Diseases

Gallstones – causes, symptoms & treatment

Gall stones

Gallstones are a common disease of the gallbladder and bile ducts. The gallstones are mainly caused by solidified residues of protein and cholesterol in the gallbladder, which can then clump together in the bile duct.

What are gallstones?

Gallstones are a product of bile and about one-fifth of adult inhabitants in industrialized countries are carriers of bile. They are an end product made of crystalline liquids that have thickened. The crystalline fluids are produced in the liver and then enter the gallbladder.

Many gallstones are not dangerous and do not cause pain. There is only a problem if the bile meets a narrowing on the way from the liver to the gallbladder. Here the gallstones can form, some are so small that they can be excreted via the bladder, other stones are so large that they must be surgically removed.

Causes

Causes that lead to the formation of gallstones have not yet been fully understood. Some scientists suspect the formation of gallstones due to a defect of a particular gene, a faulty mutation responsible for the formation of gallstones. Other researchers, on the other hand, suspect that the formation of gallstones is promoted by elevated cholesterol levels in conjunction with the reduced formation of bile.

In addition to these factors, there are several other medical reasons, such as pregnancy. High-fat diet or even a radical diet with a complete withdrawal of fats. Likewise, the causes of gallstones can also be triggered by other diseases such as diabetes mellitusobesity, thyroid problems or family pressure.

Furthermore, gallstones can also be triggered after major operations, but inflammation of the liver, in the immediate vicinity or directly in the bile can also lead to formation. Therefore, anyone suffering from the aforementioned reasons should undergo a preventive medical examination with regard to gallstones.

Symptoms, complaints & signs

Whether and which symptoms patients with gallstones have, depends, among other things, on the size of the stones, the number and their location in the gallbladder or gallbladder duct. A large proportion of people with stones in the gallbladder have no or only rarely complaints.

In the other sufferers, it comes to the typical symptoms of a gallstone disease. These include bloatingnausea and pain in the right upper abdomen. These complaints occur especially after high-fat meals. It becomes extremely unpleasant when it comes to the so-called biliary colic.

Colic is the rhythmic contraction of the muscles of the gallbladder. Often there is then a stone in the bile duct. The body tries to transport the stone further in this way in order to remove it from the corridor. The resulting pain is classically undulating, i.e. it increases and decreases again and again in the course. In addition, they can radiate into the back or right shoulder.

Another symptom of a stone in the bile duct can be jaundice, the so-called jaundice. Since the bile can no longer drain out of the gallbladder through the stone, it backs up and the typical yellowing of the eyes and skin develops. This backlog can also lead to inflammation of the gallbladder in the course of time. This leads to feverchills and severe pain in the right upper abdomen.

Course

The course of gallstones varies from patient to patient. Many do not even notice that they suffer from this disease, others can not walk and lie because of pain. After one or more gallstones have formed, bloating, bloating, vomiting and sweating may occur. At the same time are very severe pain in the upper abdomen, pressure pain.

Furthermore, the liver values are very much elevated and a discoloration of the urine and the stool can be observed. Many complaints then occur mainly in the evening and also at night, especially after abundant consumption of fatty dishes. If this happens, everyone should be examined for gallstones as soon as possible.

Complications

There is a particular risk of complications from gallstones if the bile duct is blocked by a stone. As a result, the bile is no longer able to drain freely into the intestines, which in turn causes a backlog in the direction of the gallbladder and liver. In some cases, the pancreas is also involved.

The pent-up secretion sometimes threatens painful inflammation. Typical symptoms of gallbladder inflammation (cholecystitis) are weakness, exhaustion and fever. In extreme cases, the inflammation of the gallbladder leads to the brittleness of the organ, which eventually ruptures. If the bile gets into the abdomen as a result, there is a risk of life-threatening peritonitis (bilious peritonitis).

There is also a risk of inflammation of the liver and pancreas. Before the opening of the bile duct into the intestine, there is an inflow from the pancreas. If the stone is located at this tributary near the anus, bile secretion builds up in the liver, gallbladder and pancreas.

Another complication of gallstones is jaundice (icterus). This yellowish discoloration of the skin occurs when the disrupted flow of bile continues for a long period of time. The whites of the eyes are also colored yellow. The urine is dark in color while the stool is lighter in color. In rare cases, the gallbladder wall can be punctured by the gallstones.

When should you go to the doctor?

The following applies: if you experience painful symptoms or discoloration of the skin, chills and fever, you should contact a doctor or a hospital immediately. Since these symptoms occur again and again, it is essential to clarify the cause.

Pain caused by gallstones is only temporarily numb by painkillers and only provides relief from symptoms – this does not replace presentation to a doctor. Biliary colic occurs suddenly and also poses a danger to others by reflexively wincing and bending, for example when driving machinery or motor vehicles.

The clarification of other non-specific complaints (constant feeling of fullness, etc.) does not require an immediate diagnosis. If the symptoms occur again and again, a doctor should still be consulted.

If gallstones have already been diagnosed, but they do not cause any discomfort, attention must be paid to the occurrence of symptoms and the whereabouts of the stones (do the gallstones migrate? Is the bile duct partially blocked? ) are checked at regular intervals. As a result, a gentle treatment can be started at an early stage if necessary. If the gallstones remain symptom-free, no treatment is necessary.

Treatment & Therapy

Treatment and therapy is different for each patient with gallstones. It depends on the severity of the disease. Gallstones that do not cause pain do not require treatment. All other patients should be treated in advance with painkillers, and a special diet.

Only when the persistent pain has gone can you think about removing the gallstones. There are several options here. There is, for example, the destruction of the stones with drugs. However, it must be borne in mind that the medication must be taken for up to two years. Another alternative is to shatter the stones with shock waves. There is a risk here that new stones can form as a result of the destroyed gallstones.

The last option is radical therapy. Here the gallstones are removed along with the gallbladder. This therapy is one of the safest ways to remove pain and prevent recurrence.

Outlook & Forecast

In most cases, gallstones do not cause any problems for those affected. Should symptoms nevertheless arise, surgical removal is usually uncomplicated. If the gallbladder is removed in the process, the bile duct takes over its task of storing the bile. Those affected usually only have symptoms from the operation for a few days. After that, they are usually completely symptom-free.

Also, a drug dissolution of the gallstones usually proceeds without complications. However, the recurrence rate is relatively high for all treatment options. Even after removal of the gallbladder, new gallstones form in 30 to 50% of cases within five years. With drug treatment, the risk is even greater.

Gallstones often go unnoticed because they do not cause any discomfort. However, if they become symptomatic, they should be removed. They increase the risk of developing rare cancers such as .

In a few cases, they can occupy a layer through which they close the main bile duct. The bile can therefore not drain, so that a life-threatening backlog forms. In addition, gallstones can drill through the gallbladder wall in rare cases. Bile could thus migrate into the abdomen and cause . In order to avoid such complications, treatment is urgently recommended.

Aftercare

If the gallstones have dissolved by medication or even on their own, no further follow-up care is necessary. If this is not the case, possible causes must be diagnosed and treated. First and foremost, the patient must take care of himself and otherwise comply with the doctor’s guidelines regarding nutrition and physical exercise.

After gallstone surgery, pain and fatigue may initially persist. As part of the follow-up, the doctor will examine the surgical wound and, if necessary, also check the bile duct and gallbladder artery. In the first hours after the procedure, the patient receives painkillers, first by drip and later as tablets.

If no complications are detected, the hospital may be left after a few days. At home, painkillers must continue to be taken, which should be gradually reduced according to the doctor’s instructions. The magnesium supplements prescribed for flatulence may have to be taken a few days longer. The follow-up examination is carried out by the family doctor.

Here, the doctor will ask for the findings and then perform a physical examination and a short patient interview. Any remaining stitches may have to be removed. Depending on how fit the patient is, he also needs a sick leave. In the case of a positive course, a short control is sufficient. Further follow-ups are not necessary after a successful gallstone operation.

What you can do yourself

Gallstones are only noticeable in about a quarter of all cases. The rest of the stones remain asymptomatic. They are therefore usually only discovered by chance finding. This also means that there is no need to adapt behaviour in everyday life and that self-help consists mainly of preventive measures, especially if cases of gallstones are known in the family, because genetic factors play a role in the formation of gallstones in the gallbladder or bile ducts.

The most important preventive measure is a healthy diet, which should also include natural food components such as vegetables and fruits with a balanced amount of indigestible fiber. Extreme obesity, but also rapid weight loss and metabolic diseases such as diabetes are risk factors for the development of gallstones, which then predominantly correspond to the category of cholesterol stones.

As soon as gallstones show symptoms that are often initially non-specific, biliary colic in particular is feared. It is caused by spasmodic contraction of the muscles in the walls of the gallbladder to transport the gallstone further into the bile duct and small intestine.

If biliary colic or other painful symptoms occur, a decision should be made about dissolving the stones by medication or about a mechanical removal of the stones by surgery or catheters. Further self-help measures are omitted, since, for example, biliary colic occurs in attacks and without prior notice.

Website | + posts

Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.