What are gallstones and bile duct stones. How do they form. What are the risk factors for developing gallstones. How are gallstones diagnosed. What treatment options are available for gallstones and bile duct stones. When is surgery necessary for gallstone removal. What are the different surgical approaches for treating gallstones.

Understanding Gallstones and Bile Duct Stones

Gallstones and bile duct stones are common digestive system issues that can cause significant discomfort and health complications. These solid, pebble-like formations develop when there are abnormalities in bile composition, leading to crystallization and stone formation. While gallstones typically form in the gallbladder, they can sometimes migrate to the bile ducts, causing blockages and more severe symptoms.

The gallbladder, a small organ located beneath the liver, serves as a storage reservoir for bile – a digestive fluid produced by the liver. After meals, the gallbladder contracts, releasing bile into the small intestine to aid in the digestion of fats. When the balance of substances in bile is disrupted, it can lead to the formation of gallstones.

What causes gallstones to form?

Gallstones form due to several factors:

• Excess cholesterol in bile
• Excess bilirubin in bile
• Insufficient bile salts
• Incomplete emptying of the gallbladder

These factors can cause bile components to crystallize and form stones over time. The size of gallstones can vary from tiny grains of sand to golf ball-sized formations.

Who is at risk for developing gallstones?

While anyone can develop gallstones, certain risk factors increase the likelihood:

• Being female
• Obesity
• Age over 60
• Pregnancy
• Rapid weight loss
• Certain medical conditions (e.g., diabetes, liver disease)
• Family history of gallstones

Understanding these risk factors can help individuals take preventive measures and seek early medical attention if symptoms arise.

Diagnosing Gallstones and Bile Duct Stones

Accurate diagnosis of gallstones and bile duct stones is crucial for determining the appropriate treatment plan. Healthcare providers employ various diagnostic tools and techniques to identify these conditions.

What diagnostic procedures are used to detect gallstones?

Several diagnostic methods are available for detecting gallstones and bile duct stones:

1. Ultrasound: This non-invasive imaging technique uses sound waves to create pictures of the gallbladder and surrounding structures.
2. Cholecystography: An X-ray procedure that uses contrast dye to visualize the flow of fluid through the intestines and gallbladder.
3. Blood tests: These can reveal signs of infection, obstruction, jaundice, or pancreatitis associated with gallstones.
4. Computed tomography (CT) scan: This advanced imaging technique provides detailed cross-sectional images of the abdominal organs.
5. Endoscopic retrograde cholangiopancreatography (ERCP): A procedure that combines endoscopy and X-ray imaging to examine the bile ducts and pancreatic duct.

In some cases, a sphincterotomy may be performed during ERCP to widen the opening of the bile duct, allowing stones to pass into the intestine.

Treatment Options for Gallstones and Bile Duct Stones

The treatment approach for gallstones and bile duct stones depends on the severity of symptoms, the location of the stones, and the patient’s overall health. Treatment options range from non-surgical interventions to various surgical procedures.

When is surgery necessary for gallstone removal?

Surgery is typically recommended when gallstones or bile duct stones cause persistent symptoms or complications. These may include:

• Recurrent episodes of severe abdominal pain
• Inflammation of the gallbladder (cholecystitis)
• Blockage of the bile ducts
• Jaundice
• Pancreatitis

In such cases, surgical intervention aims to remove the gallbladder or extract the stones from the bile ducts to prevent further complications.

Surgical Approaches for Treating Gallstones

Surgeons at leading medical institutions offer various surgical options for treating gallstones and bile duct stones. These procedures range from minimally invasive techniques to traditional open surgeries.

What are the different surgical techniques for gallstone removal?

Several surgical approaches are available for treating gallstones:

1. Common Bile Duct Exploration: This procedure involves removing gallstones from the common bile duct. It can be performed laparoscopically or during open cholecystectomy.
2. ERCP (Endoscopic Retrograde Cholangiopancreatography): This technique is used to remove stones that have migrated from the gallbladder to the common bile duct. It is particularly useful for treating jaundice or pancreatitis caused by bile duct obstruction.
3. Open Cholecystectomy: This traditional surgical approach involves removing the entire gallbladder through a large incision. It requires general anesthesia and a longer recovery period but is highly effective in preventing future stone formation.
4. Laparoscopic Cholecystectomy: A minimally invasive procedure that uses small incisions and specialized instruments to remove the gallbladder. This technique offers reduced pain, faster recovery, and shorter hospital stays compared to open surgery.

The choice of surgical approach depends on factors such as the patient’s overall health, the location and size of the stones, and the surgeon’s expertise.

Non-Surgical Treatment Options for Gallstones

While surgery is often the most effective treatment for symptomatic gallstones, non-surgical options may be considered for patients who are not suitable candidates for surgery or prefer to avoid surgical intervention.

Are there non-surgical treatments available for gallstones?

Non-surgical treatments for gallstones include:

• Oral Dissolution Therapy: This involves taking medications that attempt to dissolve small gallstones. However, this treatment has limited success rates and is only suitable for a small percentage of patients.
• Watchful Waiting: For patients with asymptomatic gallstones, healthcare providers may recommend monitoring the condition without immediate intervention.
• Lifestyle Changes: Adopting a healthy diet, maintaining a healthy weight, and regular exercise may help prevent the formation of new gallstones.

It’s important to note that non-surgical treatments have lower success rates compared to surgical interventions and may not be suitable for all patients.

Preparing for Gallstone Treatment

If you are diagnosed with gallstones or bile duct stones, proper preparation is essential for a successful treatment outcome. This involves understanding the treatment process, discussing potential risks and benefits with your healthcare provider, and following pre-treatment instructions carefully.

How should patients prepare for gallstone treatment?

To prepare for gallstone treatment, patients should:

1. Undergo a thorough diagnostic examination to determine the extent of the condition
2. Discuss treatment options with their healthcare provider, including potential risks and benefits
3. Provide a complete medical history, including any allergies or medications
4. Follow pre-treatment instructions, such as fasting before surgery or stopping certain medications
5. Arrange for transportation and post-treatment care, especially if undergoing surgery
6. Prepare their home for recovery, if applicable

Proper preparation can help ensure a smoother treatment process and improve recovery outcomes.

Recovery and Follow-up Care After Gallstone Treatment

Recovery from gallstone treatment varies depending on the type of procedure performed. Patients who undergo minimally invasive procedures typically experience faster recovery times compared to those who have open surgery.

What can patients expect during recovery from gallstone treatment?

Recovery expectations after gallstone treatment include:

• For laparoscopic cholecystectomy: Most patients can return home within 24 hours and resume normal activities within a week.
• For open cholecystectomy: Hospital stay may be 3-4 days, with a 4-6 week recovery period at home.
• Pain management: Patients may experience some discomfort, which can be managed with prescribed medications.
• Dietary changes: A low-fat diet may be recommended initially, with gradual return to normal eating habits.
• Follow-up appointments: Regular check-ups to monitor recovery and address any concerns.

Following post-treatment instructions and maintaining open communication with healthcare providers are crucial for a successful recovery.

Preventing Gallstones and Maintaining Digestive Health

While not all gallstones can be prevented, certain lifestyle choices can reduce the risk of developing them and promote overall digestive health.

How can individuals reduce their risk of developing gallstones?

To lower the risk of gallstone formation, individuals can:

• Maintain a healthy weight through balanced diet and regular exercise
• Avoid rapid weight loss or extreme dieting
• Stay hydrated by drinking plenty of water
• Consume a diet rich in fiber and low in saturated fats
• Limit alcohol consumption
• Manage underlying health conditions, such as diabetes
• Consider preventive medications if at high risk (consult with a healthcare provider)

By adopting these healthy habits, individuals can promote digestive health and potentially reduce their risk of developing gallstones.

Understanding gallstones and bile duct stones, their causes, diagnostic methods, and treatment options is crucial for individuals experiencing symptoms or at risk of developing these conditions. By working closely with healthcare providers and following recommended prevention and treatment strategies, patients can effectively manage gallstone-related issues and maintain optimal digestive health. Remember that early detection and appropriate intervention are key to preventing complications and ensuring the best possible outcomes in gallstone management.

Gallstones and Bile Duct Stones

The function of the gallbladder is to store bile that is secreted by the liver. Following a meal, this stored bile is released into the intestine, aiding digestion. Abnormalities of bile composition can lead to the formation of gallstones. Anyone can develop gallstones, but known risk factors include being female, obese and older than 60. In most patients with gallstones, the stones are confined to the gallbladder but sometimes they appear in and block the common bile duct, the tube that transports bile from the gallbladder to the intestine. Learn more about gallstones, their risks and causes.

At Brigham and Women’s Hospital (BWH), our board certified general and gastrointestinal surgeons offer the most innovative and effective treatment for patients with bile duct stones and gallstones, performing the latest and most effective minimally invasive surgical procedures, including laparoscopic cholecystectomy.

Diagnosis of Gallstones and Bile Ducts Stones

Surgeons at BWH offer a range of procedures for diagnosing gallstones and bile duct stones:

• Ultrasound
• Cholecystography is an X-ray that shows the flow of contrast fluid through the intestines into the gallbladder.
• Blood tests look for signs of infection, obstruction, jaundice, and/or pancreatitis.
• Computed tomography scan (also called CT or CAT scan)
• ERCP (Endoscopic retrograde cholangiopancreatography) involves inserting an endoscope through the stomach and into the small intestine. A special dye is injected to reveal the ducts in the biliary system. This is done through the Division of Gastroenterology, Hematology and Endoscopy
• Sphincterotomy is a procedure that opens the muscle sphincter wide enough so stones can pass into the intestine.

Learn about additional diagnostic tests for liver and biliary conditions.

Treatment for Gallstones and Bile Duct Stones

Surgical Treatment

If gallstones or bile duct stones cause persistent symptoms, surgical treatment may be recommended. Surgeons at BWH are experts in all surgical approaches for gallstones and bile duct stones including traditional and minimally invasive options:

• Common Bile Duct Exploration Gallstones within the common bile duct can be removed using a surgical procedure known as common bile duct exploration. This procedure can be done either laparoscopically or during open cholecystectomy.
• ERCP (Endoscopic retrograde cholangiopancreatography) is an appropriate technique for removal of stones that have passed from the gallbladder and are stuck in the common bile duct. This can cause the development of jaundice or pancreatitis. When a stone is found during diagnostic endoscopy, it is typically removed by a gastroenterologist.
• Open Cholecystectomy refers to surgical removal of the gallbladder. In the open procedure, general anesthesia is used. A five-inch incision is made under the right rib cage or in the upper midline, and the gallbladder is removed. Usually three to four days of hospitalization are required. A four to six week recovery period at home follows, after which patients can resume full activity. The disadvantages are the pain, the long recovery and the large incision. The advantages are that the gallbladder has been removed and there is almost no chance of further stones forming.
• Laparoscopic Cholecystectomy During laparoscopic cholecystectomy your surgeon operates miniature instruments under video laparoscopic monitoring. Although general anesthesia is still used, the incisions are smaller than an inch in length. Because this procedure is less invasive, there is less pain and the recovery is more rapid than after open cholecystectomy. The procedure usually is completed in less than two hours, and most patients can be discharged from the hospital several hours afterwards. Most patients resume full activities within seven days after the operation.

Read recommendations for before and after cholecystectomy surgery.

Non-Surgical Treatment

Non-surgical methods for treating gallstones are associated with limited success rates, but may be options for patients who are not surgical candidates:

• Oral Dissolution Therapy is used to attempt to dissolve the gallstones. The stones must be small, not too numerous, and not contain calcium. Less than twenty percent of patients qualify for this treatment; of those who do, only one-third respond to this form of therapy. Even among patients successfully treated, more than half develop new gallstones within five years.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have gallstones or bile duct stones and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced general and gastrointestinal surgeon are important to the successful outcome for patients with liver and gallbladder conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with gallstones or bile duct stones. After surgery you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

Brigham and Women’s Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues who have extensive experience in diagnosing and treating gallstones and bile duct stones. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

General and Gastrointestinal Surgery Appointments and Locations

• Our General and Gastrointestinal Surgery Team
• Request General and Gastrointestinal Surgery Appointment
• General and Gastrointestinal Surgery Locations

Resources

Go to our health library to learn more about gallstones and bile duct stones.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Visit the Weiner Center for Preoperative Evaluation.

Managing Your Gallstones – Symptoms & Treatment

What Are Gallstones?

Gallstones are solid deposits of cholesterol and other substances in bile that develop because the levels of these chemicals become unbalanced. The gallbladder is a small sack located underneath the liver. It stores bile that the liver makes and squirts the bile into the bowel (intestine) when a meal is eaten. Bile helps digest fats in the food. Under certain conditions, the gallbladder can form gallstones (cholelithiasis).

Gallstones are common: up to 20% of men and 40% of women get gallstones. More women get gallstones because of the effects of estrogen (a female hormone) on bile. Being overweight, aging, and fasting for a long time increase the risk of getting gallstones.

What Are the Symptoms of Gallstones?

Most gallstones produce no symptoms and may never lead to trouble, but they can cause intense pain. If a gallstone gets stuck in the tube (duct) that takes bile to the bowel, the gallbladder will squeeze harder, and the duct may tighten around the stone. Severe cramps in the belly (abdomen), or maybe between the shoulder blades, will result. Feeling sick to the stomach and vomiting are likely. Symptoms go away if the stone falls back into the gallbladder or moves through the bile duct into the bowel. A gallstone stuck at the end of the duct may cause swelling (inflammation) in the pancreas, and the skin and eyes may turn yellow (jaundice) if the bile ducts are blocked and there is a backup of bile.

How Are Gallstones Diagnosed?

Ultrasound (a special x-ray machine that uses sound waves to get pictures of body organs) can be used to find almost all gallstones and is usually the first test ordered. When ultrasound shows unclear results, the health care provider can use a special x-ray test (HIDA scan) or a CT scan to rule out other diseases that cause similar symptoms.

How Are Gallstones Treated?

Gallstones can be cured by surgically removing the gallbladder and gallstones (cholecystectomy). This is usually done with a laparoscopic method using only tiny cuts, instead of one large cut, for the health care provider to insert instruments into the belly to remove the gallbladder. This operation allows a shorter recovery time and can be an outpatient surgery.

Treatment of gallstones in people without symptoms (asymptomatic) remains unclear. Some doctors recommend avoiding surgery unless symptoms are present. Others suggest surgery because of possible complications and the risk of complications from surgery is generally small. You should discuss the situation with your health care provider, because you may have a higher risk (e.g., if you have diabetes, heart disease, emphysema).

In rare cases when surgery is too dangerous, your health care provider may suggest drugs to dissolve the gallstones, but medicines may not work and must be used for a long time.

DOs and DON’Ts in Managing Gallstones:

• DO maintain a normal weight. If you are overweight, ask your health care provider to help you with slow, steady weight loss.
• DO notify your health care provider if you have pain that you think may be related to gallstones. Call your health care provider immediately if you have a fever with the pain.

• DON’T eat meals high in fat, extra large meals, and foods that cause stomach upset. Fatty foods make the gallbladder tighten and it may squeeze a stone into the duct. Even more important, avoid high-fat meals after following a low-fat diet.
• DON’T fast for long periods or go on a crash diet.

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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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90,000 Gallstones. Treatment at the ABC Clinic. Gallbladder stones

Gallbladder stones are solid formations inside the cavity or duct of an organ that appear due to a metabolic disorder in the hepatobiliary system. An imbalance of cholesterol and bilirubin leads to precipitation of bile components, as its colloid changes. That is, the liquid substance becomes a coarse suspension densely filled with solid particles. Treatment of gallstones is aimed at normalizing the functioning of the gastrointestinal tract, dissolving or removing existing stones. Medicines are selected according to the results of biochemistry, where it will be seen which metabolic factor needs to be influenced.

Gallbladder stones are 3 times more common in women than in men. With the onset of middle age, old age, the risks increase. This is affected by the slowdown of physiological processes. The quality and quantity of bile components change: lecithin, cholates, bilirubin, H₂O. Congenital imbalance is detected a thousand times less often.

According to world statistics, more than 1 million calculous diseases are diagnosed annually, including those found in children. There are cases of pathology in newborns.

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Etiology of cholelithiasis

Dynamics of development depends on the time of diagnosis, quality of treatment. There are 3 factors in the formation of stones in the gallbladder, which are closely related to the clinical stages:

1. Shift in the physicochemical parameters of bile – impaired metabolism, thickening of the secretory fluid.
2. Stone carrying – stagnation, outflow disturbance, mechanical irritation of the bile.
3. Cholecystitis – acute inflammation, gradually turning into a chronic stage.

Infection can serve as a key link in the imbalance. Bacteria are able to transform bilirubin into its insoluble forms. It reacts with calcium ions that come in response to exudation to infection.

Small stones in the gall bladder do not exceed 10 mm. Therefore, they are mobile and easily change localization, provoking inflammation in any part of the organ. According to their location, the disease is divided into:

1. Cholecystolithiasis . They are located directly in the gallbladder.
2. Choledocholithiasis . Penetrate into the bile duct.
3. Intrahepatic cholelithiasis . Blockage of the hepatic ducts.

By composition they are divided into calcareous, cholesterol, bilirubin. Mixed forms are detected when there are many stones in the gallbladder. With single elements, they appear due to the adhesion of microcrystals of different origin.

Triggering factors and underlying diseases

Paradoxically, the clinical stages are reversed. For example, the initial stage may be biliary stasis. This condition occurs in pregnant women when the fetus begins to put pressure on the stomach, adjacent organs.

The leading risk factor is obesity. But even people with normal body weight are prone to gallbladder stones if they abuse meat, high-fat dairy products, chicken eggs.

With stones in the gallbladder, an anamnesis of life is collected, an outpatient card is studied. The measure is necessary to establish the cause of the pathology, eliminate it or compensate for physiological functions. By frequency of occurrence, patients most at risk are those with:

• blood lipid overload – hyperlipidemia
• poor absorption of bile acids after removal of part of the intestine
• autoimmune inflammation, when antibodies target their own cells in the gastrointestinal tract, causing their destruction ― Crohn’s disease
• lack of insulin – diabetes mellitus
• biliary motility disorders – dyskinesia
• chronic or acute process in the bile – chole cystitis

Influenced by hereditary predisposition, congenital anomalies. Anatomical defects can be acquired – adhesions, scars after operations, previous diseases.

How to recognize symptoms and prevent complications?

Small gallstones found incidentally on abdominal ultrasound. The patient does not make any complaints, because the calculi lie at the bottom of the bladder, not resting on its walls. The clinical picture becomes expanded when one of them enters the neck or duct.

Biliary colic is caused by intravesical pressure, a bursting feeling is replaced by spasms due to reflex contraction of the sphincter. Calculus mullions scratch the walls when displaced. A large stone in the gallbladder does not move if it has entered the duct. By exerting constant pressure, it interferes with blood supply, innervation, bedsores appear, then necrosis. With perforation, acute inflammation of the peritoneum develops.

Mechanical jaundice occurs against the background of obturation. A stagnant secret causes cholangitis, suppuration of the bladder, dropsy. It becomes the cause of secondary cirrhosis of the liver, intestinal fistulas, and oncology of the gallbladder.

Methods of treatment

Getting rid of gallstones begins with determining their location, size, and chemical composition. Used cholecystography with a contrast agent, transhepatic cholangiography, ultrasound.

Ultrasound diagnostics comes to the fore, as it has no limitations of the distinctive X-ray method (cholecystography), and thanks to digital counting, it increases the accuracy of deciphering the results.

In uncomplicated forms, medication is prescribed, supported by a diet. Table number 5 provides for a fractional meal, 5 times a day. Dishes should be lean, without the addition of hot spices. Steamed, baked or boiled. Prohibited fatty varieties of fish, meat, mushrooms.

Conservative treatment is allowed if the ducts are open, bladder tone is normal, stones do not exceed 1.5 cm. There must be free space in the body of the bladder. The goal of treatment is to dissolve the stones. This effect is produced by bile acids, but since the body lacks them, it is necessary to take medications containing them: 9Similar Folk remedies have an effect: corn stigmas, immortelle, radish juice. Attacks of colic are stopped by antispasmodics: papaverine, no-shpa, spasmalgon. You can not use analgesics, the bladder will remain tense, which will lead to rupture.

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Large gallstone to be lithotripsy. Shock wave treatment is performed after taking deoxycholic acid derivatives (drugs listed above). Provided that the drainage function is preserved, the presence of one element up to 3 cm or 3 pieces of 1 cm each. Gallbladder stones are treated surgically with complications of cholecystitis, obstructive jaundice. A radical approach is indicated when conservative treatment has failed.

Our medical center performs surgical removal of stones in the body. You can have a consultation at the ABC Clinic. To register, you need to use the phone or the feedback form on the site. The administrator will select the most convenient time for your visit.

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Gallbladder stones are a pathology faced by every third person on the planet.

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Gallbladder stones is a pathology faced by every third person on the planet. The problem of the disease is that stones are formed in the cavity of the gallbladder or bile ducts due to precipitation from the components present in bile. These include:

• cholesterol;
• protein;
• calcium salt;
• bile pigment.

It is they, in large quantities, that contribute to the formation of stagnation, disruption of lipid metabolism, and even infect bile.

Causes

Stones in the gallbladder and ducts are a disease that must be fought as early as possible. In general, this is a pathology that occurs due to a violation of the composition of bile, and more precisely, the quantitative ratio of substances is violated. Each solid component precipitates, and over time, the formation of stones occurs.

The development of choleliatosis occurs if the level of cholesterol is elevated, which occurs for various reasons and provoking factors:

1. Consumption of a large amount of foods containing cholesterol.
2. Presence of dysfunction of hepatocytes, which reduces the secretion of bile.
3. Deficiency of phospholipids in the body, which reduces the level of obstruction to precipitation.
4. The process of outflow of bile is disturbed, which leads to stagnation.
5. Too much weight.
6. Consumption of hormonal drugs.
7. Pregnancy.
8. Surgical intervention. In particular, vagotomy, removal of the lower lobe in the ileum, and the like.
9. Presence of concomitant diseases such as diabetes, cirrhosis of the liver, anemia, Caroli syndrome, Crohn’s disease.

The formation of stagnation in the gallbladder has a different genesis.

• Mechanical.
• Functional.

In the first case, the cause of blockage of the duct is the presence of obstacles in the form of adhesions, tumors, edema, bending or narrowing. In the second case, the work of the bile ducts is disrupted due to the problem of the motility of the pathways for the excretion of bile, or in other words, the presence of dyskinetic processes.

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Gallbladder stones begin to accumulate due to an infectious or inflammatory process in the biliary system, as well as the presence of:

• autoimmune condition;
• various types of allergies;
• sedentary lifestyle;
• fasting;
• pregnancy;
• injury to the abdominal cavity;
• pathologies in the liver and other organs.

The pathological process during which the formation of stones in the gallbladder should not be ignored, as it can cause new problems, as well as a deterioration in the condition that requires immediate medical attention in order to preserve the health of a person as best as possible.

Symptoms

The size of the calculi primarily affects where they are located in the gallbladder and the overall clinical picture. The patient should contact a specialist for diagnosis as early as possible and preferably when the first symptoms or primary signs appear, by which metabolic disorders can be detected.

The main symptoms include:

• pain in the right hypochondrium;
• nausea;
• vomiting;
• weakness;
• malaise;
• elevated body temperature;
• jaundice;
• belching;
• bitterness in the mouth;
• discoloration of feces;
• bloating;
• heartburn;
• irregular stool;
• unstable chair.

Pain in the area of ​​the right hypochondrium begins to manifest itself and develops due to the fact that this is where the gallbladder is located. In another way, it is called biliary colic.

Depending on the stage of the disease, pain may:

• be dull and cutting;
• reverberate in the back;
• extend to the shoulder blades;
• give to the shoulder and collarbone.

In extremely rare cases, the course of the disease can be in the form of a heart attack, since the transition of pain to the left side of the sternum contributes to the formation of angina pectoris. Basically, colic with stones in the gallbladder begins to manifest itself when consuming forbidden food. Namely:

• fried;
• oily;
• acute.

This also includes alcohol, extreme stress or too much exercise. The clinical picture of the disease is that there is a reflex spasm of the smooth muscle in the gallbladder and its ducts, during which the stones begin to move, they can enter the outflows and thereby form bile stasis, which leads to the obstructive nature of the pain.

With complete blockage of the ducts, the cavity of the hepato-bile duct expands, which leads to:

• liver enlargement;
• distension of liver capsules;
• formation of cholelithiasis.

Symptoms of such gallstone stagnation are quite bright in the form of heaviness and pain, and in most cases irresistible and unbearable.

At an early stage, such pains can lead to nausea, vomiting and worsening of the condition, however, even with a cleansing of the stomach, and even more so taking drugs that eliminate nausea, it does not get better, and therefore a visit to a doctor is required. Vomiting is a type of reflex reaction that occurs due to irritation in a certain part of the intestine. As soon as the process begins to spread, and the inflammation passes into the cavity of the pancreas, vomiting begins, in the impurities of which bile is present. This symptom is hard to miss, and you should consult a doctor to diagnose cholelithiasis or vice versa to exclude its presence. If the stone filled not only the gallbladder, but also its ducts, then these formations lead to the occurrence of obstructive jaundice, leading to discoloration of the excrement.

It is necessary to get rid of stones in the gallbladder as early as possible to avoid trauma to the mucous membrane, as well as to avoid calculous or chronic cholecystitis, leading to fever, loss of appetite and increased fatigue.

Treatment of gallstones

Signs of the presence of gallstones may be bright, or may not appear at all, which greatly complicates treatment, which begins late. If the stone located in the gallbladder is for a long time, then the metabolic process in the body is disturbed, and symptoms may not always appear, since if the stone deposits do not move, then there are no clear manifestations.

In order to exclude serious stone deposits and consequences, it is necessary to undergo regular diagnostics and timely treatment. In some cases, surgery may be required to remove the gallstone to eliminate the gallstone.

In addition, in order to preserve the gallbladder, treatment can be complex and without surgery. There are a variety of methods, and they help to eliminate the gallstone inflammatory process more painlessly.

1. Initially, stones need to be dissolved, provided they are small, using a special preparation containing acid. What can the procedure give? There is a dissolution of calculi, but their re-formation is possible, and therefore regular diagnosis of gallstone disease is required.
2. Crushing of large stones with a diameter of more than 2 cm is performed by wave lithotripsy. Most patients choose this treatment without surgery, especially if there are 1-2 stones in the bile duct or bile duct.

Violation of metabolic processes in the body must be brought back to normal and this requires complex conservative treatment, which consists in:

• normalization of lifestyle;
• selection of the optimal diet;
• drug use;
• regular diagnostics.

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As soon as the first symptom appears in the form of hepatic colic, foods rich in cholesterol should be eliminated from the diet. This case requires treatment by following diet No. 5. Be sure to limit the consumption of fried foods, carbonated drinks and anything that can cause contractile function and, accordingly, colic. Recommended consumption of fruits, vegetables and everything that has fiber.

Oral litholytic drug is a treatment that should be accompanied by moderate physical activity, especially if there is overweight, endocrine system diseases and similar problems. Chronic cholecystitis can develop due to an infection of the bile ducts. In this case, antibiotics and drugs are prescribed to promote:

• stimulation of bile acid production;
• normalization of bile composition;
• improve the digestive process, especially for lipid digestion;
• removal of pain that occurs during the contraction of the gallbladder.

The stone can not only form, but gradually increase, and to cure this problem, ultrasound is used as an aid. In particularly difficult cases, surgery is needed, during which the gallbladder is removed from the abdominal cavity. There are a number of specific guidelines for the use of shock wave therapy. Namely, presence:

• large quantities of stones;
• frequent bouts of pain;
• comorbidities.

If the gallbladder is not removed, the calculus will form again and again, however, this can be avoided if regular ultrasound is done and the optimal performance of the gallbladder function is monitored.

There are a number of drugs that have been used for decades, and they are needed to maintain the body in a normal state, and also due to the accumulation of certain components in the body, each formed stone will dissolve on its own to a small size, after which it is excreted along with feces. If problems such as intestinal obstruction arise, it is worth visiting a doctor to undergo an ultrasound scan and possibly reconsider therapy.

The choice of treatment depends on the location of the immediate stone in the gallbladder. However, it is surgery that is recommended for those who are too often diagnosed with perforation of the gallbladder or, in other words, inflammation of the empyema. Frequent exacerbation and sharp unbearable pain is a consequence of the formation of large stones, and with several wave therapy procedures, it is desirable to remove the gallstone, since it is impossible to eliminate the cause of the formation of pathologies.

Which doctor to contact

Diagnosis and treatment of gallstone disease is carried out by a gastroenterologist and a specialist in functional diagnostics. Only after a holistic picture of the patient’s condition is revealed, decisions are made about where to send the patient next, namely to a nutritionist or a surgeon for follow-up.

Bladder after conservative treatment can normalize in work, and the probability of new problems is 50%. However, even with normal indicators in the diagnosis, one should not forget about proper nutrition and a healthy lifestyle.