Gallstones - Causes, Symptoms, Treatment
Gallstones are solid deposits of cholesterol or calcium salts that form in your gallbladder or nearby bile ducts. They often cause no symptoms and require no treatment. But some people with gallstones have a gallbladder attack that can cause symptoms, such as nausea and an intense, steady ache in their upper middle or upper right abdomen. In some cases, the pain can be severe and intermittent.Gallstones usually form in the gallbladder; however, they also may form anywhere there is bile–in the intrahepatic, hepatic, common bile, and cystic ducts. Gallstones also may move about within bile, for example, from the gallbladder into the cystic or common duct.
Causes
Scientists believe cholesterol stones form when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason these imbalances occur is not known. The cause of pigment stones is not fully understood. The stones tend to develop in people who have liver cirrhosis, biliary tract infections, or hereditary blood disorders—such as sickle cell anemia—in which the liver makes too much bilirubin.
Symptoms
Gall stones usually remain asymptomatic initially. They start developing symptoms once the stones reach a certain size (>8mm). A main symptom of gallstones is commonly referred to as a gallstone “attack”, also known as biliary colic, in which a person will experience intense pain in the upper abdominal region that steadily increases for approximately thirty minutes to several hours. A victim may also encounter pain in the back, ordinarily between the shoulder blades, or pain under the right shoulder. In some cases, the pain develops in the lower region of the abdomen, nearer to the pelvis, but this is less common. Nausea and vomiting may occur.
Symptoms usually occur as complications develop. The most common symptom is pain the right upper part of the abdomen. Because the pain comes in episodes, it is often referred to as an “attack.”
Treatment
Watchful waiting: Sometimes gallstones are found by chance during medical tests for other conditions. If they aren’t causing any symptoms, they can usually be left alone, as most will not go on to cause problems. This “wait and see” approach is called expectant management or “watchful waiting”.
Surgery: People can normally live without a gallbladder, and the most common treatment for gallstones that are causing problems is surgical removal of the gallbladder. This is known as cholecystectomy (pronounced “co-lee-sist-ect-omy”). There are several surgical options.
Yes, there are other treatments. They are usually for people who would have a high risk in surgery because they are elderly, or have heart problems or lung disease. Your doctor might be able to use sound wave therapy to break up the stones so they can move into the intestine without problem. However, only 1 of 5 people can have this treatment. People who have this treatment often form new gallstones after a few years.
