Gallstone Disease Treatment
Gallstones formation in the gallbladder is also known as cholelithiasis.
Gallstone disease is one of the most common causes of upper abdominal pain. It includes a spectrum of conditions, including colicky abdominal pain, inflammation of the gallbladder, infection of the bile duct, and severe inflammation of the pancreas.
Gallstones are small, pebble-like, hard pieces of concentrated bile materials such as cholesterol and bilirubin that collect at the bottom of the gall bladder until they harden. Gallstones can vary in size and can be either as small as grains of sand or even as big as golf balls.
Oftentimes, those with gallstones won’t even know they have them, as they usually do not pose a problem. However, in some cases, the gallstones can cause blockage problems, which could lead to further complications and would need medical attention.
Symptoms:
Approx 80% of the patients with gallstones have no symptoms.
The rest of the 20% will have symptoms. Since the gallstones are mobile, the presentation of the symptoms varies with the stone location.
The common symptoms that patients present are as follows:
- Upper abdominal pain
- Fever
- Jaundice
- Lower blood pressure – when there is a severe infection.
Conditions related to Gallstones:
Your gallbladder is a small organ in the digestive system that helps store bile that the small intestine later uses to digest food. When infections or blockages of any kind occur in the gallbladder, it can severely disrupt its functioning, leading to medical conditions that negatively affect the gallbladder and sometimes even the neighboring organs. More often than not, gallbladder conditions occur due to blockages/infections caused by gallstones. Gallstones refer to the hardened deposits of digestive fluids like bile.
Although gallbladder conditions can occur to anyone, it is most often observed in those with high cholesterol levels, obesity, diabetes, liver cirrhosis, those above the age of 60, females, etc. Gallbladder conditions can manifest itself in various different forms, exhibiting specific symptoms for each. Some common gallbladder conditions, which we offer extensive consultation and treatment for, can include:
Biliary colic: It is gallstone-related abdominal pain. The stones jam at the gallbladder neck intermittently, causing intermittent pain over the right upper abdomen after food.
Acute cholecystitis: It is inflammation of the gallbladder. It happens when the stone jam tightly at the neck of the gallbladder and is associated with infection. The pain of acute cholecystitis is constant over the right upper abdomen, and this is usually presented together with fever.
Perforated cholecystitis: It is a severe form of gallbladder inflammation where the gallbladder swells and builds up pressure within the gallbladder and leading it to rupture.
Acute cholangitis and Mirizzi syndrome: This is inflammation of the bile duct. This is a medical emergency where the gallstone drops into the bile duct, causing obstruction to the bile flow. The patient will present with pain over the upper abdomen, together with fever and jaundice. The patient will also experience chills when there is presence of infection.
Acute pancreatitis: It is inflammation of the pancreas. Gallstone pancreatitis is one of the commonest causes of pancreatitis in our population. This happens when the stone drops further down the bile duct and compresses the pancreatic duct, which shares the common channel with the bile duct. The pain is usually centrally located at the upper abdomen. The patient may also have signs and symptoms of acute cholangitis if the same stone obstructs both the pancreatic and bile ducts.
Investigation:
Prior to administering treatment, you will undergo diagnostic tests that help the doctor to determine the location and severity of the gallstone-related problem.
The common diagnostic tests include the following:
- Laboratory investigation:
- Full blood count: to look for the presence of infection and inflammation.
- liver function test: to investigate for obstruction of stones.
- Amylase or lipase: to look for the presence of pancreas inflammation.
- Scans: including an ultrasound of the abdomen, a CT scan or an MRI scan.
- Endoscopy evaluation to locate the stone or to remove the stones.
Treatment:
Individuals with gallstones but with no symptoms need not go for treatment of the gallstones.
Gallbladder problems such as gallstones, inflammation, infection, or cancer can cause pain, nausea, and other digestive symptoms. In these cases, removing the gallbladder may be necessary.
Traditionally, gallbladder removal was done through an open surgery, which involves making a large incision in the abdomen. However, laparoscopic cholecystectomy is a newer technique that uses small incisions and specialized surgical tools to remove the gallbladder.
However, gallstones with symptoms are advised to undergo surgery to remove the gallbladder together with the stones; without the surgery, it will lead to recurrence of pain and more severe gallstone-related problems.
Depending on the severity of the conditions and the location of the stone, the treatment may include the following:
- Intravenous antibiotics.
- Laparoscopic cholecystectomy.
- tube drainage of the gallbladder.
- Endoscopic retrograde cholangiopancreatography, ERCP
Laparoscopic cholecystectomy is a minimally invasive surgical procedure used to remove the gallbladder. The gallbladder is a small, pear-shaped organ on the right side of the abdomen, just under the liver. It stores bile, a digestive fluid that helps break down fats.
Surgery to remove the gallbladder:
It is known as Laparoscopic cholecystectomy. or keyhole surgery to remove the gallbladder. It is a standard treatment for patients with gallstones causing symptoms.
The duration of surgery: commonly last for half an hour to 1 hour. However, the surgery may take longer for patients with inflamed gallbladder.
Surgery for patients with biliary colic needs only one night of admission for observation and can return to normal activity within a few days.
Surgery to remove the gallbladder:
It is known as Laparoscopic cholecystectomy. or keyhole surgery to remove the gallbladder. It is a standard treatment for patients with gallstones causing symptoms.
The duration of surgery: commonly last for half an hour to 1 hour. However, the surgery may take longer for patients with inflamed gallbladder.
Surgery for patients with biliary colic needs only one night of admission for observation and can return to normal activity within a few days.
Preventive measures:
To prevent gallstone formation, one has to eat on time and eat healthily by:
- Limiting fast/fried foods
- Replacing red meats with fish
- Eating more fruits, vegetables and whole grains
- Excessive, sudden weight loss, on the other hand, can cause stone formation.
Once gallstones have formed, there is no effective way to get rid of them besides surgery. Nevertheless, we can avoid the complication of gallstones by reducing the intake of oily and fatty food.
FAQs
Gallstones found incidentally with no symptoms are not serious. Gallstones that cause on-and-off pain over the upper abdomen are the earliest signs of gallstone problem, and other non-specific conditions are abdominal bloating, nausea and vomiting.
Gallstones become more serious when the pain becomes more intense and frequent.
Patients with gallstones causing pain, fever, and jaundice must seek medical attention immediately, as this can lead to sepsis and can be life-threatening.
If you notice any telltale signs and symptoms of gallstones, you should consult a doctor soon.
This is because the pain can become more frequent and intense, leading to more complicated gallstone conditions, e.g. inflammation of the gallbladder and obstruction of the bile duct.
You should seek immediate medical attention when you have the following conditions:
- Extreme and intense abdominal pain
- Yellowing of skin and whites of your eyes.
- High fever with chills.
Gallstone removal surgery involves the removal of the gallbladder (cholecystectomy) together with the gallstone within. Your need for surgery would depend upon your condition and its severity. This can be accurately determined and diagnosed by the doctor upon thorough consultation. Depending on the results of your diagnosis, Dr Lee will be able to determine the type of treatment that would be best suited for you.
You are expected to have some pain from the surgical wounds and the need to change your diet.
The surgery to remove your gallbladder (cholecystectomy) is performed with the keyhole method. The pain over the keyhole wounds is usually mild and can easily be managed by taking oral pain killer.
You may need to change your diet after gallbladder surgery; you are advised to avoid oily, fatty or spicy foods to help prevent digestive issues such as bloating, gas, and diarrhoea, as your body adjusts to the absence of the gallbladder.
