Cholelithiasis - Gallstones

Overview, Causes, & Risk Factors Symptoms & Signs Diagnosis & Tests Prevention & Expectations Treatment & Monitoring Attribution

Overview, Causes, & Risk Factors

Gallstones are stones that form in the gallbladder. Most gallstones are crystals of cholesterol. Cholesterol is a waxy substance used for many body processes. Gallstones may also be crystals of calcium and bilirubin. Bilirubin is a byproduct formed when red blood cells break down.

What is going on in the body?

The gallbladder stores bile. Bile is a liquid produced in the liver that aids in digestion. When a person eats, bile flows through a series of tubes or ducts into the intestines. It helps to break up food so that it can be used by the body. When bile is supersaturated with cholesterol or bilirubin, it may form the crystals known as gallstones.

What are the causes and risks of the condition?

Gallstones are crystals that form from excess cholesterol or bilirubin. Factors that increase a person's risk for gallstones include: alcoholism decreased intake of fluids diet high in fat and low in fiber excessive breakdown of red blood cells, such as sickle cell anemia gallbladder disease genetics obesity pregnancy

Symptoms & Signs

What are the signs and symptoms of the condition?
There are three stages of gallstones: asymptomatic, symptomatic, and with complications. Sixty to 80% of gallstones are asymptomatic, meaning that they cause no symptoms. If gallstones become symptomatic, the person may have the following symptoms: a feeling of abdominal bloating and excessive gas nausea and sometimes vomiting pain that is usually in the upper right or middle part of the abdomen radiation of the pain through to the back or into the shoulder worsening of the pain after a heavy or fatty meal

If complications occur, the individual may develop further symptoms: abnormally light-colored stools blockage of the bowels dark-colored urine

fever itching jaundice, or yellowing of the eyes and skin severe, constant abdominal pain

Diagnosis & Tests

How is the condition diagnosed?
Diagnosis of gallstones starts with a medical history and physical exam. Blood tests are often done to rule out other causes or detect complications. An ultrasound may be ordered to check for gallstones.

Prevention & Expectations

What can be done to prevent the condition?
Most cases cannot be prevented. Maintaining a normal weight and eating a low-fat, high-fiber diet may prevent some cases.

What are the long-term effects of the condition?

Many people have asymptomatic gallstones for years without any problem. However, complications of gallstones may include: blockage of the ducts that carry bile to the intestines bowel obstruction gallbladder disease liver disease pancreatitis, or infection of the pancreas

What are the risks to others?

Gallstones are not contagious and pose no risk to others.

Treatment & Monitoring

What are the treatments for the condition?
Asymptomatic gallstones are not usually treated. For example, gallstones are often discovered by accident when an Xray is done for another reason. If gallstones are causing symptoms, a person may want to consider surgery. Surgery is usually not required for uncomplicated gallstones, but a person may want it done. Treatments other than surgery are used in some cases but are less effective. Some medicines, such as ursodiol, can dissolve gallstones. A procedure that uses special sound waves to break up stones may also be done in some settings. If a person gets complications from gallstones, surgery is usually advised. In some cases, surgery must be done quickly because of serious complications. Removal of the gallbladder stops the symptoms in almost all cases. The gallbladder may be removed through a lighted tube, or laparoscope. Occasionally, the gallbladder is removed with traditional surgery.

What are the side effects of the treatments?

Surgery may cause bleeding, infection, and allergic reaction to anesthesia. Some people may notice more frequent bowel movements for a short time after surgery.

What happens after treatment for the condition?

Gallstones may recur after they are dissolved with medicines or destroyed with ultrasound. Surgery is usually more successful.

How is the condition monitored?

Any new or worsening symptoms should be reported to the healthcare provider.

Attribution
Author:Michael Peetz, MD Date Written: Editor:Crist, Gayle P., MS, BA Edit Date:06/30/01 Reviewer:Eileen McLaughlin, RN, BSN Date Reviewed:05/31/01

Source : http://www.medicineonline.com/topics/C/2/Cholelithiasis/Gallstones.html 15.48