The Gall!(Stones)

Worldwide gallstone disease is a very common problem. Gallstones are hardened deposits of bile juice which can form anywhere along the path of flow of bile, but more commonly in the gallbladder.

Gallstones will only show symptoms if one blocks the duct, obstructing the flow of bile. Then symptoms include sudden and rapidly intensifying pain in the right upper abdomen or upper mid abdomen. If a complication develops then the pain will persist and increase in intensity, possibly accompanied by vomiting, high fever with chills and yellowing of skin and eyes.

The cause of gallstone formation is not known. Cholesterol and Bilirubin, two constituents of bile juice, are well dissolved in bile but if they get precipitated or their concentration in bile increases due to any reason, then stone formation takes place.

Despite the unknown cause, certain associated risk factors have been identified. Females are more prone than males, as those who are aged above 40, are obese, or are eating high fat low fiber diet, have a family history of gallstones, are on cholesterol lowering medications and hormone therapy.

Complications include gallbladder inflammation (Cholecystitis), blockage of bile ducts, pancreatic duct blockage and a very rare possibility of gallbladder cancer.

Imaging tests used to diagnose gallstones and their complications are: Abdominal Ultrasound (USG), Computed Tomography (CT) scan, Magnetic Resonance Cholangio-Pancreaticography (MRCP), Endoscopic Retrograde Cholangio-Pancreaticography (ERCP) and Hepatobiliary IminoDiacetic Acid (HIDA) scan.  Blood tests help in detecting any infections, jaundice, pancreas inflammation and other related complications.

As for the treatment, those without symptoms don’t require treatment when a gallstone is found incidentally in a scan done for another purpose. For those with symptoms, surgical removal of gallbladder (A.K.A. Cholecystectomy) is the treatment of choice, done either by open method or by keyhole method (Laparoscopic cholecystectomy) which is more popular now.

Preventing gallstones requires reducing associated risk factors through regular exercise, maintaining a healthy weight, healthy dietary habits like low fat and high fiber diets.

Dr. Narendra Kumar M [MBBS, MS, FMAS] is a General Surgery Specialist at Royal Bahrain Hospital. For more information or to book your appointment call 17246800 or plan your visit at www.royalbahrainhospital.com.