Cholelithiasis

Cholelithiasis is then the medical name given to the deposition of hard and crystalline deposits within the gallbladder, normally referred to as gallstones. In the United States, the condition is relatively common, affecting about 10 percent of adult females and about six percent of adult males in the country. Additionally, cholelithiasis is among the leading cause of surgical operations across the world.

Based on statistical findings, the condition is more prevalent in the western countries. For instance, between 8 and 20 percent of United States nationals are expected to develop this condition by the time they attain 40 years of age. The American Indians and the Mexican Americans are also more likely to develop this condition, as compared to other races, with the ladies being more susceptible as compared to the men by a ratio of 2:1. However, the chances of developing gallstones increase with advancing age, regardless of the race and gender.

What Is Cholelithiasis?

Basically, gallstones are hard, crystalline, pebble-like substances that develop within the gall bladder. Situated just below the liver, the gall bladder stores bile before it is secreted in the intestines to aid in digestion. Bile juice, on the other hand, is a liquid that is synthesized by the liver to aid in digestion of fats within the intestines. Gallstones form as a result of crystallization of bile. The main components of bile juice include cholesterol, fats, water, bile salts, bilirubin and proteins. The bile salts aid in digestion of fats, within the digestive system while bilirubin gives the stool and bile their characteristic color. If bile contains large quantities of bilirubin, bile salts or cholesterol, it is more likely to crystallize and form gallstones.

Currently, there are two main types of gallstones, the pigment stones and the cholesterol stones. The cholesterol stones are rather common, accounting for about 80 percent of all cholelithiasis cases. Cholesterol stones have a characteristic yellow-green color and are a result of hardened cholesterol in the gall bladder. Pigment stones, on the other hand, are dark and small crystalline pebbles that are formed as a result of hardened bilirubin. In general, the size of gallstones varies, ranging from the size of sand grains to the size of a golf ball. As such, cholelithiasis may be a result of a single large gallstone, hundreds of tiny stones or even a combination of large and small stones.

Symptoms of Cholelithiasis

Although the gallstones may be formed in the gallbladder, they may relocate to the bile ducts and cause blockage. This blockage may lead to an array of symptoms, which normally occur suddenly. Owing to the sudden occurrence of the symptoms, they are commonly referred to as gallbladder 'attack'. In most cases, the attack occurs after having a fatty meal and may occur at night. Some of the symptoms associated with the gallbladder ‘attack’ are:

  • Back pain, normally between the shoulder blades
  • Patients may also experience pain under the right shoulder
  • Nausea and vomiting
  • Low fever and chills
  • Prolonged pain, which may last for more than five hours
  • Clay-colored fecal matter
  • The whites of the eyes and the skin may turn yellowish in color.
  • Steady pain in the upper abdomen, on the right side. The intensity of the pain increases rapidly and lasts for a while, about 30 minutes on average.

While such symptoms may only happen when the gallstones are moving, an extended blockage of the bile ducts may result into a rupture and even infection. In other cases, people suffering from this condition may not experience any symptoms. Such gallstones are referred to as silent stones. Such stones will not interfere with the functioning of the liver, pancreas or the gall bladder. As such, gallstone treatment is not necessary on silent stones.

Cholelithiasis Treatment

Once you experience the above mentioned symptoms, it is highly advisable that you seek immediate medical attention from a qualified physician. Initially, the health care provider will take blood samples and subject you to various tests to ascertain whether you are suffering from cholelithiasis. In some cases, gallstones will not cause any symptoms. However, if the condition displays symptoms, hospitalization may be required. If you happen to be hospitalized because of this condition, food intake will be stopped. Instead of food, intravenous fluids will be administered. This allows the digestive system to rest and heal. Additionally, you will also be given antibiotics to prevent infection. The physician may also give you medication to ease the abdominal pain associated with this condition. Other cholelithiasis treatment options include surgical and non-surgical intervention.

Surgery

If the cholelithiasis symptoms keep on recurring, surgery is normally the best treatment option. Currently, there are two main surgical methods that may be used to remove the gallbladder, including laparoscopic cholecystectomy and open cholecystectomy. In open cholecystectomy, the entire gallbladder is removed using a single surgical incision. Laparoscopic cholecystectomy, on the other hand, involves the removal of the gallbladder several incisions. After undergoing this surgical removal, many patients lead normal lives because the gall bladder is not very essential in the body. Some of the commonly used laparoscopic cholecystectomy options include:

  • Lithotripsy – This is a technique that makes use of electric shock waves and is aimed at dissolving the gallstones.
  • Laparoscopic cholecystectomy - This is rather less invasive surgical removal of the gallbladder, which involves the removal of the ladder in multiple small incisions.
  • Endoscopic retrograde cholangiopancreatograph – This is not a treatment option, but rather an imaging procedure that enhances gallstone treatment.

In other cases, medications may be used to dissolve the gallstones. This option may take a while to fully dissolve the stones.

Nonsurgical Treatment

In rare cases, patients suffering from gallstones may have serious health conditions that may prevent them from undergoing surgery. In such a case, non surgical treatment options for gallstones are used. However, the gallstones may recur within a period of five years after the following nonsurgical treatment options.

  • Contact dissolution therapy – This is an experimental procedure in which methyl tert-butyl ether is injected directly into the gallbladder to help dissolve the stones. This remedy dissolves the stones within one to three days, but may lead to irritation as well as other complications.
  • Oral dissolution therapy – In this procedure, drugs that are made from bile acid are used to dissolve the gallstones. Some of the commonly used drugs with this procedure are chenodiol (Chenix) and Ursodiol (Actigall). The drugs are more effective on cholesterol stones and may take a couple of months to fully dissolve the stones.
 
 
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