| What are GALLSTONES?
Some people form different size stones in the gallbladder.
There may be a single stone or as many as 100 or more. Some stones are made of
cholesterol, calcium, a blood pigment, or complex mixed stones with combination of above.
What is gallbladder and what is its function in the body?
Gallbladder is a pear shaped and sized bile bag, that is part of the biliary tree.
It is connected to the bile tube coming from the liver. This bile tube is called common
bile duct that joins with a tube coming from an organ called pancreas and opens in to a
part of intestine called duodenum. The normal function of the gallbladder is to store the
bile produced by the liver until a person eats and then the gallbladder muscles squeeze
the bile in to the common bile duct to empty in to the duodenum, where it plays a part in
the digestion of fatty food.
Are gallstones normally present in everyone?
No gallstones are normally present in everyone. The presence of gallstones in
gallbladder indicates the diseased gallbladder. The person is at an increased risk of
complications of gallstones. These include gallstone attacks, infection of gallbladder,
passage of stones in the common bile duct, obstruction of common bile duct,
cholangitis,
yellow jaundice, gallstone Pancreatitis to name a few.
What happens
when some one has gallstones?
Gall stones in the gallbladder act as a ball valve. Whenever gallbladder contracts
the stones get wedged in to the outlet tube called cystic duct. This leads to increase of
pressure inside the gall bladder. This produces referred pain and discomfort. Some people
describe that as gas pain in upper abdomen, or right side back or right upper side of the
abdomen under the rib cage. This can also produce vomiting. The symptoms can mimic heart
attack or angina. Fatty foods are usually the culprit in the attacks but virtually any
food can cause gall stone attacks. The pain or discomfort may ease up when the stone falls
back or passes down the cystic duct in to the common bile duct.
What happens if the gall bladder remains obstructed?
This can lead to infection of the gall bladder and is called
cholecystitis. This is
an urgent problem and requires urgent surgical management of the gall stone disease. If
acute cholecystitis is allowed to progress untreated then it can turn in to gangrene of
the gall bladder and eventually it ruptures - spilling infected bile and material in the
abdominal cavity. This is a serious complication of gallstones and if still untreated,
death of the person may ensue.
What happens if the gallstones travel to the common bile duct?
This is another complication of the gallstones. Stones obstructing the common bile
duct may produce gall stone pancreatitis, obstructive jaundice, acute cholangitis and or
suppurative cholangitis. These are all very serious complications of gallstones. The x-ray
here shows an obstructed common bile duct.
How do I know I
have gallstones?
If you are having symptoms suggestive of gallstones problem, then contact your
doctor. If appropriate your doctor may order an ultrasound examination of your abdomen.
This usually shows gallstones in the gallbladder.
What should one do if one is found to have gall stones?
Surgical removal of the gall bladder is the current gold standard for the
management of the gall stone disease. I used to remove the gall bladder by making a long
incision on the right upper abdomen under the rib cage. For past 8-9 years I have been
using a relatively newer procedure called Laparoscopic Cholecystectomy.
How will I digest my food when the gallbladder is removed?
After the Cholecystectomy, the bile produced by the liver goes directly in the
duodenum. Most people do not notice the difference as due to the presence of stones in the
gall bladder, the gall bladder was not getting all the bile produced by liver any way.
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