Gallstones

Overview

Although it may seem like a relatively minor problem, gallstones can cause excruciating pain. Gallstones are caused by high cholesterol. Affecting nearly 30 million adult Americans every year, gallstones are deposits that may be as small as grain, soft or hard and could be many or just one. Gallstones appear in the organ
Gallbladder whose main function is to produce bile and help in breaking down food particles for digestion. Most of the time the stones go unnoticed just floating in the organ until they are caught by an ultrasound with generally no symptoms or no pain.

Symptoms of Gallstones

The silent stones, however, pose a big threat, the longer they go unnoticed the more problematic they become. People who have these silent stones have a 20% chance of pain during their lifetime. Symptoms do occur when the stone somehow gets lodged between the duct that carries the bile like the cystic duct more commonly
known as the bile duct. The symptoms start occurring either right after a hefty meal or in the middle of the night.

The symptoms include abdominal pain, nausea, indigestion, and fever. This can be explained by the fact that bile helps in the digestion of food and is an integral part of the digestive system. When the duct gets
blocked the bile cannot reach the food and help break it down. When that occurs, the body unable to digest the food will reject it out of the body, making it difficult for the body to retain any nutrients. What should be noted is that these can grow up to the size of a golf bowl and can be multiple in number as well, so this is an inevitable
outcome however minor it seems before.

If gallstones go untreated, they can cause excruciating pain in the upper right abdominal region or the centre of the abdomen. As mentioned before these can appear right after a big meal or meals with a high level of fat like fried food etc. The pain caused by gallstones lasts only for a few hours, although it is severe. Other symptoms of gallstones include high fever, rapid heartbeat, yellowing of the skin and the white of the eyes, itchy skin, diarrhoea, chills, confusion, and a loss of appetite.

Although a lot of these symptoms mimic that of gallbladder infection, appendicitis and pancreatitis, you need to visit the doctor urgently to get this sorted out as any of these diagnoses aren’t good and you need immediate care.

Causes of Gallstones

To understand what causes the gallstones to occur one must understand how the digestive system works. The primary function of the gallbladder is to create bile and one of the main ingredients of bile is cholesterol. Usually, the concentration of bile acid is strong enough to keep the cholesterol in liquid form and keep balance.

However, when the patient is consuming a high-fat diet the scales tip as the liver starts producing more cholesterol and eventually the cholesterol starts hardening and forming little crystals that we call gallstones. 80% of the stones are cholesterol and the rest 20% is calcium mixed with a bile pigment called bilirubin. Now most people would assume that eating a low-fat or no-fat diet would be the solution to this problem but that is also not true.

With less fatty food being consumed the bile is called less into action and this inactivity can lead to the cholesterol having more time to solidify. Other factors that can be the reason for gallstones to form are the usage of birth control pills, hormone replacement therapy or pregnancy. Family history, sudden weight loss, diabetes medicine for cholesterol and old age can also be different factors for gallstones.

Prevention for Gallstones

Diet plays a huge role in preventing gallstones. Too much or too little of anything is bad for your body and gallstones show that very well. Anything with saturated fat content should be avoided or eaten in moderation. Food like meat, sausages, butter ghee, cream, hard cheese, cakes or baked goods and food containing coconut oil or palm oil. A diet full of fresh vegetables and whole grains is advised. Recent studies have shown that eating peanuts or cashew nuts reduces your chances of gallstones.

Alcohol should also be consumed in small amounts, no more than 14 units should be consumed. Regular drinking may lead to poor liver health and is a risk to your overall health. Losing weight is also a very important factor in preventing gallbladder issues in general. Being overweight, particularly obese, increases your
cholesterol levels and that is a surefire way of getting gallstones. You must control your diet and exercise regularly.

However, you should avoid low calorie rapid weight loss diets as that create an imbalance in your bile chemistry and instead of avoiding gallstones your risk in fact increases. Foods that should be consumed to
prevent gallstones are olive oil, as it helps lower the cholesterol level in the bloodstream.

Other foods include lecithin, a natural substance used to thicken ice cream, mayonnaise etc., which helps prevent gallstones. Lecithin is found in oatmeal, eggs, milk, peanuts, cabbage and chocolate. However, you must be prescribed by a doctor to take the medicinal supplements of lecithin as overconsumption of it can lead to health problems such as your liver being compromised.

Tests and Treatment for Gallstones

To find out whether you do have gallstones or not your doctor will check for tenderness in your abdominal region, examine your skin for Jaundice and a blood test that would reveal any obstructions. As infection of the bile duct can have the same symptoms as gallstones the doctor may run some other tests to find out whether
the real reason is in fact the gallstone. But the most foolproof way to find out whether you have gallstones or not is through an ultrasound.

It is a quick and painless procedure that uses high-frequency sound waves to create a picture of the gallbladder, the bile duct and its contents. CT scans are also done sometimes to look at the organs properly. There is a more invasive procedure known through its acronym ERCP that allows the doctor to see the bile duct with an endoscope. The patient is put under for the procedure and an anaesthetic is sprayed at the back of the throat to prevent gagging. While the doctors are looking at the obstruction, they can also remove it. In total, the procedure takes about an hour.

The most commonly used treatment for gallstones is the removal of the gallbladder as the risk of more gallstones does not get alleviated after they first appear. There are other treatments, but they only alleviate the symptoms of gallstones and not the issue itself. Some doctors suggest waiting to see once the patient has a pain episode because if the stone dislodges itself then it goes back to its silent stage and does not bother the patient anymore. Your surgery may get postponed due to any other health conditions and during that time you must remain under the watchful eye of the doctor.

Some patients do not wish to go through surgery and there is a non-invasive treatment but it only works on stones that are formed with cholesterol and not bile pigment, if the stone has calcified the treatment will not work. It is through a medication called Actigall that uses bile salt to make the stone dissolve, depending
on the size of the stone and as mentioned above the composition, it may take months to years for the stone to go away.

FAQs

Q1. Can I have Gallstones without having any symptoms
A1. Yes, two thirds of gallstone diagnosis happen only due to some other procedural scans.

Q2. Are women more likely to develop Gallstones?
A2. Yes, women are more likely to develop gallstones

Q3. Should I stop eating high-fat food all together?
A3. No, your body needs fatty food to maintain the balance of cholesterol in your blood and for your health in general. They should be eaten in moderation.

Q4. Is the treatment determined on the size of the stone?
A4. No, the size of the gallstone does not matter for the treatment

Q5. Will there be changes to my food habits after the surgery?
A5. No, there will be no major changes to your eating habits.