February 08, 2010
|
|
Gallstones and Complications: Detection and Treatment
Nicole D. Simpson, M.D., Tommy Yen, M.D.,* and Aijaz Ahmed, M.D.
Drs. Simpson, Yen and Ahmed are from the Department of Medicine, Division of Gastroenterology, Stanford University School of Medicine, Stanford, California and *Division of General Internal Medicine and Geriatrics Veteran's Administration Medical Center, San Diego, California University of California, San Diego School of Medicine, San Diego, California.
We all have a gallbladder but most of us do not spend much time thinking about it. Those that do are probably among the 25 million or so Americans who suffer from gallstones. The pear-shaped gallbladder sits below the liver in the upper right-hand corner of the abdomen. It is connected to the liver and to the small intestine by several tubes called bile ducts. Its purpose is to store bile, a liquid which is produced by the liver that helps us digest fat. After a meal, the gallbladder contracts and sends bile into the intestine. Once a meal has been digested, the gallbladder stops sending bile and returns to its old job of storing up bile for our next steak dinner. What is a Gallstone?
Bile is a brown liquid made up of bile salts, cholesterol, bilirubin and lecithin. Bile salts and lecithin help break up fat so that it can be digested more easily. Bilirubin, which gives both bile and stool their characteristic color, is a waste product.
Problems begin when some of the components of bile form hard crystals (or stones). Most gallstones are made up of either cholesterol or bilirubin but not both. Because they range in size from as small as a grain of sand to as large as a golf ball, a gallbladder may contain anywhere from one stone to hundreds. These gallstones may cause problems in the gallbladder or in the bile duct, or they may cause no problems at all. We are not sure why gallstones happen but we do know that people with high levels of cholesterol in their bile are more likely to develop cholesterol stones and those with high levels of bilirubin are more likely to develop bilirubin stones. Problems with the gallbladder muscle, causing incomplete emptying of the gallbladder, also seem to play a part in gallstone development. Exactly how diet affects gallstone formation is not well understood but it is suspected that a diet high in cholesterol and fat can increase a person's risk of developing gallstones Really Bad Pain
The most typical first sign of gallstones is pain — sometimes excruciating pain — in the upper abdomen or right side. This is sometimes accompanied by fever, vomiting or sweating. The most common treatment is surgical removal of the gallbladder, although there are other treatments, depending on the type of gallstone, the severity of a person's attacks and the presence of complications such as infection.
Most treatments are much more successful if they are given early on. Anyone who thinks they might have gallstones should see a doctor as soon as possible. Typical symptoms
Table 1.
Risk Factors for Cholesterol Gallstone Formation.
Add Your Comment: Note: We regret that we cannot answer medical questions.
Comment by: JJ
Mon., Feb. 8, 2010 at 5:55 pm EST I had my gallbladder out on the 3rd. I had only had one severe attack in the last 6 months. I def noticed that certain foods affected it. I too thought about putting off the surgery. Fortunately I did not. When the doctors removed my gallbladder they indicated that it was very very inflamed. Recovery has been pretty easy. No major problems. I feel ready to return to work. Good Luck.
Comment by: moorthy
Sun., Feb. 7, 2010 at 12:50 pm EST i have been diagnosed with uncomplicated gall stones in gallbladder. whether it is necessary to remove the gallbladder
Comment by: TheDoctor Ed.
Tue., Feb. 2, 2010 at 9:50 am EST Dr. Gary Gray, our specialist in gastroenterology, has responded to this concern about gallbladder operations in the Question of the Week.
Comment by: zimmrah
Sun., Jan. 31, 2010 at 8:41 pm EST It must be that time of year! I am having my gallbladder removed on Feb. 10. Val - they try laparoscopic (keyhole) surgery first on everyone - but if there are any complications, they may need to switch to "open" surgery. You should definitely prepare for that. Also, for those of you reconsidering - I was as well. I'm not a fan of surgery - and wasn't happy with the high percentage of people who had severe issues post-surgery. HOWEVER, the fact remains that if you do have stones - and they get lodged in the wrong places - you'll be in a life threatening situation. Also, depending on your age/choices - the attacks tend to flare up when you're pregnant. I decided on a pre-emptive strike before the stones could threaten my life - or a baby's.
Comment by: val murphy
Fri., Jan. 29, 2010 at 2:59 pm EST I am also due to have my gallbladder removed by keyhole surgery on feb 4th 2010 and I am also having second thoughts about the whole process, I suppose the nerves are getting to me just like linda jackson, all I can say is good luck linda and I'm sure everything will be okay
Comment by: linda jackson
Sun., Jan. 17, 2010 at 10:05 pm EST i am due to have my gallbladder removed on feb.10,2010. after reading up on it, i am really reconcidering it..i have gall stones. i have had 3 attacks in 2 yrs. am i better off leaving the gallbladder in or takng it out? i dont know if or when i will have another one and what the time span will be between the attacks.i am really concerned about what to do..your return answer would be greatly; appreciated..thank you |
| The Doctor Will See You Now | |
LEGAL RESTRICTIONS AND TERMS OF USE OF THIS SITE. USE OF THIS SITE IS YOUR AGREEMENT TO THESE TERMS. Copyright 2010 interMDnet Corporation. All rights reserved. About Us | Privacy Policy | Disclaimer | System Requirements |