Summary about Disease
Cholelithiasis, commonly known as gallstones, is the formation of hard, pebble-like deposits in the gallbladder. These stones can range in size from as small as a grain of sand to as large as a golf ball. The gallbladder is a small organ located under the liver, and its primary function is to store and concentrate bile, a digestive fluid produced by the liver. Gallstones can block the flow of bile from the gallbladder, leading to pain, inflammation, and other complications.
Symptoms
Many people with gallstones (about 80%) experience no symptoms. When symptoms do occur, they may include:
Sudden, intense pain in the upper right or center abdomen: This pain, known as biliary colic, typically lasts from several minutes to a few hours.
Pain in the back between the shoulder blades
Pain in the right shoulder
Nausea
Vomiting
Indigestion
Dark urine
Clay-colored stools
Jaundice (yellowing of the skin and eyes), in severe cases if a gallstone blocks the bile duct.
Fever or chills can indicate infection (cholecystitis or cholangitis).
Causes
The exact cause of gallstones isn't fully understood, but contributing factors include:
High cholesterol in bile: When bile contains too much cholesterol, it can crystallize and form stones.
High bilirubin in bile: Bilirubin is a waste product produced when red blood cells are broken down. Conditions that cause the liver to make too much bilirubin, such as certain blood disorders, can lead to pigment gallstones.
Concentrated bile: If the gallbladder doesn't empty completely or often enough, bile can become overly concentrated, contributing to the formation of gallstones.
Risk factors: Obesity, diet (high in fat and cholesterol, low in fiber), rapid weight loss, family history of gallstones, female gender, pregnancy, certain medications (such as birth control pills or hormone replacement therapy), diabetes, and certain blood disorders.
Medicine Used
Ursodeoxycholic acid (Actigall, Urso): This medication can dissolve cholesterol gallstones, but it can take months or years of treatment, and gallstones may recur after treatment is stopped. It is generally only effective for small, cholesterol-based gallstones.
Pain relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage mild pain. Stronger pain medications may be prescribed for more severe pain.
Antibiotics: If an infection is present (e.g., cholecystitis), antibiotics will be prescribed. Important Note: Surgery to remove the gallbladder (cholecystectomy) is the most common and effective treatment for symptomatic gallstones.
Is Communicable
No, cholelithiasis (gallstones) is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
While you can't entirely prevent gallstones, you can take steps to reduce your risk:
Maintain a healthy weight: Obesity and rapid weight loss increase the risk of gallstones.
Eat a healthy diet: Focus on a diet high in fiber and low in fat and cholesterol.
Exercise regularly: Physical activity can help prevent gallstones.
Avoid skipping meals: Regular eating helps ensure the gallbladder empties regularly.
If you have risk factors: Discuss them with your doctor.
How long does an outbreak last?
Gallstones don't "outbreak" like an infectious disease. Individual episodes of biliary colic (gallstone pain) typically last from several minutes to a few hours. The underlying condition of having gallstones is chronic and can persist indefinitely unless treated.
How is it diagnosed?
Abdominal Ultrasound: This is the most common and preferred method. It's non-invasive and can detect gallstones very effectively.
Abdominal CT scan: Can detect gallstones, though less sensitive than ultrasound.
Hepatobiliary Iminodiacetic Acid (HIDA) Scan (also called cholescintigraphy): This test uses a radioactive tracer to assess the function of the gallbladder and bile ducts. It can help identify a blockage or other problems.
Endoscopic Ultrasound (EUS): Provides detailed images of the gallbladder and bile ducts.
Magnetic Resonance Cholangiopancreatography (MRCP): A type of MRI scan that provides detailed images of the bile ducts and pancreatic duct.
Blood tests: Liver function tests (LFTs) can help determine if gallstones are causing inflammation or blockage of the bile ducts. A complete blood count (CBC) may also be done to check for signs of infection.
Timeline of Symptoms
The timeline of symptoms varies greatly:
Asymptomatic: Many people have gallstones and never experience any symptoms.
Acute episodes: Biliary colic (pain) comes on suddenly, reaching peak intensity within minutes, and lasts from several minutes to a few hours.
Chronic cholecystitis: Can cause ongoing, less intense symptoms like indigestion, nausea, and abdominal discomfort.
Complications: If a gallstone blocks a bile duct, symptoms like jaundice, dark urine, and clay-colored stools may develop over hours to days. Infection (cholecystitis or cholangitis) can cause fever and chills within hours.
Important Considerations
Silent gallstones: Many people have gallstones without symptoms. Treatment is usually not required unless symptoms develop.
Complications: Gallstones can lead to serious complications such as cholecystitis (inflammation of the gallbladder), cholangitis (infection of the bile ducts), pancreatitis (inflammation of the pancreas), and gallbladder cancer (rare).
Pregnancy: Gallstones are more common during pregnancy. Treatment may be delayed until after delivery unless symptoms are severe.
Cholecystectomy (gallbladder removal): After gallbladder removal, most people can digest food normally. However, some may experience mild diarrhea or other digestive issues for a period of time. The liver still produces bile, but it flows directly into the small intestine instead of being stored in the gallbladder.
Consult a doctor: If you suspect you have gallstones, it's essential to consult a doctor for diagnosis and treatment. Self-treating can be dangerous.