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Gall Stones or Cholelithiasis

Gall stones are hardened deposits of digestive fluid that make up as small stones in the gallbladder. The size of gallstones vary from as small as a grain of sand to as large as a golf ball. It may be one or multiple in number and develop due to excess of cholesterol or pigments in the bile. Most of the gall stones are asymptomatic and do not need treatment till the time they get trapped in the duct.
Gallstone disease can further cause inflammation of the gallbladder (cholecystitis) or acute pancreatitis leading to progressively worsening abdominal pain.
Types of gallstones
Gall stones are basically of following two types:
Cholesterol gallstones are common, yellow-green in color and are made of undissolved cholesterol.
Pigment gallstones are dark brown or black stones that are smaller in size and are made up of bilirubin.
What causes??Gallstones?
Gall stones are very common and are believed to develop because of an imbalance in the chemical make-up of bile inside the gallbladder. This imbalance is in the following forms
Bile contains too much cholesterol
Bile contains too much bilirubin
Gallbladder doesn’t empty correctly
In addition to these, several factors may come together to create gallstones, including:
Being female
Age above 60 years
Higher level of estrogen
Ethnic background especially Native Americans and Mexican-Americans
Cholesterol-lowering drugs
Higher levels of triglycerides
Rapid weight loss
Symptoms of Gall Stones
Generally gallstones may not cause any signs or symptoms until they gets lodged in a duct. The patient will have following symptoms due to obstruction:
Sudden and rapidly intensifying pain either in the upper right portion or center of abdomen (biliary colic)
Back pain between shoulder blades especially right side
Nausea & Vomiting
Yellowing of skin and the whites of eyes
High fever with chills
Other gastrointestinal problems, include bloating, indigestion, heartburn, and gas
How Are Gallstones Diagnosed?
The diagnosis of gall stones involve thorough physical examination of the patient by the doctor along with following tests:
Blood tests
CAT scan
Magnetic resonance cholangiopancreatography(MRCP
Cholescintigraphy (HIDA scan
Endoscopic ultrasound
Endoscopic retrograde cholangiopancreatography (ERCP
Treatment of Gallstones
Treatment is usually necessary only in the cases where gallstones are causing symptoms.
Medication: Medicines called chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UDCA, ursodiol) are prescribed by the physician to dissolve gall stones but these take long and stones will eventually return.
Surgical treatment: In most of the cases when gall stones are symptomatic, open or laparoscopic cholecystectomy is performed to remove gall bladder from the body.
Advantages of Laparoscopic Cholecystectomy Performed at Agada Hospital
Day care procedure
Minimal pain
Patient is discharged within 24 hours
Less invasive
Recovery time is shorter
Almost no scar
Less chances of infection

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