All You Need To Know About Gallstones And How To Avoid Them

Gallbladders help to store bile, which is then released into our intestines to assist in breaking down fats during digestion. Located at the right side of our abdomen, below our liver, its fundamental purpose is to store bile. It does not produce bile. Bile is a vital digestive fluid that is produced by our liver and consists of bilirubin, bile salts, fats, water, and cholesterol.

When the level of bile and other digestive fluids in the gallbladder becomes unbalanced, it can result in the development of gallstones, which are hardened bile. The bile becomes unbalanced due to higher concentrations of bile salts, bilirubin, or cholesterol, resulting in the consistency of the bile being less watery.

Gallstones are typically more common among females as compared to males, individuals with haemolytic diseases, or individuals who are overweight. The size of gallstones varies from as tiny as an individual rice grain to as big as a golf ball.

Types of gallstones

There is a couple of gallstones diagnosis that could be made:

• Pigment stones: They develop when the system contains a high level of bilirubin, resulting in the formation of brown and black stones when combined with calcium in our body.

• Cholesterol stones: They are the most common type that individuals get. They typically consist of bile salts, lecithin, and cholesterol, resulting in the formation of yellow-green stones.

• Mixed stones: Pigment and cholesterol stones, over a period, may accumulate a significant level of calcium, resulting in the formation of mixed gallstones.

It is possible that you may be diagnosed with all three at the same time.

Gallstones symptoms

Most gallstones pose no prior signs and symptoms, and unless you conduct regular gastroenterology screenings, you probably would not know about their presence. In fact, alongside gastric polyps, they are known for being silent conditions. However, depending on where, if, and how the gallstones are lodged or blocked, they can lead to a series of bothersome and painful symptoms.

Additionally, it is not so much about its presence, number of developed gallstones, or its size. All it takes is a single stone to cause an inflammation, also known as cholecystitis. Some signs include the following:

• Upper right abdominal tenderness and pain which may spread to the right shoulder and upper right back

• Fever symptoms

• Vomiting symptoms

• Nausea symptoms

• Pain or discomfort after meals

• Jaundice

• Indigestion

• Flatulence

Risk factors causing gallstones

Some individuals have an increased risk of developing gallstones than others. Such individuals include the following:

• Family history of gallstones

• Low in fiber and high in cholesterol and fat diet

• Pregnancy

• Being female

• Being overweight

• Diabetes

• Prolonged fasting or rapid weight loss

Possible diseases and complications resulting from gallstones

The development of gallstones can result in several complications, such as:

• Gallbladder cancer: While it is a rare development, the cancer is often associated with individuals suffering from chronic cholecystitis and the formation of gallstones.

• Blockage of the pancreatic duct: Gallstones restricting the flow of pancreatic juices can cause pancreatitis, which leads to lasting and intense abdominal pain that often requires being hospitalised. Severe pancreatitis can lead to life-threatening widespread inflammation and complications, such as multi-organ failure.

• Blockage of the common bile duct: Gallstones restricting the bile flow from the liver to the small intestine can cause bile duct infection, which leads to jaundice, severe pain, rigours, chills, and high fever. Severe bile duct infection can lead to life-threatening infections, such as sepsis.

• Gallbladder infection and inflammation: Also known as cholecystitis, gallstones found at the neck of the gallbladder can result in high fever and severe pain. In the case of severe cholecystitis, it can result in the perforation of the gallbladder, which leads to sepsis or peritonitis, causing the gallbladder to fail and die.

How to diagnose gallstones

A body scan is required to diagnose the presence of gallstones. Most commonly, a simple ultrasound is sufficient to confirm the presence of gallstones. However, in certain situations, the gastroenterologist or doctor will conduct a Magnetic Retrograde Cholangiopancreatography (MRCP) or an Endoscopic Retrograde Cholangiopancreatography (ERCP) to assess if the gallstones are obstructing your bile ducts. Other than those diagnosis methods, a blood test or a gallbladder radionuclide scan might be employed to determine inflammation or bile duct leakage and blockage.

How to treat gallstones

In most cases, especially gallstones that are asymptomatic, surgery is not required. Instead, simple medications, such as ursodeoxycholic acid and diet changes, are all the individual needs to prevent or minimise new stones from developing, sometimes even dissolving small ones too. However, once symptoms start to appear, the risk of complications and recurrence increases. As such, surgical procedures are advocated. Depending on the experienced symptoms, complication risk, general health, and age, examples of surgical procedures include the following:

• Cholecystectomy: A keyhole surgical procedure is conducted, removing the entire gallbladder.

• ERCP: This is usually administered when gallstones block the common bile duct. The ERCP enters the bile duct via the duodenum to remove the stone from the common bile duct.

• Sphincterotomy: The sphincter, also known as the muscle between the duodenum and the common bile duct, is cut, allowing the smaller gallstones to pass through the widened exit into the small intestine.

Conclusion

Gallstones are, in general, asymptomatic in most people. However, they can result in severe complications, especially life-threatening ones, when symptoms start to surface. Hence, do not delay treating them when you experience any of the symptoms mentioned above. The best is if you conduct regular health check-ups.

At GUTCARE, we take care of your digestive health needs, and that includes gallstones and any of the complications mentioned above. From pile symptoms to colon cancer symptoms, our team of gastroenterologists and medical professionals treat all gut-related issues.

References:

• https://www.digestivediseasescenter.com/blog/gallstone-risks-symptoms-and-treatment-explained

• https://www.singhealth.com.sg/patient-care/conditions-treatments/gallstones

• https://www.gleneagles.com.sg/conditions-diseases/gallstones/symptoms-causes