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Problems associated with the Gall Bladder
The gallbladder is a small sac that holds the bile(Bile is a digestive juice produced by the liver that is used in the breakdown of dietary fats). The gallbladder extracts water from its store of bile until the liquid becomes highly concentrated. The presence of fatty foods triggers the gallbladder to squeeze its bile concentrate into the small intestine.
Gallstones (biliary calculi) are small stones made from cholesterol, bile pigment and calcium salts, usually in a mixture that forms in the gallbladder.
They are a common disorder of the digestive system, and affect around 15 per cent of people aged 50 years and over.
Some things that may cause gallstones to form include the crystallisation of excess cholesterol in bile and the failure of the gallbladder to empty completely.
In most cases, gallstones don’t cause any problems. However, you might need prompt treatment if stones block ducts and cause complications such as infections or inflammation of the pancreas (pancreatitis).
Surgeons may remove your gallbladder (called a cholecystectomy) if gallstones (or other types of gallbladder disease) are causing problems. Techniques include laparoscopic (‘keyhole’) cholecystectomy or open surgery. The gallbladder is not a vital organ, so your body can cope quite well without it.
Symptoms of gallstones
In majority of patients stone formation keeps going on with no symptoms.
The symptoms of gallstones may include:
(i) Sudden pain in the abdomen and back. Pain is generally infrequent, but severe increase in abdominal pain after eating a fatty meal
(ii) Jaundice
(iii) Fever and pain, if the gallbladder or bile duct becomes infected.
(iv) The pain can also spread to the chest, shoulder, neck or back.
Types of gallstones
(i) Mixed stones – the most common type. They are made up of cholesterol and salts. Mixed stones tend to develop in batches.
(ii) cholesterol stones – made up mainly of cholesterol, a fat-like substance that is crucial to many metabolic processes. Cholesterol stones can grow large enough to block bile ducts
(iii)Pigment stones – bile is greenish-brown in colour, due to particular pigments. Gallstones made from bile pigment are usually small, but numerous.
What Causes Gallstones?
Cholesterol accumulation in the bile is the main cause of biliary sludge and gallstones. Cholesterol can build up in the bile for various reasons, including:
(1) Oversaturation of cholesterol in the bile. The bile cannot keep all the chlolesterol compounds dissolved so some of them settle into your organs, turning into biliary sludge and potentially into gallstones.
(2) Underproduction of bile by the liver. This makes the bile flow too weak to flush out cholesterol deposits from the gallbladder.
(3) Undersupply of lecithin and bile salts in the bile. Lecithin and bile salts are fat-carrying substances especially designed to keep cholesterol molecules dissolved.
Diet and Factors responsible for causing onset of Gall Stones
The most common triggers for gallbladder attacks are caffeine, chocolate, eggs, dairy products (especially ice cream) and greasy or deep fried foods. Other predisposing factors are:
(i) Gallstones are more common in women than in men.
(ii) They are also more common in overweight people and people with a family history of gallstones.
(iii) There is no single cause of gallstones. In some people, the liver produces too much cholesterol. This can result in the formation of cholesterol crystals in bile that grow into stones. In other people, gallstones form because of changes in other components of bile or because the gallbladder does not empty normally.
Diagnosis of gallstones
(i) Physical examination and x-rays
(ii) Ultrasound – soundwaves form a picture that shows the presence of gallstones: This confirms the stone and its size. It is added that Gall stones above the size of 10 mm can not be treated by non-surgical mathodssince there are chances of lodging of gall stones in bile duct.
(iii) Endoscope test – endoscopic retrograde cholangiopancreatography (ERCP). A thin tube is passed through the oesophagus and injects dye into the bowel to improve the quality of x-ray pictures
(iv) hepatobiliary iminodiacetic acid (HIDA) scan – a special type of nuclear scan that assesses how well the gallbladder functions.
(v) Magnetic resonance cholangiopancreatography (MRCP) – a form of the body-imaging technique magnetic resonance imaging (MRI). The person’s liver, biliary and pancreatic system is imaged using an MRI unit. The image is similar to an ERCP test.
Complications of gallstones
If gallstones cause no symptoms, you rarely need any treatment. Don't go for any unwanted gall bladder surgery. My Uncle Mr G R Chopra who is 65 year old has gall stones since 10 years but still living healthy without operation.
In most of patients although the stones are there in gall bladder yet they live near normal life.
However in some cases following complications that may require prompt medical treatment include:
(i) Biliary colic – a gallstone can move from the body of the gallbladder into its neck (cystic duct), leading to obstruction. Symptoms include severe pain and fever
(ii) Inflammation of the gallbladder (cholecystitis) – a gallstone blocks the gallbladder duct, leading to infection and inflammation of the gallbladder. Symptoms include severe abdominal pain, nausea and vomiting
(iii) jaundice – if a gallstone blocks a bile duct leading to the bowel, trapped bile enters the person’s bloodstream instead of the digestive system. The bile pigments cause a yellowing of the person’s skin and eyes. Their urine may also turn orange or brown
(iv) Pancreatitis – inflammation of the pancreas, caused by a blocked bile duct low down near the pancreas. Pancreatic enzymes irritate and burn the pancreas and leak out into the abdominal cavity
(v) cholangitis – inflammation of the bile ducts, which occurs when a bile duct becomes blocked by a gallstone and the bile becomes infected. This causes pain, fever, jaundice and rigors (shaking)
(vi) infection of the liver
(vii)cancer of the gallbladder (occurs rarely).
RG Stone Delhi Dr K N Shrivastava
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Problems associated with the Gall Bladder
The gallbladder is a small sac that holds the bile(Bile is a digestive juice produced by the liver that is used in the breakdown of dietary fats). The gallbladder extracts water from its store of bile until the liquid becomes highly concentrated. The presence of fatty foods triggers the gallbladder to squeeze its bile concentrate into the small intestine.
Gallstones (biliary calculi) are small stones made from cholesterol, bile pigment and calcium salts, usually in a mixture that forms in the gallbladder.
They are a common disorder of the digestive system, and affect around 15 per cent of people aged 50 years and over.
Some things that may cause gallstones to form include the crystallisation of excess cholesterol in bile and the failure of the gallbladder to empty completely.
In most cases, gallstones don’t cause any problems. However, you might need prompt treatment if stones block ducts and cause complications such as infections or inflammation of the pancreas (pancreatitis).
Surgeons may remove your gallbladder (called a cholecystectomy) if gallstones (or other types of gallbladder disease) are causing problems. Techniques include laparoscopic (‘keyhole’) cholecystectomy or open surgery. The gallbladder is not a vital organ, so your body can cope quite well without it.
Symptoms of gallstones
In majority of patients stone formation keeps going on with no symptoms.
The symptoms of gallstones may include:
(i) Sudden pain in the abdomen and back. Pain is generally infrequent, but severe increase in abdominal pain after eating a fatty meal
(ii) Jaundice
(iii) Fever and pain, if the gallbladder or bile duct becomes infected.
(iv) The pain can also spread to the chest, shoulder, neck or back.
Types of gallstones
(i) Mixed stones – the most common type. They are made up of cholesterol and salts. Mixed stones tend to develop in batches.
(ii) cholesterol stones – made up mainly of cholesterol, a fat-like substance that is crucial to many metabolic processes. Cholesterol stones can grow large enough to block bile ducts
(iii)Pigment stones – bile is greenish-brown in colour, due to particular pigments. Gallstones made from bile pigment are usually small, but numerous.
What Causes Gallstones?
Cholesterol accumulation in the bile is the main cause of biliary sludge and gallstones. Cholesterol can build up in the bile for various reasons, including:
(1) Oversaturation of cholesterol in the bile. The bile cannot keep all the chlolesterol compounds dissolved so some of them settle into your organs, turning into biliary sludge and potentially into gallstones.
(2) Underproduction of bile by the liver. This makes the bile flow too weak to flush out cholesterol deposits from the gallbladder.
(3) Undersupply of lecithin and bile salts in the bile. Lecithin and bile salts are fat-carrying substances especially designed to keep cholesterol molecules dissolved.
Diet and Factors responsible for causing onset of Gall Stones
The most common triggers for gallbladder attacks are caffeine, chocolate, eggs, dairy products (especially ice cream) and greasy or deep fried foods. Other predisposing factors are:
(i) Gallstones are more common in women than in men.
(ii) They are also more common in overweight people and people with a family history of gallstones.
(iii) There is no single cause of gallstones. In some people, the liver produces too much cholesterol. This can result in the formation of cholesterol crystals in bile that grow into stones. In other people, gallstones form because of changes in other components of bile or because the gallbladder does not empty normally.
Diagnosis of gallstones
(i) Physical examination and x-rays
(ii) Ultrasound – soundwaves form a picture that shows the presence of gallstones: This confirms the stone and its size. It is added that Gall stones above the size of 10 mm can not be treated by non-surgical mathodssince there are chances of lodging of gall stones in bile duct.
(iii) Endoscope test – endoscopic retrograde cholangiopancreatography (ERCP). A thin tube is passed through the oesophagus and injects dye into the bowel to improve the quality of x-ray pictures
(iv) hepatobiliary iminodiacetic acid (HIDA) scan – a special type of nuclear scan that assesses how well the gallbladder functions.
(v) Magnetic resonance cholangiopancreatography (MRCP) – a form of the body-imaging technique magnetic resonance imaging (MRI). The person’s liver, biliary and pancreatic system is imaged using an MRI unit. The image is similar to an ERCP test.
Complications of gallstones
If gallstones cause no symptoms, you rarely need any treatment. Don't go for any unwanted gall bladder surgery. My Uncle Mr G R Chopra who is 65 year old has gall stones since 10 years but still living healthy without operation.
In most of patients although the stones are there in gall bladder yet they live near normal life.
However in some cases following complications that may require prompt medical treatment include:
(i) Biliary colic – a gallstone can move from the body of the gallbladder into its neck (cystic duct), leading to obstruction. Symptoms include severe pain and fever
(ii) Inflammation of the gallbladder (cholecystitis) – a gallstone blocks the gallbladder duct, leading to infection and inflammation of the gallbladder. Symptoms include severe abdominal pain, nausea and vomiting
(iii) jaundice – if a gallstone blocks a bile duct leading to the bowel, trapped bile enters the person’s bloodstream instead of the digestive system. The bile pigments cause a yellowing of the person’s skin and eyes. Their urine may also turn orange or brown
(iv) Pancreatitis – inflammation of the pancreas, caused by a blocked bile duct low down near the pancreas. Pancreatic enzymes irritate and burn the pancreas and leak out into the abdominal cavity
(v) cholangitis – inflammation of the bile ducts, which occurs when a bile duct becomes blocked by a gallstone and the bile becomes infected. This causes pain, fever, jaundice and rigors (shaking)
(vi) infection of the liver
(vii)cancer of the gallbladder (occurs rarely).
RG Stone Delhi Dr K N Shrivastava
Link Link2 Link3 LinkR Priyankagandhi Celebrity c2
