Monday, March 19, 2012

Inflamed Gallbladder

Gallbladder inflammation or inflamed gallbladder is most of the time caused by gallstones. Gallbladder inflammation is often accompanied by an intense and sharp abdominal pain and abdominal discomfort. Read on to find more about inflamed gallbladder, its causes, symptoms and treatment.
The medical term used for the inflammation of the gallbladder is cholecystitis. Gallbladder is a tiny sac like organ connected to the liver. It is the reservoir of bile, which is required to digest fats in the intestine. So, whenever, we consume a high fat diet, bile is released by the gallbladder through the bile duct to the intestine to facilitate the digestion of fat. An inflamed gallbladder is usually a result of the formation of gallstones. There are generally two types of cholecystitis or gallbladder inflammation, acute and chronic. Acute cholecystitis is characterized by sudden inflammation of the gallbladder that come with a sharp and intense abdominal pain, while chronic cholecystitis is marked by an inflammation of low intensity, that has lasted for a long time.

Inflamed Gallbladder: Causes

Cholecystitis is generally caused by the formation of gallstones. When the gallstones block the cystic duct, bile starts to accumulate inside the gallbladder, and cause inflammation and infection of the organ. This is the most common cause of acute cholecystitis, accounting for almost 90% of the total cases. Chronic cholecystitis, can occur due to repeated inflammation of the gallbladder or recurrent attacks of acute cholecystitis. This can cause extensive damage to the wall of the gallbladder, due to which it can thicken or get scarred. Rarely, serious illness and tumor in the gallbladder can also be responsible for causing cholecystitis.

Inflamed Gallbladder: Symptoms

Inflamed gallbladder or cholecystitis is characterized by a pain in the upper right quadrant of the abdomen. In case of acute cholecystitis, the abdominal pain is sharp and intense, that is usually experienced after eating fatty or greasy foods. Sometimes, this pain can radiate to the back or below the right shoulder blade. In addition to abdominal pain, inflamed gallbladder can also be accompanied by low fever, chills, indigestion, heartburn, nausea and vomiting.

If the gallstones come out of the gallbladder and obstruct the common bile duct, then the flow of bile from the liver to the intestine can get blocked. This can result in complications like, cholangitis or inflammation of the bile duct, which can present symptoms like, fever, jaundice and abdominal pain. Chronic cholecystitis, on the other hand, is marked by an intermittent pain in the abdomen and some non-specific symptoms like, nausea, belching, abdominal discomfort and chronic diarrhea. Sometimes, chronic cholecystitis may not produce any symptom at all. Read more on cholecystitis symptoms.

Inflamed Gallbladder: Treatment

Diagnosis of inflamed gallbladder usually requires a thorough analysis of the symptoms, as well as some laboratory tests like, complete blood count test, blood tests for determining the level of the enzymes, amylase and lipase, and the level of the pigment bilirubin, ultrasound and liver function test. Physical examination of the patient often reveals a tender abdomen. Both dietary restrictions and medications are used to treat acute cholecystitis. Usually, acute as well as chronic cholecystitis require hospitalization of the patient, where he or she is given fluid and electrolyte intravenously. During this period, the patient is not allowed to consume any food or drink. Meanwhile, the stomach is suctioned in order to keep it empty, and to prevent accumulation of fluid in the intestine. Once, an attack of acute cholecystitis subsides, the physician may suggest an inflamed gallbladder diet, low in fat.

If infection is present, then antibiotics are prescribed, which are also administered intravenously. Pain medications, as well as medications to control nausea and vomiting can be required, depending on the severity of these symptoms. If these inflamed gallbladder remedies fail to treat the condition, and if acute cholecystitis leads to severe complications like, gangrene, inflammation of the common bile duct, abscess formation and perforation of the gallbladder, then surgery has to be carried out to remove the gallbladder. Inflamed gallbladder surgery is often carried out with the help of a laparoscope. Surgery is also the preferred treatment option for chronic cholecystitis.

Inflamed gallbladder, if not treated on time can lead to some serious complications. Therefore, on observing any of the symptom of cholecystitis or inflammation of the gallbladder, it is very important to inform your physician about it. Fatty and greasy foods should be avoided by the people experiencing recurrent attacks of acute cholecystitis or inflamed gallbladder. A diet low in fat can be very helpful in preventing the attacks of cholecystitis. However, surgical removal of the gallbladder is the more commonly preferred option for preventing the recurrences of acute cholecystitis.

By Chandramita Bora

Gallstones Surgery Risks

Risks are involved in most surgical procedures and this holds true for gallstones surgery as well. Before I move on to the aspects of gallstones surgery risks, let me tell you what causes gallstones. Gallstones are small stone-like deposits that may form in the gallbladder or the bile duct due to the concentration of cholesterol or bilirubin in bile. Bile is a digestive fluid that is secreted by the liver. It is the gallbladder, a small sac located underneath the liver, that concentrates and stores this digestive fluid. Bile is made up of bile salts, cholesterol and a pigment called bilirubin. When we consume foods that are rich in fat, the gallbladder contracts in order to force out bile onto the small intestine. Whenever the quantity of cholesterol or bilirubin increases beyond the normal limits, it crystallizes into gallstones.
Gallstones could be as tiny as a grain of sand or as big as the size of a golf ball. These deposits could get trapped in the bile duct, cystic duct or the hepatic duct. When these get lodged in any of the ducts, these obstruct the flow of bile. As a result, the gallbladder can get inflamed. This can give rise to severe abdominal pain, nausea and vomiting. Generally, such intense pain or biliary colic is experienced after one consumes a fatty meal. If episodes of biliary colic become frequent, one might have to undergo a gallstones surgery to alleviate these symptoms. Before I move on to risks that come with this surgery, let me give you some idea about the gallstones surgery procedure.

Gallstones Surgery Procedure

Gallbladder surgery is a procedure involving the removal of the gallbladder. Also known as cholecystectomy, this surgical procedure can be performed in two different ways. One can either undergo an open gall bladder surgery or a minimally invasive laparoscopic gallbladder surgery. Surgical removal is often suggested when the gallstones give rise to frequent gallbladder attacks. Gallstones surgery risks are definitely higher in case of an open surgery. The risks are attributed to the larger sized incisions made during this surgery. On the other hand, laparoscopic surgery is performed by making small incisions, through which a laparoscope attached with a miniature video camera is inserted. The surgeon looks at the close-up view of the internal organs on the video monitor to make the required cuts for separating the gallbladder from the ducts and the other structures. The gallbladder is then removed from the body through a small incision. While this minimally invasive gallstones surgery procedure is safer than the open surgery, it cannot be performed if there is scarring from a previous surgery or other anatomical problems. The duration of gallstones surgery recovery time depends on the type of surgery performed. Since the size of incisions is smaller, recovery is faster in case of a laparoscopic surgery. The patient is generally discharged the next day itself. One might completely recover from a laparoscopic gallstones surgery within six weeks, while a person who has undergone an open surgery might take a few months to recover completely.
Gallstones Surgery Complications

Now that you have a basic idea about the surgical procedure, let's move on to gallstones surgery risks. Internal bleeding is one of the most common gallbladder surgery complications. The chances of bleeding and infection at the site of incision are higher in case of an open gallstones surgery. While the surgeon makes incisions and inserts surgical instruments to remove the gallbladder, there is a risk of injury to the tissues and structures surrounding the gallbladder. Injury to the common bile duct or the small intestine are the most common gallstone surgery risks. An injury to the common bile duct can cause leakage of bile in the abdomen. This can give rise to an infection. If the injury is severe, additional surgery will be required to correct the problems created by a surgery gone wrong. Some of the gallstones surgery risks might be attributed to the administration of general anesthesia. Other factors such as age and overall health of the patient could also make a difference. Once the gallbladder is removed, the bile cannot be stored and concentrated at one place. The bile will then be carried directly from the common bile duct to the small intestine. This might cause post-cholecystectomy syndrome, a condition wherein the patient might experience symptoms such as bloating, gas or diarrhea. These symptoms, however, can be managed with the help of medicines. Gallstones surgery cost is high and the patient might have to pay anywhere between $10,000 to $15,000 for having the gallbladder removed. Since risks are involved in the surgery, one can also find out about non-surgical gallstones treatment options.

This was all about gallstones surgery risks. Most surgical procedures involve certain risks and gallstones surgery is no exception. If you are not keen to undergo this surgery, you can try gallstones home remedy or other gallstones treatments without surgery. In case, such remedies are not helping and symptoms are worsening, it would be best to have the surgery performed by an experienced surgeon.

By Smita Pandit

Gallstones Treatment Options

Gallstones treatment options basically fall into two types, surgery and non-surgical treatments. While some people opt for gallstones treatment at home, it is non-reliable and results vary from one person to another.
As the name goes, gallstones are hard, stone-like aggregates deposited in the gallbladder. The size of a gallstone may be as small as a grain, or it may resemble a golf ball. Likewise, gallstones remain asymptomatic in many people, while they may cause medical emergency complications in some instances. Gallstones treatment options are decided based on the severity of the symptoms, general health of the patient and future complications (if any).

Gallstone Treatment: Explained

In medical terms, presence of stones in the gallbladder is referred to as cholelithiasis. The commonly manifested gallstones signs and symptoms are upper right abdomen pain, a feeling of fullness, fever, nausea, vomiting and change in stool color. Therapeutic intervention for gallstones is considered, only when there are notable indications. The alternatives for gallstones treatment are many, of which surgery is the best option. However, there are also non-surgical techniques for patients who are not in a condition to undergo surgery. Some of the gallstones treatment options are:

Surgery
 Surgery is the most reliable treatment option for gallstones. Known as cholecystectomy, it can be performed by traditional open surgery or non-invasive laparoscopic procedure. The latter is a better option, as it requires no hospital stay and recovery period is shorter than the open surgery. In a laparoscopic gallstone surgery, small incisions are made in the upper abdomen for removal of gallbladder. If everything goes well, the patient is discharged on the same day itself.

Treat with Medications
 With this gallstones treatment option, patients are given either ursodeoxycholic acid (UDCA) or chenodeoxycholic acids (CDCA) in the form of oral pills. Both these medications are useful for dissolving stones. But, the concerning issue for gallstone treatment with medicine is the time required for complete gallstones removal, which may take up to 2 years. Also, there is a high chance of gallstone reformation in future.

Lithotripsy Method
 Extracorporeal shock wave lithotripsy (ESWL), or simply lithotripsy is no longer a popular option for gallstones treatment. The reason being increased risk for post treatment complications, like pain in abdomen and pancreas inflammation. In this form of gallstones treatment, high-energy, ultrasound waves are given in the upper right abdomen, where the stones are present. These shock waves split up the stones into smaller fragments, which are then excreted from the body.

Dissolution Treatment
 The dissolution therapy for gallstones is focused on dissolving gallstones with certain chemical agents. Under this, there are again two gallstones treatment options, oral method and contact method. The former refers to ingestion of oral pills formulated with bile acids, whereas contact dissolution is performed by injecting methyl tert-butyl ether (abbreviated as MTBE). Dissolution therapy is usually performed with lithotripsy for best results. But, complications still exist, and cost of treatment is very high.

Natural Gallstone Treatment
 In natural treatment for gallstones, curative herbs that promote secretion of bile juice are taken in specific amounts. Some examples of medicinal herbs are milk thistle, turmeric and artichoke. Another option for gallstones treatment at home is gallstone flush. It is claimed that having a fluid diet and consuming olive oil in large amounts are effective to get rid of gallstones. But, it may take a long time to flush off stones and also, its effectiveness is unpredictable.

For people who experience suspected gallstone symptoms, prompt diagnosis is a necessity. This is because, presence of stones in the gallbladder indicates gallbladder cancer in some patients. So, it is best to rule out serious medical problems at the earliest. The doctor will analyze gallstones treatment options, and suggest an appropriate alternative for the patient. In a nutshell, gallstones treatment without surgery is performed for selective patients, who cannot undergo surgery due to some underlying health problems.

By Ningthoujam Sandhyarani

More on Gallstones

Pigment stones:
 These are dark green, small, usually multiple and irregular shape. They are usually seen inside the gallbladder and rarely in the bile duct. They are formed due to blood disorders such as haemolytic jaundice, chronic myeloid leukemia (blood cancer) and other chronic infections that keep the sedimentation rate (ESR) at a high level. These conditions, due to the destruction of the blood, causing an increase in serum bilirubin. These bilirubins are trapped in the liver and excreted in the bile. If the bile does not flow properly, these pigments accumulate as sediment and form stones.

Cholesterol stones are yellow and usually seen in singles. It is oval, of soft and smooth. This type of stone is generally considered in the pocket of Hartmann in the neck of the gallbladder, as these types of stones usually float.
Stone tanks are more than stones asepsis.
 Mixed stones are brown, large, often multiple and irregularly shaped. These types are 70-80 percent stones. These stones are composed of cholesterol, pigments, salts and other chemicals. As it is a little larger in size, it is generally seen in the body of the gallbladder because it can escape into the intestine and outweigh the risk of blockage in the bile duct.

The causes of gallstones:
 Mainly, the stagnation of bile in the gallbladder or duct for a long time suggests the formation of stones as the result of precipitation or sediment. It may also be due to the variation of the concentration ratio of cholesterol with bile salts (normal, it is 1:20-1:30) in the bile. In general, the routine causes are:
Functionless gall bladder ie bladder bile thick wall without contraction of any
Untimely, diet and famine often unconditioned. Food intake also lowered can reduce the secretion of bile acids in the liver. This causes difference in composition ratio of bile salts and cholesterol, which ultimately results in cholesterol stones.

* Prolonged use of drops, avoiding oral food when staying in hospital
 * Bold, the flabby belly and pregnancy can relax the gallbladder and cause stones
 * Malfunction of the liver that secretes less bile with bile salts less
 Infection of the gallbladder * (acute or chronic cholecystitis)
 * Injuries in the field of the gallbladder that causes inflammation of the gall bladder
 * Take non-veg foods, fast foods, pastries, spicy and fatty foods often.
 * Increase in blood cholesterol levels
 Diseases of the gut-for example, ulcerative colitis, Crohn's disease, irritable bowel syndrome, etc. here, the absorption of bile acids from the intestine or recycling of bile salts is interrupted, so that the liver secretes bile containing bile salts very low. These bile salts can not maintain lowered cholesterol in solution, forming cholesterol gallstones.

Symptom of gallstones
 Although many gallstones are silent or symptom-less, its presence can be assessed from:

Intermittent or constant * Feeling uncomfortable or fullness in the upper right quadrant of the abdomen
 * Pain occurring just below the center of the rib pointing to the lower right area of ​​the gallbladder
 * Vague pain after eating in the upper right quadrant of the abdomen. The pain is more while bending or displacement (since the presses coasts of the gallbladder) or due to infection
 The pain may radiate to the back right * or just below the right scapula or the right shoulder
 * Fever in the case of infection or symptom complex obstruction Bilious - headaches, nausea, constipation and abdominal discomfort. These complaints are generally better after vomiting.
 * Indigestion, bad gas, belching or heartburn and vomiting
There are many times that the pain arises in the dark stone, like a toothache. This is because small stones blocking the neck of the gallbladder while the person is in a horizontal position.

By Prerna Salla
Calculs pigmentaires:
 Ce sont de couleur vert foncé, de petite taille, généralement multiples et de forme irrégulière. Ils sont généralement visibles à l'intérieur de la vésicule biliaire et rarement dans le canal cholédoque. Ils sont formés en raison de troubles sanguins tels que ictère hémolytique, la leucémie myéloïde chronique (cancer du sang) et d'autres infections chroniques qui maintiennent le taux de sédimentation (VS) à un niveau élevé. Ces conditions, en raison de la destruction du sang, provoquer une augmentation du taux sérique de bilirubine. Ces bilirubins sont piégés dans le foie et excrétée dans la bile. Si la bile ne s'écoule pas correctement, ces pigments s'accumulent sous forme de sédiments et de pierres de forme.

Calculs de cholestérol sont de couleur jaune et le plus souvent vu en simple. Il est de forme ovale, de consistance molle et lisse. Ce type de pierre est généralement considérée dans la poche de Hartmann dans le cou de la vésicule biliaire, car ces types de pierres habituellement flotter.
Pierres septiques sont plus que des pierres d'asepsie.
 Pierres mixtes sont de couleur brune, de grande taille, souvent multiples et de forme irrégulière. Ces types constituent 70-80 pour cent de pierres. Ces pierres sont composés de cholestérol, des pigments, des sels et des produits chimiques autres. Comme il est un peu plus grand en taille, il est généralement vu dans le corps de la vésicule biliaire car il ne peut s'échapper dans l'intestin et l'emportent sur le risque de blocage dans le canal cholédoque.

Les causes de calculs biliaires:
 Principalement, la stagnation de la bile dans la vésicule biliaire ou conduit pendant un temps prolongé évoque la formation de calculs comme le résultat de la précipitation ou les sédiments. Il peut également être due à la variation du ratio de concentration de cholestérol avec les sels biliaires (normal, il est 1:20-1:30) dans la bile. En général, les causes de routine sont les suivantes:
Functionless de la vésicule biliaire à savoir la vessie biliaire épaisse paroi sans contraction du tout
Intempestif, le régime alimentaire et la famine inconditionnée souvent. L'apport alimentaire a également réduit peut réduire la sécrétion d'acides biliaires dans le foie. Cela provoque différence de rapport de composition des sels biliaires et du cholestérol, ce qui entraîne finalement dans les calculs de cholestérol.

* L'utilisation prolongée de gouttes, en évitant les aliments par voie orale en cas de séjour à l'hôpital
 * Gras, le ventre flasque et la grossesse peuvent se détendre de la vésicule biliaire et provoquer ainsi des pierres
 * Dysfonctionnement du foie qui sécrète moins de bile avec les sels biliaires moins
 Infection de la vésicule biliaire * (cholécystite aiguë ou chronique)
 * Blessures dans le domaine de la vésicule biliaire qui provoque une inflammation de la vésicule biliaire
 * Prendre des aliments non-veg, fast-foods, les pâtisseries, les aliments épicés et gras souvent.
 * Hausse du niveau de cholestérol sanguin
 Les maladies de l'intestin-par exemple, la colite ulcéreuse, la maladie de Crohn, le syndrome du côlon irritable, etc ici, d'absorption des acides biliaires de l'intestin ou le recyclage de sels biliaires est interrompue, de sorte que le foie sécrète la bile contenant des sels biliaires de très faibles. Ces sels biliaires baissés ne peut pas maintenir le taux de cholestérol en solution, formant ainsi des calculs biliaires de cholestérol.

Symptôme de calculs biliaires
 Même si de nombreux calculs biliaires sont silencieux ou un symptôme-moins, sa présence peut être évaluée à partir de:

* Sentiment intermittent ou constant mal à l'aise ou de plénitude dans le quadrant supérieur droit de l'abdomen
 Douleur * se produisant juste en dessous du centre de la nervure inférieure droite pointant vers la zone de la vésicule biliaire
 * La douleur Vague après avoir mangé dans le quadrant supérieur droit de l'abdomen. La douleur est plus tout en se pliant ou le déplacement (depuis les presses côtes de la vésicule biliaire) ou due à une infection
 La douleur peut irradier vers * l'arrière droit ou juste en dessous de l'omoplate droite ou l'épaule droite
 * Fièvre dans le cas d'infection ou de complexe de symptômes d'obstruction Bilieux - maux de tête, nausées, constipation et de l'inconfort abdomen. Ces plaintes sont généralement mieux après des vomissements.
 * Indigestion, mal à gaz, éructations ou brûlures d'estomac et des vomissements
Il ya de nombreuses fois que la douleur se pose de pierre dans la nuit, semblables à mal aux dents. C'est parce que les petites pierres bloquent le col de la vésicule biliaire tandis que la personne est dans une position horizontale.