Causes of gallbladder stones
A genetic factor plays a key role in the formation of cholesterol gallstones. Oversaturation of bile with cholesterol occurs due to hypersecretion of cholesterol by the liver. Increased absorption may occur at the intestinal level. All this is accompanied by impaired gallbladder motility and hypersecretion of mucin. Prolonged course of cholelithiasis is accompanied by the formation of dense crystals and inflammation of the gallbladder wall.
Another type of stone is pigmented, which occurs with hemolysis (with blood diseases), cirrhosis or inflammatory diseases of the bile ducts.
Stones can be in the gallbladder — cholecystolithiasis, or they can be in the common bile duct — this is choledocholithiasis.
Risk factors for GI
- Hereditary predisposition (GI in the next of kin).
- Overweight/obese.
- Female; age over 40 years.
- Diabetes mellitus; liver diseases.
- High-fat/low-fiber diet.
- Taking medications containing estrogens (for example, oral contraceptives or hormone therapy).
- Blood diseases (sickle cell anemia).
- Fast weight loss.
- Pregnancy (an increased risk of gallstones is associated with physiological changes — estrogen increases cholesterol secretion, and progesterone slows down the motility of the gallbladder. After giving birth, these changes may go away).
Symptoms
Quite often, the detection of gallstones is an accidental finding, for example, during an ultrasound scan of the abdominal cavity for some other reason. However, some people find out about this when there is an attack of biliary colic:
Severe persistent pain in the upper abdomen and/or the right hypochondrium.;
Pain radiates under the right shoulder blade, in the right supraclavicular region or behind the sternum;
The pain occurs after eating (mainly after eating fatty foods) and is accompanied by nausea and vomiting.;
The pain lasts for at least 30-60 minutes (sometimes several hours), which is a reason to call 03 or consult a doctor to relieve pain.
If an attack of biliary colic lasts more than 6 hours, acute cholecystitis may develop, sometimes with the development of gallbladder phlegmon and peritonitis. Jaundice with choledocholithiasis (stones in the bile duct), the development of acute pancreatitis, which requires surgical treatment, can also be a complication.
If you experience such pain attacks, Olympus Clinics MARS will provide you with timely assistance in the emergency department 24/7.
Prolonged GI can be a risk factor for developing gallbladder cancer, especially if:
- Age over 50 years;
- The size of gallbladder stones is 3 cm or more.;
- The stones were discovered more than 20 years ago;
- At the same time, there are also gallbladder polyps larger than 8 mm.;
- First-line relatives had gallbladder cancer;
- "Porcelain" gallbladder according to ultrasound examination;
- There is hereditary colon cancer (non-polypous colorectal cancer);
- At the same time, there is primary sclerosing cholangitis.
A reason to consult a gastroenterologist:
If there are risk factors for the development of GKB, to conduct a comprehensive follow-up examination.
If you have already been diagnosed with GI, accompanied by any complaints from the digestive system or attacks of biliary colic.
When planning pregnancy and hereditary predisposition to the formation of gallstones.
When planning bariatric operations (gastric surgery for weight loss), it is advisable to know in advance about the presence of gallstones, because if they are detected, simultaneous surgery (simultaneous surgery on both the stomach and gallbladder) is possible.
With rapid weight loss, including against the background of treatment with special drugs for obesity (because this increases the risk of gallbladder stones), to prescribe drugs that prevent the formation of gallstones.
Diagnostics:
At Olympus Clinics MARS you will be able to undergo:
Ultrasound of the abdominal cavity.
MR-cholangiopancreatography to determine the presence of stones in the bile duct (choledocholithiasis).
Sometimes a CT scan of the abdominal cavity may be required.
Surgical treatment
Cholecystectomy (removal of the gallbladder) is indicated for patients at risk of gallbladder cancer, complicated by the course of GI (attacks of biliary colic, the development of acute cholecystitis and / or acute pancreatitis, with a "porcelain" gallbladder).
In choledocholithiasis (stones in the common bile duct), endoscopic removal of the stone from the duct is performed using a special endoscope, as in gastroscopy.
If you have indications for surgical treatment of cholelithiasis, you can consult a surgeon at Olympus Clinics Mars.
Conservative treatment
Conservative treatment or surveillance tactics may sometimes be considered if:
No biliary colic attacks;
Low density of stones (does not exceed 100 units of Hounsfield according to X-ray examination or CT);
Stones less than 10 mm in size (the highest frequency of stone dissolution if stones are less than 5 mm);
The function of the gallbladder is preserved and the volume of stones is no more than 1/3 of the gallbladder.
However, conservative treatment will not be effective for everyone, even if treated for at least a year (more often it takes up to 2 years), and there is a high risk of recurrence of gallstones in 1/4 of patients over the next 5 years.
Cholelithiasis is a serious disease, in order to avoid risks, it is important to be diagnosed on time and consult a specialist at the first signs of GI. At Olympus Clinics MARS, you will be able to receive qualified help, undergo an examination and choose the optimal treatment strategy.
Author: Treyman Elena Vladimirovna