What is Gallstone Disease?
The gallbladder is located under the surface of the liver, bound by vessels, connective tissue, and lymphatics. It has four regions: the fundus, body, infundibulum, and neck. The gallbladder terminates in the cystic duct and then enters the extrahepatic biliary tree. The fundus is the round, blind edge of the organ. It is composed of fibrotic tissue and projects just beyond the right lobe of the liver. The fundus leads to the body of the gallbladder, the largest part.
The superior surface of the body is attached to the visceral surface of the liver unless a mesentery is present. This close relationship allows for the direct spread of inflammation, infection, or neoplasia into the liver parenchyma. The infundibulum is the tapering area of the gallbladder between the body and neck. This portion and the free surface of the body of the gallbladder lie close to the first and second portions of the duodenum, and near the hepatic flexure and right third of the transverse colon. The infundibulum is attached to the right transverse colon surface of the second part of the duodenum by the cholecystoduodenal ligament.
The neck of the gallbladder is 5 to 7 mm in diameter and often forms an S-shaped curve. It is superior and to the left, narrowing into a constriction at the junction with the cystic duct.
Symptoms
The following are the most common symptoms of gallstones depending upon gallstone pain area:
- Pain or tenderness under the rib cage on the right side
- Pain between shoulder blades
- Stools light or chalky colored
- Fatty stools
- Indigestion after eating, especially the fatty foods
- Burping or belching
- The feeling of fullness or food not digesting
- Nausea
- Dizziness
- Diarrhea
- Bloating
- Gas
- Vomiting
- Constipation or frequent use of laxatives
- Headache over eyes, especially right
- Bitter fluid comes up after eating
Causes
The following are the most common causes of gallstone disease:
Age
The incidence of gallstone disease increases with age. The symptomatic calculous disease of the biliary tract is rare before the age of 20, and when found in this group, it is common among patients with chronic predisposing conditions such as cystic fibrosis or hemolytic anemia.
Drugs
Many drugs have been implicated in gallstone disease. The most common offenders include ceftriaxone, clofibrate, oral contraceptives, estrogen replacement, progestogens, and octreotide. Some drugs are secreted into bile and may complex, precipitate, and form stones. Other compounds can produce gallbladder stasis with concomitant increases in cholesterol secretion into bile.
Gender
The prevalence of gallstones is higher in women than in men. Studies have shown that gallstone disease is common in young women but rare in young men. However, the difference narrows with increasing age. It is presumed that the reason for this gender difference is hormonal. Serum estrogen increases (especially during pregnancy) promote biliary cholesterol saturation and increased progesterone may lead to inhibition of the contraction of the gallbladder.
Geography and Ethnicity
The Pima Indians of Arizona have the highest prevalence of gallstones worldwide. Ninety percent of Pima women over the age of 65 have gallstone disease. The Micmac Indians of Canada, Hispanics, and Mexican American women also have a higher prevalence of gallstone disease, as do both men and women in Norway and Chile. The risk appears to be lower in blacks. No genes have been identified in humans that are conclusively linked to gallstone development.
Obesity
Obesity is a significant risk factor for gallstone disease, especially in women. Studies have demonstrated that overweight women with a body mass index (BMI) greater than or equal to 30 kg/m2 have double the risk of gallstone disease when compared with normal-weight women with less than 25 kg/m2. Cholesterol hypersecretion(associated with obesity) is a major pathogenic factor. Gallstone disease has also been associated with the regional distribution of fat. High central or truncal adiposity has been positively correlated with the risk of gallstone disease. Physical activity and diet have been studied independently as risk factors for gallstone disease. Increased vigorous physical activity and recreational activity appear to reduce gallstone disease risk.
Weight Loss
An increased risk of gallstone disease may be found among individuals who undergo rapid weight loss on very low-calorie diets. Gallstone formation is one of the most significant complications of voluntary weight loss plans. In these instances, cholesterol is activated from adipose tissue and secreted into the bile. This leads to cholesterol supersaturation and diminishes gallbladder contraction, producing stasis. Studies have shown that individuals on weight loss plans, either dramatically reduced-calorie diets or surgical weight-loss procedures, have a higher incidence of development of gallstone disease when compared to those who are not dieting. Weight fluctuation may also be a risk factor.
Diagnosis
The physical exam in patients with gallstone-related symptoms can often be completely normal. However, sometimes a gallbladder can be palpated and there may be right subcostal tenderness with inspiratory arrest (Murphy’s sign), which is suggestive of acute cholecystitis. There are several diagnostic tests available to detect stones
Ultrasound
An ultrasound test which is also known as ultrasonography uses sound waves to detect the gallstones in the gallbladder. Generally, to detect the gallstones, pulses of sound waves are sent into the abdomen to create an image of the gallbladder. If gallstones are present, the sound waves will bounce off the stones, revealing their location in the gallbladder. Ultrasonography is a non-invasive technique, which means nothing is injected into the body or penetrates the body. In addition, ultrasound is painless and eliminates exposure to radiation from X-rays.
X-Rays
Three different tests use X-rays to examine the gallbladder, which is as follows:
Oral Cholecystography
Oral Cholecystography is commonly used to detect gallstones in the gallbladder. The procedure requires a patient to swallow pills containing a dye the night before X-rays are taken. This dye is absorbed into the bile and outlines on Z-ray film the gallbladder and any stones that may be present. Oral Cholecystography is now rarely performed because it has been largely replaced by ultrasound of the gallbladder. Risks of Oral Cholecystography include cellular damage from radiation exposure from X-rays. Also, this procedure should not be used for patients who have severe kidney or liver damage.
PTC (Percutaneous Transhepatic Cholangiography)
In PTC the dye is injected through a very thin tube which is called a catheter. The injected dye outlines the network of bile ducts when an X-ray picture of the abdomen is taken and thus can detect stones lodged in the bile ducts. Complications of the dye include leaking from the liver into the abdomen and also increased the risk of bleeding or puncture of the vessels with a catheter.
ERCP (Endoscopic Retrograde Cholangiopancreatography)
ERCP is an invasive procedure that will involve the use of an endoscope. An endoscope is a long, flexible tube through which a doctor can directly view the digestive tract.
Treatments
Patients who are suffering from gallstones should get that treated to avoid any emergency conditions.
Natural Treatment for Gallstones
Wondering how to dissolve gallstones naturally, follow these precious tips to cure gallstones by natural treatment.
- Maintain a Healthy Body Weight
- Avoid Rapid Weight Loss and Fad Diets
- Follow an Anti-Inflammatory Diet that Supports Liver and Gallbladder Health
- Be More Active
- Reconsider Taking Birth Control Pills or Unnecessary Medications
Surgical Treatment for Gallstones
Gallstones will not go away on their own. The doctor may suggest removing the gallbladder if the gallstones start to cause other symptoms. This type of surgery is called a cholecystectomy. It’s one of the most common surgeries doctors perform. About 80% of people who have gallstones will need surgery.
Gallstones Surgery
Doctors may remove the gallbladder in any one of the following ways: Open surgery, Laparoscopic gallbladder surgery
Open Surgery
During open surgery, the surgeon will make a 5 to 7-inch incision on the belly to take out the gallbladder. The patient need’s open surgery if the patient has a bleeding disorder. The patient may also need this surgery if they have severe gallbladder disease. The patient is overweight or is in the last trimester of pregnancy.
Laparoscopic Cholecystectomy
Generally, this surgical procedure is also called keyhole surgery. This means the surgeon will make a few very tiny holes to perform the surgery (the size of a keyhole). He makes four small cuts. He inserts a very thin, flexible tube that contains a light and a tiny video camera into the belly. These help the surgeon see the gallbladder better. Next, he will insert special tools to remove the diseased organ.
Risk Factors
Several factors make people more susceptible to developing gallstones, including their diet, age, gender, body composition, and genetics. Gallstones are most common in:
- Women
- Over 40 years people
- Overweight or obese people
Other risk factors for gallstones include
- Eating a poor diet
- Losing weight too quickly (for example, fasting and going long periods without eating)
- Pregnancy
- High triglycerides
- Diabetes
- Lack of physical activity
- Family history of gallstones
- Low HDL (good) cholesterol
Gallstones Diet
| Low-fat food | Foods that are fried, like french fries and potato chips |
| High fiber foods like brown rice and wholemeal bread can help to make stools more firm | High-fat meats, such as bacon, bologna, sausage, ground beef, and ribs |
| Fruits, vegetables, and whole grains | High-fat dairy products, such as cheese, ice cream, cream, whole milk, and sour cream |
| Caffeine-free drinks | Pizza |
| Low sugar foods and drinks | Foods made with lard or butter |
| Less spicy foods | Creamy soups or sauces |
| Avocados – a good way to get needed fats directly from food | Meat gravies |
| Garlic helps with liver cleansing but not processed types like flakes or powder. Some people have difficulty with it but is usually ok and even helpful. Just pay attention to your own body with this one | Chocolate | Omega 3 oils like flax or hemp. Use these with fresh lemon juice or vinegar on your salads. DO NOT COOK flax oil. | Oils such as palm and coconut oil | Grapes, apples, berries, papaya, pears, pomegranates, watermelon, and fresh organic grape juice | The skin of chicken or turkey |
Symptoms After Gallbladder Removal
- Mild pain
- Gas and bloating, distension
- Burping, belching
- Feelings of fullness
- Heartburn, often worse
- Acid and bile reflux
- Constipation
- Diarrhea
- Dumping syndrome
- Weight gain
