovsk, Dalnegorsk, Partizansky and Nakhodkinsky urban districts, the Bolshoy Kamen urban district and ZATO Fokino, Lazovsky, Olginsky, Partizansky, Shkotovsky, Terneisky and Kavalerovsky districts may experience heavy rains of up to 20 millimeters. On the coast, wind and sea waves will increase up to 4 meters, “the message says. overlapping power lines and communication lines, difficulties in the work of repair and restoration teams; disturbances in the operation of the housing and communal services system, collapse of structures, falling trees, cancellation of ferries.Rescuers advise to move to safe areas, temporarily refrain from leaving the settlements. Tourists – to postpone exits on routes, owners of small vessels – not to go out into the water area, the Ministry of Emergency Situations notes.

    https://ria.ru/201/1558598239.html

    Primorsky Krai

    Russia

    RIA Novosti

    [email protected]

    7 495 645-6601

    FSUE MIA “Russia Today”

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    2019

    RIA Novosti

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    7 495 645-6601

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    News

    ru-RU

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    RIA News

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    https://cdnn21.img.ria.ru/images/155493/07/1554930789_532-0:3263:2048_1920x0_80_0_0_9bf261cddf987f16c0bca0a54e381579.jpg

    internetgroup

    RIA Novosti

    internetgroup

    495 645-6601

    FSUE MIA “Russia Today”

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    RIA Novosti

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    7 495 645-6601

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    incidents, Russian Ministry of Emergency Situations (Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters), Primorsky Krai, Russia

    VLADIVOSTOK, September 20 – RIA Novosti. Rescuers have issued a warning about the approach of Typhoon Tapa, which on September 23 will bring downpours in the southeastern and eastern regions of Primorye, according to the regional head office of the Russian Emergencies Ministry.

    Earlier forecasters reported that typhoon “Tapa” will pass over the waters of the Sea of ​​Japan on September 23-24.On the night of September 23, the typhoon will pass over the south of the Korean Peninsula and then move northeast to the island of Hokkaido. On the afternoon of September 23rd, it will begin to influence the weather in Primorye.

    “On the afternoon of September 23 and at night on September 24 in the southeastern and eastern regions of the region in Artyomovsky, Dalnegorsky, Partizansky and Nakhodkinsky urban districts, Bolshoy Kamen urban district and ZATO Fokino, Lazovsky, Olginsky, Partizansky, Shkotovsky, Terneisky and Kavalerovsky districts pass the rains, in places strong with an amount of up to 20 millimeters.On the coast, the wind and sea waves will increase up to 4 meters, “the message says. Housing and communal services, collapse of structures, falling trees, cancellation of ferries.

    September 12, 2019, 10:18 am

    In the Khabarovsk Territory, because of the typhoon, the cordons of the reserve were flooded

    Rescuers advise to move to safe areas, temporarily refrain from leaving the settlements.Tourists – to postpone exits on routes, owners of small vessels – not to go out into the water area, the Ministry of Emergency Situations notes.

    Heavy rains expected in Vladivostok: storm warning announced – News – Events

    According to Primhydromet, tomorrow afternoon, August 23 , rain is expected from time to time in Vladivostok, and on the night of August 24 and in the morning August 24 – strong rain with 15-49 mm precipitation in 12 hours or less. The rains will be accompanied by winds up to 28 m / s.

    “Typhoon” SOULIK “reduced the speed of movement and in the afternoon on August 23, will leave for the southwestern coast of Korea. Further, the typhoon will move across the Korean Peninsula to the north to China, touching the Primorsky Territory with its eastern periphery, ”, – reported in Primhydromet.

    According to the Unified Duty Dispatch Service of Vladivostok, all life support services were ordered to be ready to eliminate the consequences caused by adverse weather conditions.It is also necessary to take measures to combat flooding of territories and structures.

    The brigades of the municipal enterprise “Maintenance of Urban Areas” continue to work on cleaning the storm sewer system to prevent flooding of city streets during the period of heavy rainfall. During peak hours, mobile brigades of UHT workers monitor city streets and promptly take action in case of flooding. In order for the water to leave the roadway faster, the road services promptly clean the grids of the storm inlets, and in extreme cases raise them, ensuring the drainage of the water.To clean storm pits clogged with silt, stones and other debris, special equipment is used – channel-washing machines.

    All violations in the work of the municipal economy can be reported to the operational duty officer of the city’s EDDS by phone 2222-333, 2614-033, 2400-813 (fax).

    It is possible that in the event of a significant amount of precipitation, water will be discharged from the Bogatinsky and Pionersky reservoirs and, as a consequence, flooding of the floodplains of the Sedanka and Bogataya rivers is possible.

    According to the information of the Single Duty Dispatch Service of the Vladivostok Administration

    Hiking in the Crimea. Part III. Laspinsky pass – Balaklava (7-9 days). – Our Ural

    Seventh day.

    A stormy gusty wind roared over the camp all night and it rained heavily. Everyone woke up before “getting up”. There was a swamp in the tents. Since the ground in the clearing where we set up camp was predominantly rocky, the pegs were not properly secured, therefore, the tents were not stretched enough to withstand such a storm.And there was simply nowhere to attach the windshields (storm guards) near the tent in the clearing. Whoever managed to find the stones managed to fix at least a little and pull the awning. But it didn’t help much – the stones were all small and light. As a result, the awning was soaked through – a gusty wind nailed it to the tent and it was still pouring rain from above – and all the water ended up in the tent. Nobody expected such a turn – after all, in the Crimea, and summer, heat, buzz … In addition to wet sleeping bags, many have soaked their backpacks and all their belongings.After a quick breakfast in the rain and gusty wind – the newly installed awning didn’t really save the attendants – four of our group left the route. And there were nine “little indians” left. For some reason, I still associate this with Agatha Christie’s world famous detective novel “10 Little Indians”

    We quickly assembled the camp, soaked through and through, under the drizzling rain, we moved on. On that day, I practically did not photograph anything – in order not to completely wet the equipment, the camera and phones were hidden deep in my backpack.Our way lay through Laspinsky pass to the mountain Kush-Kaya (664 m.) , which translated from the Crimean Tatar means “bird mountain” . There have always been many birds around the mountain. Basically, these were predators – falcons, kites, owls, osprey, hawks. So they called the top of Kush-Kai – Bird Mountain. And the Romans called her Senator.

    The ascent turned out to be, to put it mildly, difficult … The slope on the ascent was quite large in places, streams flowed from above, respectively, the entire path upward was blurred – there was mud, slippery porridge under our feet, in some places trees and branches freshly fallen from a strong wind lay.For those who were without trekking poles, it was even more difficult to climb – the legs slipped, there were almost no stones – no grip on the road, plus a heavy damp backpack, mud and streams under their feet, and it was raining from above … Beauty, in general … How many climbed exactly , it is difficult to say – it seemed to me that eternity.

    Having climbed to the top, we left our backpacks at about of the Cape Aya park-aviary and went to the Kush-Kaya observation deck, from where the gorgeous views of Laspinskaya bay open.Walk for 5-7 minutes. On the lookout it was just enough “fun” – the wind literally strove to blow us into the sea, it took a lot of effort to stay on our feet. The views from here are very beautiful. The southernmost point of Crimea is clearly visible – Cape Sarych , further on the coast is the village of Laspi . Laspi means mud . Perhaps this is the name because there were once numerous mud springs .You can also clearly see a mountain similar to a lobster – mountain Ilyas-Kaya (682 m.) , and below, under Kush-Kaya, the village Batiliman .

    Mount Ilyas-Kaya. Located 40 km from Sevastopol opposite Laspi Bay . This is the rocky massif of Baydarskaya Yaila , the peak of which is called Ilyas-Kaya and is located at an altitude of 682 meters above sea level.Almost at the top of Ilyas-Kai in the X-XV centuries was the fortified church of St. Ilya , which is why the name “Ilyas-Kaya” came from, which means “Saint Ilya” in Crimean Tatar. Ilya the Prophet occupies an important place in the Christian tradition, and many places in the Crimea are dedicated to him. Medieval monks were able to create a monastery in an impregnable place by building a wall of rubble stone on the eastern part of the mountain. At the approach to the top, there were fifty-meter fortifications that blocked access to the monastery buildings.This church stood here for five centuries, but now, after the same amount of time, nothing remains of it. However, the mountain continues to be named in honor of Elijah the prophet.

    Due to the wind, it was not possible to enjoy the views properly – we quickly took memorable pictures and returned to our backpacks. We dived into the open gate of the Cape Aya park-aviary . We ran along it and came out on the other side, where there is a closed enclosure for deer, and stopped in the parking lot behind the fence next to the enclosure.The parking is good. There are places for tents, a fire pit and a gazebo. Firewood is also not difficult to find. I was very pleased with the fact that at last there would be a fire – it would be possible to warm up and dry things, and the weather began to improve in the evening. We even went to the fenced part of the enclosure and looked at the deer. And there were also wild boars – they came to the evening feeding, but I did not find them, unfortunately.

    Cape Aya park-aviary. The idea to create an aviary on the slopes of the mountains Kokiya-kaya , Kush-kaya and Cape Aya belongs to a Sevastopol businessman, an avid hunter.The aviary is operated by the Orlinovskoye hunting farm. The territory of the aviary is accessible for tourists – there are 5 gates that are not locked. You need to go – open it. Opened – do not forget to close – it is not yet desirable for the animals to leave the enclosure. Then artificial migration of animals will be organized, exchange with other nurseries. There is also a gate with a vestibule of double gates for the entry of service vehicles, the supply of food and water, and new inhabitants. The territory is guarded round the clock.It is difficult to see the inhabitants of the aviary during the day. Animals are nocturnal. They go to the feeders and to the watering hole only after sunset. The beast is cautious, and does not approach a person. But there are many traces of being in the forest. Once upon a time, springs gurgled on the slopes of Kokiya-Byol tract . And today there are several sources from which the local inhabitants drink. The water is cloudy and there is not much of it, but it is there. Cleared of clay by the waterhole. In the dry season, water is provided by a tanker truck. Also, on the territory of the aviary, the remains of ancient gardens have been preserved, because people have settled here for many centuries.They have not been touched by a human hand for a long time. And so, a few years ago, modern grafts of new varieties of apple and pear trees appeared on old tree trunks, which took root well, went into growth and even gave the first poor harvest. There are already more than a hundred such trees within the enclosure. More is planned. Both scientists-breeders and entrepreneurs-agrarians are now showing interest in teapots (old gardens).

    Day eight.

    This day was probably the most enjoyable and positively eventful, especially considering the previous day.There were old ruins, beautiful mountain and sea landscapes and a bit of mountain extreme, swimming in the sea and meeting marine life, a colorful sunset and a mesmerizing moon path in the clouds on the sea surface, a delicious dinner with the “official part” of the trip. In general, such a great relaxation day came out

    I did not want to get out of the tent this morning, I think, not only me – we lay in the tent until it melted. In response to the one hundred thousandth and already slightly irritated call of the attendants that breakfast is ready, I somehow forced myself to crawl out of the “house”.It was a little cool outside, but it was felt that the weather was getting better. There was no rain at night – we managed to dry all the things. Lazily gathering the camp and, a little late on the schedule with the exit, with fresh forces, we moved further along our route. Diving again behind the gate of the park-aviary, we did not go straight along the path along which we came here yesterday, but turned right and along this road we passed the aviary to another exit. Leaving our backpacks near the trail, we climbed lightly to the observation deck “The Lost World” , which is on the mountain Kokiya-Kaya (558 m.).

    Mount Kokiya-Kaya. Or blue “Blue rock”. The height of the mountain is 558.5 meters. The name of the mountain Kokiya -Kala is a hybrid toponym (koka – “head”, Greek; kala, kale – “fortress”, Turk.). According to the researchers, there was a medieval Byzantine village, a monastery and a fortress on Kokia-Kala. Another version of the name of the mountain is also known – Kokiya-Kaya-Bash . The fortifications (local, rather later name – Kokiya-Isar ) at the top were completely destroyed in the 60s by a military radar station (radar station) built on the top. The military vehicles on which the stations were based were sheltered from the constant wind and precipitation at the summit and, if necessary, drove out of them, deployed antennas and “listened” and “scanned” the sky. The military unit was disbanded back in the 90s.From it there are concrete bunkers and ruins of houses.

    The views from the mountain are very beautiful! Nearby, in the western direction, two peaks are visible – Kok-Kiya-Kaya (557 m) and Kush-Kaya (627 m), which are sheer rocky ledges of Cape Aya extreme point of the Main ridge of the Crimean Mountains . A mountain is visible near the horizon Ilyas-Kaya (682 m.) and Cape Sarych , bordering Laspinskaya Bay from the east – this is the extreme point of Sevastopol . The part of the coastline on the eastern side directly under the steep slopes is called Batiliman (“deep bay”, Turkic). From this place, Mount Kakia-Kaya, the shortest path begins to the Turkish coast (about 270 km). According to ancient testimonies, in good weather, from the middle of the Pontus Euxine (Black Sea) one could see both shores: Cape Kriumetopon (“ram’s forehead”, Greek.) in Taurida (according to various versions, this is Ayudag, Sarych or Ai-Todor) and Cape Karambis in Asia Minor (now Cape Kerempe, Turkey). On the territory adjacent to the Laspinskaya Bay, there are many archeological monuments. In the Middle Ages, there were several villages and a port in the Laspinskaya depression. At the tip of Cape Kok-Kiya was located fortress Kok-Kiya-Isar , built to protect neighboring feudal settlements.The defensive wall with two towers is clearly visible. Excavations in the fortress-castle and on the territory of the settlements were not carried out. Also, deep below you can see a piece of sandy shore, surrounded on all sides by huge rocks. This place is called The Lost World .

    The Lost World tract. As a result of earthquakes and volcanic eruptions many thousands of years ago, there was a vertical cut of the rocks at Cape Aya.So the beach was formed, about a kilometer long. From the land, the beach was fenced off by steep stone walls half a kilometer high. It is fenced off from the sea by a vertical rocky wall about 560 meters high, which makes it almost inaccessible for an unprepared tourist – you can get here only from the sea or with the help of mountaineering equipment – and that’s why the beach got its name. This beach is located at a distance of 3.5 km from Balaklava Bay. Unlike the nearest Balaklava, this one is covered with good coarse sand, and not fine and sharp-edged pebbles.Locals say that these rocks were used by Admiral Nakhimov himself to target the guns and readily point to the characteristic round potholes from the cannonballs. On the other hand, the tract is bordered by Batiliman and Laspi Bay. For climbers, descent from the mountains surrounding the “Lost World” – Kokiya-Kala , Kush-Kaya , Samnalikh-Burun , takes more than five hours. But for tourists who decide to get here with the comfort of the sea, the journey will take only one hour. There are two beaches in the “Lost World” tract. One – the one over which the forest hangs, has a length of about one hundred meters, it is wide enough and consists of medium pebbles near the water, and a little further it crumbles into dark hot sand. The second beach is much smaller than the first and therefore less crowded, although tents are also set up there. It is located on the left – to get there, you have to jump over the stones for about fifty meters. On the way to the beach, there is a spring that is active only until July, in other months there is usually no water in it. The sea near the “Lost World” is very lively – in the waves you can often meet flocks of dolphins, and boats, boats and yachts usually stand near the coast.The water is always clear, but it can be much colder – it depends on currents, which sometimes carry deep, unheated layers to the surface.

    The Lost World tract

    I didn’t manage to take a picture of all this beauty – the equipment here decided to play a cruel joke with me. At first, in the already quite noticeably hot sun, all the optics on the camera and the camera itself fogged up. I think, okay, I’ll take a picture with my phone. I just took it out of my pocket, took one photo – he also began to “sweat”.It is no wonder – the bag from the camera, where the camera itself was, and the phone was stored in the same place – it was damp, did not have time to dry out, after the “storm actions”. The camera was still resuscitated by drying it in the hot sun, but this did not save the phone, unfortunately, upon arrival home, I still had to buy a new one.

    After enjoying the views, we went down to our backpacks. Further, our way lay to the beach “Inzhir”, where the long-awaited “unloading relaxation day” by the sea awaited us. Along the Big Sevastopol trail, along a rather steep section of it – it is better not to walk here in rainy weather, you can easily slip and fall into the sea, collecting all the protruding stones on the way down (the trail is very steep on the left hand), we reached of the Ayazma spring -Chokrak , where we took some water and turned to another path leading down directly to beach “Fig” .

    Spring Ayazma-Chokrak

    Immediately attention is drawn to the abundance of symbols of Buddhist orientation, painted on the stones, as if these are some pointers to those who are “in the subject”, you are on the right path to a certain gathering place.

    Inzhir has quite a few similar tent camps. Apparently this is some kind of “special place”, and the people were mostly peculiar around

    . After 10-15 minutes, we found ourselves in a free and quite cozy, picturesque meadow, located in a rare coniferous forest, surrounded by no less beautiful rocks and stone outliers.Here it was decided to stay for the night. The place is really very beautiful, but it is impossible to find a more or less level, not sloping place for a tent – this is a slope, it was fun to sleep.

    Ayazma tract. Ayazma tract in Crimea near extends east from Balaklava Bay to Cape Aya (absolute height – 556 m). The western border is located 3 kilometers from Balaklava and covers an area of ​​175 hectares. It is located in the Balaklava district of the city of Sevastopol, in the area of ​​ of the Gurush ridge. Nearby there is Kurshum-Bogaz pass and right there are Ayazma-Chokrak spring and a Medieval pottery kiln. It leads the tract to several wild beaches – Fig , Wandering , Cable , Komandirsky and Dalniy Fig . The modern name of the Ayazma tract near Balaklava has two versions of its origin. According to the first, it arose relatively recently, in the 1930s.It was formed from the Greek “aya” (sacred) and the Russian “zma” ​​(like Klyazma, for example). It was then that the toponym was officially registered. The second variation of the unusual name sounds a little different – “Ai-Yazma”. Translated as “blessed.” The territory of Ayazma has never been inhabited by people. The main reasons are the steep coastline and the complete absence of water sources. We can say that the tract miraculously escaped the influence of civilization. Its slopes, depending on the times and the year and the composition of the rocks, can be pink, green or brown.There are many caves, grottoes and tunnels in the rocks. The most valuable representatives of the local flora are Stankevich pines (listed in the Red Book), Pontic butcher, wild pistachios, jasmine and “shameless” (strawberry). They are all relics. The pine tree grows only in the Crimea. In 1982, the Ayazma tract in the Crimea became part of the Cape Aya State Wildlife Refuge.

    Having settled in the camp, we decided to go down to beach “Fig” , in order to swim in the sea and bask in the sun – the weather favored, it was hot enough, I think, not less than + 30ti.And our instructor went to see off another member of our group, who had a plane that day. And thus, there were eight “little indians” left (at the beginning of the journey there were 13). The paths down and not only not a little, it is difficult to get lost. The closer to the beach, the more often campgrounds are found. It is forbidden to burn fires, there is also a strain with water, there is no infrastructure on Inzhir – there is wild nature around. Those wishing to relax here will have to take food supplies with them. Water can be collected upstairs at Ayazma-Chokrak spring .

    When we went down to the beach, a girl and a guy with small backpacks walked in front of us. The guy had two five-liter plastic water bottles dangling on either side of the backpack. The bottles swayed when walking not sickly so. The descent goes downhill with a significant slope, the paths are narrow, the entire slope is strewn with stones. Looking at the guy, it seemed to me that he would not fly down, losing his balance due to the water bottles swinging in different directions. We were a little behind – we were admiring the views, having lost sight of these guys.And when they caught up, the guys were no longer on the trail – the guy was lying 10 meters from the trail below on the stones, and a girl was sitting next to him. The young man lost his balance and fell down. Of course, we offered help, etc., the guys assured that everything was fine, just bruises. From this moral – YOU MUST ALWAYS FOLLOW SAFETY TECHNIQUES! In this case, the bottles had to be tightly fixed to the backpack in order to avoid the “walking” weight behind the back, or to carry water in their hands. A couple of hours later, when we were already walking back to our camp, we passed these guys – they were doing well, they had already set up a tent and “settled down” in their camp.We also had some minor difficulties on the descent – we skipped the swerve and went further along the trail, and since we were too lazy to return, we decided to go down the stones about 2.5 meters high straight to the shore.

    Fig Beach This place is not as famous as many other natural attractions of the peninsula. There are no excursions here. Finding on your own is quite difficult. It is hidden from prying eyes by lush forests and a mountain range. Inzhir tract near Balaklava is difficult to see from the sea. Sailing by on a boat, only heaps of boulders and a narrow beach strip are visible. You can get here both by land and by sea. Shuttle boats (skiffs) go here from Balaklava – the cost is about 240 rubles per person – a full boat is dialed along the route and the captain of the ship will take you to the desired point. After disembarking the passengers, the boats remain standing a little further in the bay and, in their turn, approach the shore and pick up the passengers.This is the system. Also, from Balaklava you can walk here in about 2 hours – the trail is not easy, there are ups and downs, stones and boulders, but it is quite possible to overcome it even for a not particularly prepared person. Well, or like us, you can walk from Cape Aya along another part of the BST. There are two main versions of the origin of the name of the beach “Fig”. The first one is connected with a famous local landmark – a large remarkable rounded boulder with a crack in the middle. From a certain angle, the stone resembles a ripe fig fruit in shape.Also, because of the same specific stone with a crack, many call the beach a less decent word, which is called the “fifth point” of the human body. The second version, which looks more plausible, is several decades earlier they tried to breed figs here. Unfortunately, most of the plantings have been the victims of numerous forest fires. From them only the name remained, and the few remaining fig trees are now under the protection of the forestry.

    Beach “Inzhir”

    After a beach holiday, having met there with the local inhabitants – jellyfish and crabs, we returned to the camp, where the “official” part of the hike was waiting for us, on which all who successfully completed the entire route, the participants of the hike were given certificates about the -touristic route with characteristics.There were also memorable badges from the club and badges “Tourist of Russia” with a personal certificate were presented to him. This was the final, last evening of our trip. It was fun and soulful. And finally I managed to shoot a very colorful sea sunset. And then I had a chance to admire the big and bright moon, a lunar path on the sea surface, which was sometimes hidden by clouds, creating an indescribable feeling of the fabulousness of what was happening … Fascinating … It was a great day!

    Day nine.

    This was the final day of our campaign, the end point of which was Balaklava. From there we were to be picked up by a transfer and taken back to Simferopol. Having collected the camp, we climbed back to the Ayazma-Chokrak spring and, turning left from the spring, moved further along the Big Sevastopol trail (BST) towards Balaklava Bay , where, in fact, BST ends . A picturesque mountain trail with magnificent mountain and sea landscapes runs over the beaches “Zolotoy” and “Serebryanny”.

    Gold and Silver beaches. The bay of Megalo-Yalo (“big coast”, Greek) is bounded by Cape Fiolent (One of the translations of the name is “divine land”, Greek) in the east. The coastline is 21 kilometers long. In the central part of the bay, there is a low coast, on which the gravel and pebble beaches of Zolotoy, Blizhny and Serebryanny are located. Previously, the Golden Beach was called Megalo-Yalo in Greek. It is the longest of the Balaklava beaches.Its name is associated with the legend of gold on board the English ship “Prince”, which was wrecked during the time of the sign men and the Balaklava storm on November 2 (14), 1854. The section of the coast, referred to as the “Silver Beach”, is called by the locals “Nearest”. It is called “silver” because the color of the pebbles on the beach is silvery gray. There is also another old name for this beach – Mikro-Yalo (“small coast”, Greek).

    There are many attractions in the vicinity of the Silver Beach of Balaklava.The most famous of them is Genoese fortress Balaklava or fortress Chembalo – a defensive structure built by the Genoese on the territory of of the Fortress mountain , and nowadays it looks like ruins and is one of the most popular sights of the city … Not far from the fortress there is a fortification named Barrel of Death , built for the defense of Sevastopol during the First World War.This metal structure about two meters in diameter with loopholes cut in the walls rises above the sea surface.

    Genoese fortress and Balaklava bay

    Cembalo fortress. Cembalo is one of the architectural monuments. It was built by the Genoese in the middle of the XIV century. At that time, the fortress consisted of several parts – the Upper ( the city of St. Nicholas ) and the Lower ( the city of St. George ) cities.The latter was surrounded by walls on three sides. At the beginning of the 15th century, the Genoese settlement was captured by the Theodorites, but the inhabitants of the fortress were able to recapture it. The next seizure of Cembalo by the same feodorites took place almost 10 years later. However, the second time the siege did not last long, and the city was returned to Genoese control. In 1460, some changes were made to the appearance of the Lower City, in particular, a donjon tower was erected at the highest point of the territory. In 1475 the fortress was captured by the Turks.The guilty Crimean khans served their sentences here. After the annexation of Crimea to the Russian Empire in 1783, the territory of Chembalo was set aside for the deployment of garrison soldiers. During the Crimean War, the donjon tower was damaged. Then gradually the fortress began to decline. Great damage to the fortress was caused during the hostilities during the Great Patriotic War. In 2002, archaeological work by an expedition of the State Hermitage began on the territory of Chembalo. In 2009, the restoration of the fortress was initiated, but the restoration work was never completed.Today Cembalo, as before, is in ruins. The Genoese fortress consisted of two parts – the city of St. Nicholas and the city of St. George. The first city was the administration and was located on the edge of the cliff. In the city of St. Nicholas there was a church where noble persons were supposedly buried, a castle and a town hall, various buildings for household needs. The city of St. George is located closer to the Balaklava Bay, on the slope of the mountain. The inhabitants of Chembalo lived here: artisans, merchants, fishermen.The city of St. Nicholas, like the city of St. George, was surrounded by brick walls.

    Genoese fortress (Chembalo)

    Having reached Balaklava, I had another misfortune – I ran out of memory on the camera. Again, I didn’t really take pictures, and many adventures were planned ahead on the way home. There was no spare, later bought in Simferopol. I was very saddened by this fact – there is something to see and capture in Balaklava. The town seemed to me very warm, beautiful and cozy, despite the fair amount of people.I think that you should definitely visit Balaklava – in addition to beautiful views, there are many attractions here. Here are some of them:
    – First of all, this is of course Nazukin embankment . If you go towards the sea, you can see beautiful mountain and sea landscapes and a panoramic view of the Balaklava bay, which is full of snow-white boats and yachts. Historical and architectural structures, such as Sokolova’s dacha and Mikhaili’s House, are no less attractive.
    The Church of the Holy Twelve Apostles , along with other Orthodox shrines of Crimea, is a unique architectural monument of the 18th century.It was erected in the name of St. Nicholas the Wonderworker in 1794. The building of the temple was erected on the foundations of an old church built here in 1375.
    Genoese Fortress . Remains of the once great citadel of Cembalo, built by the Genoese in the XIV century. The fortress changed owners, was raided, destroyed and fortified again. It finally lost its purpose by the middle of the 19th century, and during the Second World War it was severely damaged.
    Balaklava Underground Museum Complex (Object 825GTS) .In the middle of the 20th century, during the Cold War, Balaklava was an important defense center: a unique complex was built under Mount Tavros for servicing military submarines and preparing nuclear missiles. Object 825GTS was well guarded: it was protected from external influences, and the disguised entrance provided complete secrecy. In 1994, the last submarine was withdrawn from here, the facility was closed. Now on its basis the Balaklava underground museum complex has been opened.
    Kadykovsky quarry , located northwest of Balaklava, was used by a local mining company, but has been abandoned.Gradually, the artificial reservoir was filled with water and turned into a small lake. The main feature of the quarry is the water with a bright blue tint.
    St. George rock. Georgievskaya rock is a mountainous island near Cape Fiolent. According to legend, the Greek sailors who founded the St. George Monastery saw St. George on this rock, who saved them from the storm. In the 19th century, a marble pedestal with a cross was erected on the island, which was removed in the 1920s. In 1991, a metal cross was installed in its place, but a few years later it fell due to a storm.Since 2019, a new 8-meter marble cross, standing on a granite base, rises above the island.
    The 19th gun battery was installed at Cape Kuron at the beginning of the 20th century. She was supposed to protect the approaches to Sevastopol from the sea – the guns placed here could hit targets at a distance of up to 20 km. Outbuildings and barracks were located next to the batteries. The defensive line was used during the Great Patriotic War, in the 1990s it was almost completely dismantled.
    Barrel of Death , built for the defense of Sevastopol during the First World War. It is a metal structure about two meters in diameter with loopholes cut into the walls.

    ⤗ Balaclava. History. According to one of the versions, Balaklava is translated from Turkish as “fish bag” (Balyk-yuv). According to another version, the name of the city is of Crimean Tatar origin and is translated as “fishy weather”. There is also another theory that Balaklava is a transformation of the Taurus name “the city of King Palak”.Some researchers believe that Balaklava was mentioned in Homer’s Odyssey. The exact information about the settlement dates back to the 1st century. According to the testimony of the ancient Roman writer Pliny, in a convenient bay there was a village of the Taurus, who hunted in fishing and piracy. The bay was named Symbolon. In the 1st century AD, the Romans defeated the Taurus and established a military camp in the bay. These lands were subject to Rome until the 3rd century. But even when the Romans left, here, for a century, there was a Greek settlement, later devastated by the Huns.In the 7th century, the Byzantine settlement of Yamboli was founded on the site of Balaklava. In the 14th century, the Genoese fortress Cembalo was founded here. In 1433, the local population organized an uprising against the Genoese, as a result of which these territories became part of the principality of Theodoro. In the 15th century Balaklava, like the whole Crimea, became part of the Ottoman Empire. In the 18th century, the peninsula was incorporated into the Russian Empire. During the Crimean War, Balaklava was occupied by the British, who built a wooden embankment here and even built a 13-kilometer railway.After the Crimean War, Balaklava was practically destroyed. The development of the city continued at the end of the 19th century, when the settlement began to be used as a resort. During the Great Patriotic War (or rather from 1942 to 1944) Balaklava was occupied by German troops. After the war, a submarine base was located in the city. Balaklava became part of Sevastopol and a closed territory. In the 90s, the military base ceased to exist. Since 2019 Balaklava has city status.

    Balaklava

    Coordinates of attractions on the route.

    44.494603, 33.598753 – Cembalo Fortress, Mount Kastron;
    44.494921, 33.597115 – Sokolova’s dacha;
    44.495758, 33.598561 – House of Mikhail;
    44.495758, 33.598561 – Yusupov’s hunting lodge – you can take beautiful photos with a view of the Balaklava Bay;
    44.497275, 33.599086 – Nazukin Embankment;
    44.500186, 33.599816 – Monument to A.I.Kuprin;
    44.500186, 33.599816 – Restaurant “Prince”;
    44.497702, 33.601381 – Church of the Holy Twelve Apostles;
    44.501157, 33.596581 – Balaklava underground museum complex;
    44.518653, 33.576576 – Kadykovsky quarry, observation deck;
    44.501803, 33.508842 – St. George’s Rock, Worship Cross;
    44.492584, 33.5

    – 19th coastal battery;
    44.492569, 33.619895 – Barrel of death.

    The best beaches of Balaklava from Kush-Kai to St. George’s Rock:
    44.418446, 33.686542 – Batiliman beach;
    44.428238, 33.648809 – Beach “The Lost World”;
    44.455923, 33.641953 – White Beach
    44.463171, 33.639712 – Dalniy Inzhir Beach
    44.466480, 33.638348 – Komandirsky Beach
    44.484229 Inzh – Beach
    44.470305, 33.637170 – Wandering Beach;
    44.472150, 33.635858 – Cable beach;
    44.479852, 33.629869 – Golden Beach;
    44.484231, 33.621410 – Gray Rock Beach
    44.482764, 33.624421 – Silver Beach;
    44.484232, 33.621392 – Blizhny beach;
    44.492754, 33.603359 – “Shaitan” beach;
    44.492024, 33.578085 – Vasili beach;
    44.503490, 33.507105 – Jasper Beach

    Balaklava beaches on the map 90,000 The Ministry of Emergency Situations issued an emergency storm warning for Friday and Saturday in Primorye – Vladivostok News on VL.ru

    Worsening weather conditions are predicted for Friday and Saturday, 2 and 3 October.In the region, it will rain with an amount of 15 to 40 mm in 12 hours or less, a strong wind with gusts of up to 27 m / s is expected, the water level will rise to 160 cm on small rivers, in some areas – with a possible exit from low banks.

    According to the Primorsky Department of Hydrometeorology and Environmental Monitoring, in the morning and afternoon of October 2 due to the impact of an active atmospheric front in the southern half of the region (Vladivostok, Ussuri, Artyomovsky, Nakhodkinsky, Partizansky urban districts and the Bolshoy Kamen urban district, Khasansky, Nadezhdinsky, Oktyabrsky, Shkotovsky, Partizansky, Pogranichny, Lazovsky, Spassky, Kirovsky, Khankaysky municipal districts) rain is expected, in places heavy with an amount of 15 to 40 mm in 12 hours or less.Thunderstorms are possible in some areas.

    In the afternoon on October 2 and in the first half of the night on October 3 , the precipitation zone will shift to the northwestern (Lesozavodsky, Dalnerechensky urban districts, Dalnerechensky, Krasnoarmeisky, Pozharsky municipal districts) and eastern districts (Dalnegorsky urban district, Terneisky, Kavalerovsky, Olginsky municipal districts).

    In Vladivostok and on the southern coast of Primorye (Nakhodkinsky urban district, ZATO Fokino, Bolshoy Kamen urban district, Olginsky, Shkotovsky, Khasansky municipal districts), the southern, southeastern wind is expected to increase up to 20 m / s, with gusts up to 27 m / s …

    On small rivers in the southern half of the region, water level rises of up to 160 cm are expected, in some areas with a possible exit from low banks, on the remaining rivers of the region, a rise of up to 100 cm is expected, without spills and flooding. Dangerous and unfavorable hydrological phenomena are not predicted.

    Due to the received warning the forecast is:

    – an increase in the number of accidents on the highways of local and federal (A-370) significance, difficulties in the operation of vehicles, restrictions on road traffic as a result of undermining of bridge supports, flooding and erosion of the roadway;

    – a rise in the water level on small rivers of the region, with flooding of farmland, outbuildings located in low areas of the terrain;

    – flooding of lowered areas of the terrain by a rain flood;

    – accidents at power lines associated with damage (undermining, breakage, overlap) of power lines and communication lines, difficulties in the work of repair and restoration teams;

    – violations in the operation of the housing and communal services system;

    – power failure due to falling trees on power lines;

    – collapse of weakly fortified, large-format, dilapidated and advertising structures;

    – violation of the ferry service on the territory of the Vladivostok city district, closed city of Fokino and Khasan MR;

    – the occurrence of emergency situations on ships located in the waters of the Sea of ​​Japan, due to strong sea waves.

    The Main Directorate of the EMERCOM of Russia in the Primorsky Territory recommends refraining from travel outside the settlements, excluding hunting, fishing and tourist routes. Vacationers on the coast need to move to safe places.

    Owners of small boats should refrain from entering the sea during the warning period, citizens are advised to refrain from swimming.

    The Ministry of Emergency Situations asks to report all incidents immediately by phones: 101 and 112.

    90,000 “Alternative” weather sites “cancel” storm for June 16 “Vladivostok and Primorsky Krai News

    “I do not confirm a storm warning announced in the Primorsky Territory!” – with this message the “alternative” weather site Maglipogoda addressed the media, according to “Vesti Primorye”

    According to this Internet resource, on June 16, near the coast of the Primorsky Territory, a moderate cyclone will pass. Light rain in the region during the day, moderate rain in the south, heavy in places.In the afternoon, moderate rain in the region, sometimes heavy in the south, heavy in the south-east. At night, light and moderate rain in the region, heavy in places, heavy rain in the east of the region. Presumably the most intense rains will take place in the eastern regions. Most precipitation will be in Lazovsky, Olginsky and Terneisky districts. The rain will be heavy mainly only in the east of the region, in the rest it will be moderate. The wind on the coast will be moderate, in gusts up to 15 m / s.

    “So I am explaining to everyone – the cyclone will not bring anything terrible, maybe it will even bring benefits to Primorye: it may drag the fog behind it.In short, it is an ordinary southern cyclone. “, According to the Maglipogod website.

    As a reminder, on June 15, the Main Directorate of the Ministry of Emergency Situations of Russia for the Primorsky Territory issued an emergency warning about an unfavorable weather phenomenon. According to the Primorsky UGMS, due to the displacement of the active cyclone near the coast of the Primorsky Territory, on June 16 and 17 over a larger territory of the Territory (Arsenyevsky, Artemovsky, Vladivostoksky, Dalnegorsky, Dalnerechensky, Lesozavodsky, Nakhodkinsky, Partizansky, Spassky, Ussuriysky urban districts, ZATO g.Fokino and GO Bolshoy Kamen, Anuchinsky, Dalnerechensky, Kavalerovsky, Kirovsky, Krasnoarmeisky, Lazovsky, Mikhailovsky, Nadezhdinsky, Oktyabrsky, Olginsky, Partizansky, Pogranichny, Pozharsky, Spassky, Terneisky, Khankaisky, Khasansky, Khorolsky, Chernigovsky, Chuguyevsky districts) heavy rains are expected with an amount of 15-40 mm in 12 hours or less. In the afternoon on June 16 in the southeast, at night and in the afternoon on June 17 in the eastern regions (Artemovsky, Vladivostok, Nakhodkinsky, Partizansky GO, Dalnegorsk GO, ZATO g.Fokino and Bolshoy Kamen, Nadezhdinsky, Partizansky, Lazovsky, Khasansky, Shkotovsky, Terneisky, Olginsky, Kavalerovsky MR), in some places very heavy rains are expected with more than 50 mm in 12 hours or less. On the coast, there is a strong wind of 15-20 m / s.

    On the rivers of the region, water levels are expected to rise up to 0.5 m. The rivers will not overflow their banks.

    Source: “Vesti: Primorye” [www.vestiprim.