The normal function of the gallbladder is to store bile produced by the liver, and to aid in the digestion and absorption of fats in the duodenum (the first portion of the small intestine). Gallstones compose a solid formation of cholesterol and bile salts. However, research shows that approximately 80 to 90 percent of all gallstones are cholesterol gallstones which form when the liver begins secreting bile that is abnormally saturated with cholesterol. The excess cholesterol crystallizes and then forms stones which are stored in the gallbladder or the cystic duct. Gallstones can also form due to low levels of bile acids and bile lecithin.
Who Is At Risk For Gallstones?
When I was diagnosed with gallstones at 26, I was told that the typical gallstone patient was fair, fat, and forty. Today gallstones are seen in younger patients, perhaps due to the large amount of fast foods being consumed. My daughter went through five years of vomiting beginning at age 15, leading me to almost believe that she was bulimic, before she was diagnosed with gallstones at age 20. Risk factors which can lead to increased incidence of gallstones include the "Four Fs:" fat, female, fertile, and flatulent, as well as sickle cell disease (bilirubin), cirrhosis, Crohn's disease, diabetes, pancreatic disease, and hyperparathyroidism.When the symptoms of gallstones occur they are often called an "attack" because they occur suddenly. The typical gallstone attack includes:
- Steady, severe pain in the upper abdomen that increases rapidly and lasts from 30 minutes to several hours.
- Pain in the back between the shoulder blades.
- Pain under the right shoulder.
- Nausea or vomiting.
Other symptoms of gallstones include:
- Abdominal bloating.
- Recurring intolerance of fatty foods.
- Colic.
- Belching.
- Gas.
- Indigestion.
- Sweating.
- Chills.
- Low-grade fever.
- Yellowish color of the skin or whites of the eyes.
- Clay-colored stools.
Until just a few years ago, the most common treatment for symptomatic gallstones was a surgical procedure called cholecystectomy which required a large abdominal incision to remove the gallbladder. This was an extremely painful (based on my personal experience) and difficult to recover from operation that required at least five days in the hospital, and approximately six weeks for recovery.
Today laparoscopic cholecystectomy is most commonly performed. Laparoscopic cholecystectomy is usually performed in a day-surgery unit and requires only a tiny incision. My daughter's gallstones were treated laparoscopically, leaving her feeling well enough to continue her normal activities later that day. However, it should be noted that not all patients will recover almost instantaneously as my daughter did--the typical patient may need up to a week to recover before returning to normal activities.
Alternative treatments for gallstones include:
- Oral bile acid dissolution therapy.
- Contact solvent dissolution.
- Mechanical extraction through a catheter placed into the gallbladder either through the skin or through and endoscope.
- Fragmentation through shock-wave lithotripsy combined with bile acid dissolution.
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