Gallstone disease is a disease in which stones form in the bile ducts (e.g. gallbladder) and remain there. This causes blockage of the bile ducts, inflammation of the pancreas, or obstruction of the pancreatic duct. Treatment is mainly based on surgical removal of stones.

What is gallstone disease?

Gallstones is a condition characterized by the presence of deposits (stones) in the gallbladder made of chemicals in the bile. Deposits usually form in the gallbladder, less often outside it.

The stones usually consist of cholesterol, proteins and inorganic ions. Mixed stones constitute the greatest amount. In a healthy patient, these substances dissolve in the bile and are excreted into the gastrointestinal tract. When bile is too dense, substances are precipitated in the bile ducts. Gallstones inhibit the flow of bile, which is essential for digestion. The symptoms worsen especially after consuming hard-to-digest foods.

Gallstones’ causes

There are many causes and factors of gallstone disease:

1. excess cholesterol in the body,
2. female,
3. significant densities of bile,
4. cystic fibrosis,
5. difficulties in the outflow of bile,
6. older age,
7. exfoliating cells
8. taking certain medications,
9. specific eating habits,
10. excessiveobesity,
11. diabetes_
12. pregnancy,
13. rapid weight loss,
14. liverdisease
15. an underactive thyroid gland(thyroid gland)
16. condition after bowel resection, short bowel syndrome,
17. hemolyticanemia,
18. Many other diseases also contribute to the formation of deposits in the bile ducts.

For many years, and in some people for life, urolithiasis may not cause any discomfort. It is then recognized accidentally.

The risk of stones in the gallbladder is determined by the 5xF rule – fertile, female, over 40, obese and fair-haired.

The incidence of gallstone disease

Gallstones occur in about 20 percent. Western European population. The risk and the incidence of the disease increase with age. This disease is much more common in women. In 10 percent of patients with gallstone disease develop deposits in the bile ducts.

Gallstones – symptoms

1. Infected gallbladder stones: dull pain in the right hypochondrium, abdominal distension and various dyspeptic symptoms.
2. Uninfected cholelithiasis: the pains are rather spasmodic and radiate towards the middle epigastrium and to the right shoulder blade.
3. Urolithiasis: harassing ailments and chronic cholestasis in the bile ducts with secondary consequences such as yellowing of the whites of the eyes and skin, inflammation and liver cirrhosis.

A characteristic symptom of gallstone disease is the so-calledbiliary colic– a feeling of sudden and very severe cramp pain in the upper abdomen and right shoulder blade area. Pains are caused by the movement of gallstones within the bile duct. It is accompanied by low-grade fever, chills and sweating.

Gallstones – what to do when symptoms appear?

If the biliary colic is not accompanied by other symptoms, the patient has dealt with it before, and it has receded after taking medications – you can use antispasmodics and painkillers, which are available at a pharmacy without a prescription.

The diastolic drugs recommended to patients during first aid are hyoscine and drotaverine, while painkillers are most often metamizole, paracetamol and non-steroidal anti-inflammatory drugs.

You should see your doctor immediately when symptoms appear for the first time in your life, as it is important to find out what is causing them. In addition, if the symptoms are much more severe than before, a doctor’s help is needed, especially in the event of fever, chills and vomiting.

Diagnosis of gallstone disease

Abdominal ultrasoundis highly effective in the diagnosis of gallstone disease , it is even over 90%. Often, gallstone disease is diagnosed accidentally, during examination for another reason. Ultrasound examination allows to determine the size of the gallstones as well as their number and location. Another additional test that your doctor may order is aCT scan ofthe abdominal cavity.In addition, blood testsare often performed to assess white blood cell counts, and tests that measure how the liver is functioning. Assessment of bile stagnation in the bile ducts is also important.

Gallstones – treatment

Patients who develop uncomplicated biliary colic of unknown cause can self-administer painkillers and diastolic medications. In the case of severe pain that persists after taking medications, a doctor should be consulted, who will refer the patient for further diagnostic tests, if necessary. Surgical consultation may also be necessary when gallstones persist for a long time or when there is a risk of complications.

Gallstones are surgically removed along with the deposits that are inside. This can be doneusing the traditional method, which involves cutting the abdominal integuments and removing the vesicle together with the deposits, orusing the laparoscopic methodwith the use of special organs (without incising the integuments). During laparoscopy, the doctor introduces a special apparatus into the abdominal cavity through three small incisions in the skin, and then removes the follicle. This method is much more often recommended because it is characterized by shorter convalescence time, fewer complications and shorter hospitalization period.

If there are contraindications to surgery, pharmacological treatment with oral ursodeoxycholic acid is initiated. The effectiveness of this type of treatment can be as high as 70%, but it is quite long-lasting and should last at least six months. Unfortunately, after discontinuation of the preparation, there is a risk of gallstone recurrence. Drug therapy is most effective for small stones, the size of which does not exceed 1.5 cm in diameter.

Complications of gallstone disease

Long-term occurrence of gallstone disease and thus blockage of the cystic duct results in complications such ashydrocele and cholecystitis. Cholecystitis is manifested mainly by a high temperature, chills, and a high white blood cell count on the test. Moreover, patients often experience pain in the right upper abdomen, which increases with deep inhalation and pressure. As for the complication of hydrocele – it is an enlarged gallbladder, distended and filled with mucus inside. It manifests itself with typical ailments associated with inflammation, i.e. temperature and chills.

Is it possible to cure gallstone disease completely?

Of course, it is possible, but only after surgical removal of the gallbladder along with the stones inside. The risk of complications following surgery is low.

As mentioned above, recurrence of gallstone disease can occur in patients who are not surgically treated and are undergoing pharmacological treatment.

Management after the end of treatment

One of the most important recommendations after the end of treatment (both the colic subsides and surgery) is to follow a proper diet. It should be based on low-fat and high-carbohydrate products. Patients should avoid eating large meals and replace them with smaller but more frequent portions (preferably 5-6 meals a day).

Patients’ favorite baked or fried dishes should be replaced with boiled and stewed dishes. Do you love mayonnaise, lard, butter and fatty meat? Unfortunately, you have to forget about them, because eating these types of products is inadvisable.

It is worth switching your diet to low-fat products, such as cereals and pasta, as well as graham or wheat bread.

How to prevent gallstone disease?

It is not possible to find unambiguous ways to prevent gallstone disease, since the causes of its formation are not fully understood. However, you can influence some factors, such as obesity, by changing the diet. Especially people with a predisposition to getting sick should change the way they think about food.