A gallbladder attack may be common, but is not to be ignored. If the bile in your gallbladder becomes chemically unbalanced, solid particles can form. Over time, these particles may grow into stones. Gallstones can be as small as a grain of sand or as la
Prevent the attack of gallstones
Over the past few months you’ve had several unusual bouts of pain in your upper abdomen. Now, you’re having another episode. But this time, the pain is more constant, lasting much longer and accompanied by nausea. Tests show that you’ve been having gallbladder attacks due to gallstones. Gallstones are common, and become more common as you age. Often, gallstones don’t require treatment. But sometimes, they cause painful attacks and lead to more serious complications. It’s important to see your doctor promptly.
Your gallbladder is a small, pear-shaped sac located below your liver in the right side of your upper abdomen. It’s part of your biliary tract – the system in your body that transports bile. Bile is a greenish-brown liquid produced by your liver that helps break down fats and remove waste products from your body. Your gallbladder concentrates and stores bile until it’s needed for digestion. After you eat, your gallbladder contracts and releases bile into your small intestine through a series of tubes known as bile ducts. If the bile in your gallbladder becomes chemically unbalanced, solid particles can form. Over time, these particles may grow into stones. Gallstones can be as small as a grain of sand or as large as a golf ball. You can have just one or hundreds. The two most common types are: Cholesterol stones – These are made mainly of cholesterol that the bile is unable to keep dissolved. Pigment stones – People with blood disorders and severe liver diseases are most likely to get this type of stones, which are formed when the bile contains too much bilirubin, a waste product. Pigment stones are also more common in Asians.
Why Do Gallstones Form?
Many factors contribute to gallstone formation. One is too much cholesterol in bile. Cholesterol isn’t easily soluble, and if bile contains more cholesterol than it can keep dissolved, stones may form. In addition, if your gallbladder doesn’t empty completely or often enough, bile may become too concentrated and contribute to gallstone formation. Other risk factors include: Your sex – Women are twice as likely as men to have gallstones. That’s because the female hormone estrogen causes more cholesterol to be excreted in bile. Pregnancy, which causes estrogen levels to rise, also increases the risk. In addition, birth control pills and hormone replacement therapy increase bile cholesterol levels and reduce gallbladder emptying. Being overweight – This increases the amount of cholesterol in your bile and can prevent your gallbladder from emptying properly. Diet and dieting – Diets high in fat and cholesterol and low in fibre may increase your risk. In addition, low-calorie ‘crash’ diets can upset the chemical balance of bile and cause your gallbladder to contract less often. Cholesterol-lowering medications – Drugs known as fibrates include fenofibrate (Tricor) and gemfibrozil (Lopid), which slightly increase the risk of gallstone formation,
probably by changing the cholesterol composition of the bile. Your age – As you age, your body tends to secrete more cholesterol into bile. Your family history – Gallstones often run in families, pointing to a possible genetic link.
When To Seek Help
When your gallbladder contracts to expel bile, one or more stones may escape. Small stones may pass through without any problem, but larger stones can get stuck at the entrance to the duct that connects the gallbladder to the main bile duct, or they can lodge at the entrance of the small intestine. Signs and symptoms of problems include: Sudden and moderate to intense pain in your upper abdomen, possibly spreading to your back or right shoulder blade and lasting from 15 minutes to several hours. Nausea and vomiting. Fever. Chills. Jaundice (yellowing of your skin and the whites of your eyes). Dark-coloured urine. Pale-coloured stools. If you experience any of these signs and symptoms, seek treatment right away. Although gallbladder attacks often pass, your gallbladder can become infected and could rupture if a blockage remains. In addition, an obstruction could block the nearby pancreatic duct, causing inflammation of the pancreas (pancreatitis), a potentially life-threatening condition. Rarely, gallstones may also be related to cancer. Diagnosis of gallstones often includes a blood test to detect infection or indications that bile has backed up into the bloodstream. Ultrasonography is the most commonly used test to find stones within the gallbladder. Endoscopic retrograde cholangiopancreatography (ERCP) is an imaging process often used to locate stones lodged in the bile ducts. This procedure involves passing a flexible tube with an attached camera (endoscope) down your throat and upper digestive tract to the common bile duct. A dye is then injected into your bile ducts so that they can be seen on X-ray. If a stone is discovered in a duct, it usually can be immediately extracted with tools passed through the endoscope. Bile duct stones also may be diagnosed by magnetic resonance imaging (MRI) or endoscopic ultrasound.
Because of the many factors that contribute to gallstones, it’s hard to prevent them from forming. But, you may be able to lower your risk by maintaining a healthy weight.
Gallstones that aren’t symptomatic typically require no treatment because, for many people, the risk of taking them out is greater than the risk they’ll cause problems. These stones are called ‘silent stones’, and they’re often discovered during tests for other health conditions. For problematic gallstones, removing the gallbladder is the most common treatment. Your gallbladder isn’t an essential organ, and new stones usually form if just the stones are removed. Gallbladder removal surgery, (cholecystectomy) often performed laparoscopically, requires several small incisions in your abdomen through which a tiny video camera and surgical instruments are passed. You’ll likely be able to return to most normal activities within a few days. An open cholecystectomy, in which your gallbladder is removed through a larger abdominal incision, generally requires three to five days in the hospital followed by several weeks of recovery at home. It may be the best choice for cases in which the gallbladder is severely inflamed or if you have scar tissue from previous abdominal operations.
Living Without A Gallbladder
After gallbladder removal, your liver still produces enough bile to digest a normal diet. But instead of being stored in your gallbladder, bile empties directly into the small intestine. You may notice that you have more bowel movements than you used to, and that your stools are softer. These changes are often temporary. But if diarrhoea persists, talk to your doctor.