Cholelithiasis

Gallbladder stones are known as cholelithiasis in medical terms. During the process of digestion several chemical reactions takes place and enzymes are secreted to break down the food particles. Sometime these digestive fluids get hardened to form stones that get accumulated in the gallbladder. Gallbladder is a small organ found on the right upper portion of the stomach just below the liver. It also secretes an enzyme (bile) that helps in digestion and gets discharged into the small intestine.

Gallstones are formed if the bile (digestive enzyme) contains high cholesterol or it contains high content of bilirubin. These stones vary in size and shape. For some people there can be only one stone and for others number of stones can be formed. Choleolithiasis can be effectively treated by removing gallbladder surgically (for severe cases) or by taking medications to destroy gallstones.

Types :

There are 2 common types of cholelithiasis :

1. If gallstones are formed due to excess of cholesterol in the enzyme bile it is known as cholesterol stone.
2. If gallstones are formed due to excess of bilirubin (breaking up of RBC causes this waste product) it is known as pigment stone.

Symptoms :

Choleolithiasis do not produce any symptoms most of the time. It causes sudden pain in the abdomen only if the gallstone strikes with a duct causing a blockage. There can be sharp and sudden pain in the upper right portion of the stomach, or in the center of the abdomen beneath the breastbone. It can also cause intense pain in the right shoulder or shoulder blades.

For some people it can cause fever, chills, nausea, vomiting, tenderness in the abdomen, black colored stools and change in skin color (yellowish skin). For serious cases it can cause high fever, intense abdominal pain, bloated sensation and abdominal swelling. In that case emergency medical help is to be taken.

Causes :

The main cause of cholelithiasis is excess of cholesterol formation in the gallbladder. These particles get hard to form stone like substance that gets accumulated in various sizes and shapes. Choleolithiasis is caused when the bile contains excess of bilirubin in the gallbladder. Gallstones are formed due to blood disorders, and biliary tract infections. Sometimes gallbladder may not function properly to eliminate the substances inside. Gradually bile gets piled up and becomes hard to form gallstones.

Who are at risk?

Women are more prone to develop cholelithiasis than males (for reasons unknown). Old age, having high cholesterol in daily diet, fat diet, being obese and belonging to certain ethnic race like American Indian, Mexican American also makes one prone to gallstone formation. Pregnancy also increases the risk of developing gallstones since gallbladder is pushed inside and it may not be able to empty the contents properly. Having a history of cholelithiasis, having diabetes, taking cholesterol reducing drugs for extended period and taking estrogen supplement poses risk for developing choleolithiasis.

Complications :

Gallstones can cause serious complications if the stone gets clogged in the gallbladder neck. Sometimes many stones can block the tubes such that no liquids can flow freely from the gallbladder into the intestine. For some people gallstones can enter into the pancreatic duct blocking its flow causing inflammation of pancreas which requires urgent medical care. In rare cases gallstones can lead to gallbladder cancer causing life threatening problem.

Diagnosis :

Ultrasound of the abdomen is done to detect the presence of gallstones. It would give exactly the number of gallstones and its position in the gallbladder. Your doctor can also use dye test for checking the bile ducts if any stone is blocking its way. Imaging tests like CT, MRI scanning may also be done for getting a clear picture. In addition he may request for blood test to rule out any infection or jaundice in the liver.

Treatment :

Gallstones that do not cause any pain or discomfort require no treatment. For people with moderate or severe symptoms of abdominal pain treatment is given based on the intensity of pain and the patient’s age and health condition. Cholecystectomy is done for removing gallbladder if there are many gallstones. During this surgery, the surgeon will remove the entire gallbladder (a small pouch found on the upper part of the stomach) so that the bile would flow directly into the small intestine.

Removal of gallbladder does not cause any serious problem in life since it is not needed for the process of digestion. For mild symptoms the patient will be given oral medications to dissolve gallstones. However only mild symptoms can be managed by this option and the person has to take drugs for years together for getting the stones dissolved.

Prevention :

You cannot do anything to prevent cholelithiasis but you can take precautionary steps to reduce the risk of developing it. If you are obese take steps to reduce your weight. Do not skip breakfast or meals which can actually make conditions worse. Take steps to maintain healthy weight. Do not consume high cholesterol diet.