Introduction
Gall stone disease is a common condition that affects the gallbladder and the bile ducts, which are part of the digestive system. Gall stones are hard, solid deposits of bile components that form in the gallbladder or the bile ducts. Bile is a fluid that helps digest fats and is produced by the liver and stored in the gallbladder. Gall stones can cause various symptoms and complications, depending on their size, number and location. In this essay, we will discuss the symptoms, causes, diagnosis and treatment of gall stone disease.
Symptoms of Gall Stone Disease
Many people with gall stones do not have any symptoms and may not even know they have them. This is called asymptomatic gall stone disease. However, some people may experience pain or discomfort in the upper right abdomen or the center of the stomach, especially after eating fatty or greasy foods. This is called biliary colic and usually lasts for a few hours. The pain may also radiate to the back, shoulder or chest.
Some people may develop more serious symptoms if the gall stones block the flow of bile from the gallbladder or the bile ducts. This can cause inflammation or infection of the gallbladder (cholecystitis), the bile ducts (cholangitis) or the pancreas (pancreatitis).
The symptoms of these conditions may include:
Fever
Chills
Nausea
Vomiting
Jaundice (yellowing of the skin and eyes)
Dark urine
Clay-coloured stools
Itching
These symptoms require immediate medical attention, as they can lead to serious complications such as sepsis, abscesses or organ damage.
Causes of Gall Stone Disease
The exact cause of gall stone formation is not fully understood, but it is thought to be related to an imbalance of bile components. Some factors that may contribute to this imbalance are:
Too much cholesterol in the bile.
Too much bilirubin in the bile.
Too little bile in the gallbladder.
Some other factors that may increase the risk of developing gall stones are:
Age. Gall stone disease is more common in older people, especially over 40 years old.
Gender. Women are more likely to develop gall stones than men, especially during pregnancy, using oral contraceptives or hormone replacement therapy.
Family history. Gall stone disease tends to run in families, suggesting a genetic predisposition.
Obesity. Being overweight or obese can increase the cholesterol level in the bile and reduce the gallbladder function.
Diet. Eating a diet high in fat, cholesterol and refined carbohydrates and low in fibre can increase the risk of gall stone formation.
Lifestyle. Lack of physical activity, smoking and alcohol consumption can also affect the bile composition and gallbladder function.
Diagnosis of Gall Stone Disease
To diagnose gall stone disease, your doctor will ask you about your symptoms, medical history and risk factors. They will also perform a physical examination to check for signs of inflammation or infection in your abdomen.
Your doctor may also order some tests to confirm the diagnosis and rule out other possible causes of your symptoms. These tests may include:
Blood tests. These can check for signs of infection, inflammation, liver function and bilirubin level.
Urine tests. These can check for signs of jaundice or infection.
Stool tests. These can check for signs of fat malabsorption or infection.
Ultrasound scan. This is the most common and accurate test to detect gall stones.
Other imaging tests. These may include computed tomography (CT) scan, magnetic resonance imaging (MRCP) scan.
Treatment of Gall Stone Disease
The treatment of gall stone disease depends on the type, size, number and location of the stones, as well as the severity of your symptoms and complications. The main goals of treatment are to relieve your pain, prevent or treat any infections or inflammation, and prevent or remove any blockages in your bile ducts.
The main treatment options for gall stone disease are:
Medications. These can include painkillers, antibiotics, anti-inflammatory drugs or bile acid pills. These can help to reduce your pain, treat any infections or inflammation, or dissolve some types of small stones. However, these medications may have side effects, may not work for everyone, and may take a long time to be effective.
Surgery. This is the most effective and definitive treatment for gall stone disease. It involves removing your gallbladder along with the stones. This is
called cholecystectomy and can be done either by open surgery or laparoscopic surgery. Open surgery involves making a large incision in your abdomen and removing your gallbladder through it. Laparoscopic surgery involves making 4 small incisions in your abdomen and inserting a camera and surgical instruments through them to remove your gallbladder. Laparoscopic surgery is less invasive, has fewer complications and has a faster recovery time than open surgery. However, both types of surgery have some risks such as bleeding, infection, injury to nearby organs or bile leakage.
Conclusion
Gall stone disease is a common condition that affects the gallbladder and the bile ducts. It can cause various symptoms and complications depending on the size, number and location of the stones. The diagnosis of gall stone disease involves a physical examination and some tests such as blood tests, urine tests, stool tests and ultrasound scan. The treatment of gall stone disease depends on the type, size, number and location of the stones, as well as the severity of your symptoms and complications. The main treatment options are medications, non-surgical procedures or surgery. The best treatment option for you will depend on your individual situation and preference.
References
Gallstones – Symptoms & causes – Mayo Clinic https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214. Gallstones: Symptoms, Causes, Treatment, and More – Healthline https://www.healthline.com/health/gallstones: Gallstone Disease | Johns Hopkins Medicine https://www.hopkinsmedicine.org/health/conditions-and-diseases/gallstone-disease
About the author
Dr Nikhil Nanjappa M.S., FRCS Ed., M.IPD Ed., M. FST Ed., is a consultant surgical gastroenterologist and a colorectal surgeon in Mysore & Coorg. He has recently returned from the United Kingdom after serving as a Consultant Surgeon at St. James’s University Hospital, Leeds. During his year as a consultant at Leeds, he performed the highest number of gall bladder surgeries for a single consultant. He is known for his extensive gastrointestinal, colorectal, laparoscopic, robotic and emergency general surgery expertise.
For appointments visit www.drnikhilnanjappa.com or call 91081 27867