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Gallstones
Cholesterol stones are yellow-green, hardened cholesterol and account for about 80% of gallstones. Pigment stones are small and dark and made up of primarily bilirubin. These two types of stones can be either very small or as large as a golf ball. There can also be many of them in any combination of size. If gallstones block the bile ducts then bile becomes trapped causing inflammation of the gallbladder, bile ducts and, possibly, the liver. If gallstones block the pancreatic duct, digestive enzymes become trapped causing an extremely painful condition called gallstone pancreatitis. If any type of blockage is left untreated, sever and even fatal damage may result in the gallbladder, liver or pancreas. Warning signs of gallstones include fever, jaundice and persistent pain in the abdomen. Cholesterol stones are caused by a lack of bile salts or too much bilirubin and cholesterol. This type of gallstone also forms when the gallbladder does not empty as often as it should. The cause of pigment stones are unknown. Patients with cirrhosis, biliary tract infection or hereditary blood disorders such as sickle cell anemia, which produces too much bilirubin in the blood, are more likely to produce this type of gallstone. Other risk factors for gallstones include:
SymptomsSymptoms of gallstones are usually called "attacks." These attacks commonly occur at night, following meals. They are characterized by:
Secondary symptoms include:
If the above symptoms occur with any of the following, you should see a physician immediately:
Sometimes, gallstones do not have any symptoms (asymptomatic). These "silent stones" do not affect any of the organs and do not require treatment. DiagnosisThe most common and sensitive form of diagnosis for gallstones is ultrasonography. This procedure uses sound waves, which bounce of organs and gallstones, to form an image on a viewing screen. Other procedures used to diagnose gallstones are Computerized Axial Tomography (CAT or CT Scan), Magnetic Resonance Cholangiogram (to view blocked bile ducts), Cholescintigraphy (HIDA Scan), which injects a radioactive chemical into the gallbladder, stimulating its contraction in order to diagnose abnormal contraction or obstruction. Endoscopic Retrograde Cholangiopancreatography (ERCP) can be used to detect and remove gallstones located in the bile ducts using a small thin viewing tube called and endoscope. Blood tests can also be used to determine signs of infection, obstruction, pancreatitis and jaundice. TreatmentThe most common form of treatment for gallstones is surgery. This type of surgery is called a cholecystectomy. There are two types:
The major complication to surgery is bile duct damage, which is painful and can cause severe infection. If stones are located in the bile ducts, ERCP is used to locate and remove by cutting away the ducts using the endoscope. Fortunately, the galldbladder is an organ that the body can do without, much like the appendix. When the gallbladder is removed, bile can no longer be stored: thus, it goes directly from the liver, where it is produced, to the small intestine, where it is used for digestion. This frequency in transmission of bile causes diarrhea in approximately 1% of patients. There also non-surgical methods of treatment for patients with cholesterol stones only, and if surgery is definitely not an option because of a prior or existing medical condition. Such methods include:
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BrooklynGI.com with offices in New York City
Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and
Connecticut. is dedicated to helping patients and physicians receive accurate
and up-to-date information on the Gastrointestinal tract (GI Tract) The organs
that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large
Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree)
Dr. Scott Tenner Contact
DrTenner@BrooklynGI.com
with questions or comments.
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A
liquid known as bile which is produced in the liver and stored in the
gallbladder can harden into "pebbles" of stone-like material called gallstones.
Bile is used to digest fat in the small intestine. If the liquid bile does not
have enough bile salts, has too much cholesterol or too much bilirubin (a
substance which gives bile and stool its yellowish color), it can harden into
gallstones. There are two types of gallstones: cholesterol stones and pigment
stones.
