Gallstones - Causes, Symptoms, Diagnosis, Treatment

Gallstones are small, pebble-like substances that develop in the gallbladder. The gallbladder is a small, pear-shaped sac located below your liver in the right upper abdomen. Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid-called bile-helps the body digest fats. Bile is made in the liver, then stored in the gallbladder until the body needs it. The gallbladder contracts and pushes the bile into a tube-called the common bile duct-that carries it to the small intestine, where it helps with digestion.



Gallstones are solid deposits of cholesterol or calcium salts that form in your gallbladder or nearby bile ducts. They often cause no symptoms and require no treatment. But some people with gallstones have a gallbladder attack that can cause symptoms, such as nausea and an intense, steady ache in their upper middle or upper right abdomen. In some cases, the pain can be severe and intermittent.



Causes



Progress has been made in understanding the process of gallstone formation. Researchers believe that gallstones may be caused by a combination of factors, including inherited body chemistry, body weight, gallbladder motility (movement), and perhaps diet. Additionally, people with erythropoietic protoporphyria (EPP) are at increased risk to develop gallstones.



Symptoms



If you have symptoms, you most likely will have mild pain in the pit of your stomach or in the upper right part of your belly. Pain may spread to your right upper back or shoulder blade area. Sometimes the pain is more severe. It may be steady, or it may come and go. Or it may get worse when you eat.



Diagnosis



The physician, and even the patient, may suspect the presence of gallstones simply from the medical history. An ultrasound or sonography exam provides a simple, quick method of diagnosis. In this test, sound waves are beamed into the gallbladder. This test looks at the anatomy of the gallbladder. Another way of testing is to evaluate its function. In this test (a hepatobiliary scan) a small amount of radioactive material is injected by vein (IV). It then concentrates in the gallbladder. An agent is then given by IV that will cause the gallbladder to contract and empty. A diseased gallbladder does not do this very well and so this test can indicate a gallbladder problem.



Treatment



Once you have one attack of pain, the chance of having another one is high--about 70%. Many doctors will suggest you have your gallbladder removed in surgery to prevent a future attack. You and your doctor should talk about your situation and decide what is right for you. If your gallbladder is irritated or inflamed, most doctors will want to take it out right away. The surgery is safe and effective. Without surgery, the gallbladder can get infected. It might even burst open, causing further problems.



You can help prevent gallstones by maintaining a healthy weight and lifestyle, including a low fat, high-fiber diet, and exercise. Do not consume large amounts of alcohol, and avoid smoking. This information has been designed as a comprehensive and quick reference guide written by our health care reviewers. The health information written by our authors is intended to be a supplement to the care provided by your physician. It is not intended nor implied to be a substitute for professional medical advice.



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