Summary about Disease
Gallstones are hard, pebble-like deposits that form inside the gallbladder. The gallbladder is a small organ located under the liver that stores and releases bile, a digestive fluid. Gallstones can range in size from a grain of sand to a golf ball. Many people have gallstones without experiencing symptoms. However, if a gallstone blocks a bile duct, it can cause pain, inflammation, and infection.
Symptoms
Many people with gallstones experience no symptoms. When symptoms do occur, they typically include:
Sudden and rapidly intensifying pain in the upper right abdomen.
Pain in the center of your abdomen, just below the breastbone.
Back pain between your shoulder blades.
Pain in your right shoulder.
Nausea or vomiting.
Jaundice (yellowing of the skin and eyes).
Fever or chills (signs of infection).
Causes
The exact cause of gallstones isn't always clear, but several factors may contribute to their formation:
Too much cholesterol in bile: Gallstones can form when the bile contains too much cholesterol.
Too much bilirubin in bile: Bilirubin is a chemical produced when the body breaks down red blood cells. Certain conditions, such as liver damage and certain blood disorders, cause your liver to make too much bilirubin.
Gallbladder doesn't empty correctly: If the gallbladder doesn't empty completely or often enough, bile can become concentrated and contribute to the formation of gallstones.
Medicine Used
Ursodiol (Actigall, Urso): This medication contains bile acids that help dissolve cholesterol gallstones. It may take months or years of treatment to dissolve the stones, and gallstones may recur after treatment is stopped. This is generally used for small cholesterol stones.
Chenodiol (Chenix): Similar to ursodiol, this medication can also dissolve cholesterol gallstones. However, it is less commonly used due to potential side effects.
Pain Management: Pain relievers (analgesics) like NSAIDs or stronger medications may be prescribed to manage acute pain.
Antibiotics: If a gallbladder infection (cholecystitis) is present, antibiotics will be prescribed.
Is Communicable
No, gallstones are not communicable. They cannot be spread from person to person.
Precautions
While it's not always possible to prevent gallstones, you can take steps to reduce your risk:
Maintain a healthy weight: Obesity increases the risk of gallstones.
Eat a healthy diet: A diet high in fiber and low in fat and cholesterol can help prevent gallstones.
Lose weight gradually: Rapid weight loss can increase the risk of gallstones.
Exercise regularly: Regular physical activity can help prevent gallstones.
Don't skip meals: Regular meals help keep the gallbladder emptying properly.
How long does an outbreak last?
An "outbreak" isn't the correct term, as gallstones aren't caused by an infectious agent. An episode of gallbladder pain (biliary colic) typically lasts from several minutes to a few hours (usually 1-5 hours). If the gallstone remains lodged in a duct, it can lead to ongoing inflammation (cholecystitis) and more prolonged symptoms, requiring medical intervention.
How is it diagnosed?
Abdominal ultrasound: This is the most common imaging test used to diagnose gallstones.
Endoscopic ultrasound (EUS): This can provide more detailed images of the gallbladder and bile ducts.
Abdominal CT scan: This can help identify gallstones and other abnormalities in the abdomen.
Magnetic resonance cholangiopancreatography (MRCP): This MRI scan provides detailed images of the bile ducts and gallbladder.
Blood tests: Blood tests can help detect signs of infection, inflammation, or liver problems.
HIDA scan (hepatobiliary iminodiacetic acid scan): This scan uses a radioactive tracer to assess the function of the gallbladder.
Timeline of Symptoms
The timeline of symptoms can vary greatly:
Years: Many people have gallstones for years without any symptoms.
Acute Attacks (Biliary Colic): Sudden onset of intense pain that lasts minutes to hours (typically 1-5 hours), often after eating a fatty meal.
Acute Cholecystitis: If a gallstone blocks a duct for a prolonged period, inflammation and infection can develop. Symptoms worsen over several hours or days and may include constant pain, fever, and chills.
Chronic Cholecystitis: Repeated episodes of biliary colic can lead to chronic inflammation of the gallbladder, causing persistent abdominal discomfort, bloating, and indigestion.
Important Considerations
Asymptomatic Gallstones: Many people have gallstones but experience no symptoms. In these cases, treatment may not be necessary unless symptoms develop.
Surgical Removal (Cholecystectomy): If gallstones cause recurrent pain or complications, surgical removal of the gallbladder is often recommended. This is a common and generally safe procedure. It can be done laparoscopically (minimally invasive) or through an open incision.
Pregnancy: Gallstones can be more common during pregnancy. Treatment options may be limited due to the pregnancy, and surgery may be delayed until after delivery if possible.
Complications: Untreated gallstones can lead to serious complications such as cholecystitis, cholangitis (bile duct infection), pancreatitis, and gallbladder cancer (rare).
Lifestyle Modifications: Even after treatment, maintaining a healthy lifestyle can help prevent future gallstone formation or other digestive problems.