The Gallstone Dilemma: Navigating Your Way to a Healthy Gallbladder
Your Comprehensive Guide to Dealing with Gallstones and Promoting Optimal Gallbladder Health
While working in the ER, gallstones were a common reason for patients to visit. According to the National Institute of Diabetes and Digestive and Kidney Diseases, it’s estimated that about 10–15% of adults in the US have gallstones. That means that millions of people in the US may be affected by this condition. However, many people with gallstones may not experience any symptoms and may never know they have them. Most of the gallstone cases were where patients either went home with outpatient follow-ups with their GI providers or stayed in the hospital for surgery. About 20% of patients with acute gallbladder infections may experience gallstones obstructing the common bile duct, which is the duct that connects to the second part of the duodenum for bile to reach our small intestine to digest fat. Symptoms of this include severe epigastric pain with nausea and jaundice (yellow like a banana).
Let me introduce you to Richard. Richard had been experiencing epigastric pain for months and had been misdiagnosed with stomach pain. He was a medium-sized man who loved fast food. He had been experiencing pain after meals with bloating for months. His primary doctor prescribed him Omeprazole for stomach pain which can reduce acid production in his stomach, but he didn’t see any improvement after three months. One night, his pain persisted for a whole day and radiated to the back with nausea. I cared for him in the ER and diagnosed him with an acute gallbladder infection with common bile duct obstruction. His urine was tea-colored, and his skin was yellow. He needed an urgent ERCP procedure to remove the obstructed stones; otherwise, he would have developed pancreatitis and increased his mortality rate.
What is Gallbladder Stone?
Gallbladder stones may not be the most glamorous topic, but they are a common medical condition that can cause discomfort and inconvenience for many people. Essentially, these stones are formed when substances in bile clump together inside the gallbladder. While they can range in size and severity, they can lead to symptoms such as pain, nausea, and digestive issues.
But fear not; there are ways to manage gallbladder stones and reduce the likelihood of future episodes. From changes in diet to medical interventions, various options are available to those dealing with this condition. And remember, you’re not alone — millions of people worldwide are dealing with gallbladder stones, and support and information are available to help you navigate this journey.
What is the function of the gallbladder?
The gallbladder is a pear-shaped sac that is located below the liver on the upper right side of the abdomen. It is a small organ, measuring about 3 to 4 inches long and about 1 inch in diameter. The gallbladder’s primary function is to store and concentrate bile, a digestive fluid produced by the liver. Bile is important for breaking down fats in the small intestine and helps absorb fat-soluble vitamins. When food is consumed, the gallbladder releases bile into the small intestine to aid in the digestion of fats. Without a gallbladder, the liver would still produce bile, but it would continuously drip into the small intestine instead of being stored and released in a controlled manner. While it is possible to live without a gallbladder, its removal can sometimes lead to digestive problems, particularly after eating fatty foods.
Causes of Gallbladder Stone
There are several factors that can increase the risk of developing gallbladder stones, including:
- Gender: Women are more likely than men to develop gallbladder stones.
- Age: People over 40 years of age are more prone to developing gallbladder stones.
- Obesity: Obesity or being overweight can increase the risk of developing gallbladder stones.
- Rapid weight loss: Losing weight too quickly can lead to the formation of gallbladder stones.
- Genetics: A family history of gallbladder stones can increase the risk of developing the condition.
- Other medical conditions: Certain medical conditions, such as diabetes and liver disease, can increase the risk of gallbladder stones.
Rapid weight loss can lead to the formation of gallbladder stones because when the body breaks down fat too quickly, it can cause an imbalance of cholesterol and other substances in the bile, leading to the formation of stones. Additionally, when the gallbladder does not empty properly, bile can become concentrated, increasing the risk of stone formation.
Certain medical conditions, such as diabetes, can increase the risk of gallbladder stones. This may be because people with diabetes often have high levels of triglycerides, a type of fat found in the blood, which can contribute to forming gallstones. Additionally, people with diabetes may have reduced gallbladder function, which can lead to the formation of gallstones.
Symptoms of Gallbladder Stone
The symptoms of gallbladder stones can vary from person to person. Some common symptoms include:
- Sharp pain in the upper right abdomen that may spread to the back or shoulder blade.
- Nausea and vomiting.
- Indigestion and bloating.
- Jaundice (yellowing of the skin and eyes).
- Fever and chills.
- Clay-colored stools and dark urine.
Diagnosis and Treatment of Gallbladder Stone
Doctors may perform various tests to diagnose gallbladder stones, including ultrasound, CT scan, and blood tests. Treatment options for gallbladder stones may include:
- Watchful waiting: In some cases, doctors may recommend a wait-and-see approach if the stones are small and not causing any symptoms.
- Medications: Certain medications can help dissolve gallbladder stones.
- Surgery: Surgical gallbladder removal (cholecystectomy) is the most common treatment for gallbladder stones.
- Non-surgical procedures: Non-surgical procedures such as shock wave therapy and endoscopic removal may be an option for some people.
Do you remember Richard? His liver function test showed his total bilirubin was elevated, which indicated he had gallstone obstruction at his biliary tree. Now, what is the biliary tree, you ask? It’s a system of vessels that directs secretions from the liver, gallbladder, and pancreas through a series of ducts into the duodenum. The exit hole into the duodenum is called the papilla of Vater. A gastroenterologist performed an endoscopic retrograde cholangiopancreatography (ERCP) on him the next day. During an ERCP, a flexible, lighted tube with a camera on the end (called an endoscope) is passed through the mouth, down the throat, and into the upper digestive system. Once the endoscope reaches the small intestine, a special dye is injected into the ducts that drain the liver, pancreas, and gallbladder. The dye then helps create detailed X-ray images of the bile and pancreatic ducts, which can reveal blockages, inflammation, or other abnormalities. ERCP can also be used to treat certain conditions, such as removing gallstones or placing a stent to open a blocked duct. It’s a minimally invasive procedure typically performed under sedation or anesthesia, so Richard was comfortable throughout the process. He had surgery to remove his gallbladder the day after his ERCP. He was in full recovery without any complications. However, he experienced some new symptoms after the gallbladder removal. We can talk about it next time, “what do you expect without a gallbladder in your life.”
How can I avoid gallstone formation?
- Maintain a healthy weight: Being overweight or obese increases your risk of developing gallstones. To maintain a healthy weight, eat a balanced diet and exercise regularly.
- Eat a healthy diet: A diet high in fat and cholesterol can increase your risk of developing gallstones. To reduce your risk, eat a diet rich in fiber, fruits, and vegetables, and limit your intake of processed foods and saturated fats.
- Stay hydrated: Drinking plenty of water can help prevent gallstones by keeping bile flowing smoothly through the gallbladder and reducing cholesterol concentration in the bile.
- Exercise: Regular exercise can help maintain a healthy weight and reduce your risk of developing gallstones.
- Avoid crash diets: Rapid weight loss can increase your risk of developing gallstones, so avoid crash diets that involve extreme calorie restriction.
- Manage underlying medical conditions: Certain medical conditions, such as diabetes, can increase your risk of developing gallstones. Work with your healthcare provider to manage underlying conditions to reduce risk.
The gallstones dilemma
When it comes to deciding whether to have surgery to remove the gallbladder due to gallstones, there are a few things to think about. First off, timing is key. Should you wait until you feel pain or an infection, or would it be better to have the surgery sooner rather than later? Another thing to consider is your age. As you age, the risks of surgery may increase, and it’s important to discuss this with your healthcare provider. Remember to consider the potential long-term effects of not having the gallbladder removed, too. This can cause complications like recurrent gallstones and other digestive issues. Ultimately, it’s up to you to weigh the pros and cons of surgical removal of the gallbladder and make an informed decision based on your individual circumstances and medical history. Don’t hesitate to reach out to your healthcare provider with any questions or concerns you may have.
Feel free to ask me any questions you may have about gallstones. I’m here to help! 😊
Pacific Vistas Telehealth
