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GALLSTONE/CHOLELITHIASIS

As name suggest presence of calculi/ stone in gall bladder is k/a Cholelithiasis. Choledocholithiasis refers to the presence of gallstones in the common bile duct.

Symptoms

•    Sporadic and unpredictable episodes 
•    Pain that is localized to the epigastrium or right upper quadrant, sometimes radiating to the right scapular tip 
•    Pain that begins postprandially, is often described as intense and dull, typically lasts 1-5 hours, increases steadily over 10-20 minutes, and then gradually wanes 
•    Pain that is constant; not relieved by emesis, antacids, defecation, flatus, or positional changes; and sometimes accompanied by diaphoresis, nausea, and vomiting 
•    Nonspecific symptoms (eg, indigestion, dyspepsia, belching, or bloating) 

 

Causes

Gallstone risk increases for females (especially before menopause) and for people near or above 40 years
No clear relationship has been proved between diet and gallstone formation. Nutritional factors that may increase risk of gallstones include:

  • rapid weight loss; constipation; eating fewer meals per day; and low intake of the nutrients folate, magnesium, calcium, and vitamin C.

  • Wine and whole-grained bread may decrease the risk of gallstones.

  • Risk factors for pigment stones include hemolytic anemias (such as sickle-cell disease and hereditary spherocytosis), cirrhosis, and biliary tract infections. People with erythropoietic protoporphyria (EPP) are at increased risk to develop gallstones.Additionally, prolonged use of proton pump inhibitors has been shown to decrease gallbladder function, potentially leading to gallstone formation  

Diagnosis

The examination may involve using diagnostic testing to see inside your body. These tests include:

1.Ultrasound: Ultrasound tests produce images of your abdomen. This is the preferred imaging method to initially confirm that you have gallstone disease.

2.Abdominal CT Scan: This is an imaging test that takes pictures of your liver and abdominal region.

3.Gallbladder Radionuclide Scan: This is a very important scan that takes about one hour to complete. A specialist injects a radioactive substance into your veins. 

4.Blood Tests: May order blood tests that measure the amount of bilirubin in your blood. The tests also help determine how well your liver is functioning.

Preventions

Drink sufficient amounts of water each day to keep your body hydrated. If you plan to lose weight, do it slowly. Aim to lose no more than two pounds per week. Rapid weight loss may increase your risk of gallstones and other health problems.

Risk Factors

  • being overweight or obese

  • eating a diet that’s high in fat or cholesterol

  • rapid weight loss within a short period of time

  • eating diet that’s high in fiber

  • having diabetes mellitus

Treatment

Cholesterol gallstones can sometimes be dissolved by oral ursodeoxycholic acid but  most of the cases need surgical treatment(open or laparoscopic).