Gallstones are hardened deposits of digestive enzymes in the gallbladder. The gallbladder is a tiny, pear-shaped organ located on the right side of the abdomen. The gallbladder stores bile(secreted by liver) which is then discharged into the small intestine. Sizes of gallstones can vary greatly. Some people may develop only one gallstone, while others can develop multiple gallstones at once. Gallstones that cause symptoms may necessitate the removal of the gallbladder through surgery. 

Symptoms

Gallstones may not create any symptoms at times. When a gallstone becomes lodged in a duct and produces a blockage, the following signs and symptoms may occur:

  • Pain in the upper right abdomen that comes on suddenly and gets worse.
  • Pain in the center of the abdomen, right below your breastbone, that is sudden and rapidly intensifying
  • Backache between the shoulder blades
  • Right shoulder discomfort
  • Nausea or vomiting

Gallstone pain may last from several minutes to a few hours.

Patients are advised to seek immediate medical attention if they develop any of the following signs and symptoms:

  • Pain in the abdomen so severe that you can’t sit still or find a comfortable posture
  • Signs of Jaundice (yellowing of the skin and the whites of eyes)
  • High fever accompanied by chills

Diagnosis:

The following tests and methods are used to identify gallstones and complications of gallstones:

Ultrasound of the abdomen: It is done by moving a device (transducer) across the abdomen. The transducer provides signals to a computer, which generates images of the abdomen’s structures.

Endoscopic ultrasound: This method can help locate tiny gall stones that abdominal ultrasonography may miss. During EUS, the doctor will insert a thin, flexible tube (endoscope) through the mouth into the digestive tract. In the tube, a small ultrasound device (transducer) generates sound waves that form a precise image of the surrounding tissue.

Other imaging tests: Oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP), or endoscopic retrograde cholangiopancreatography (ERCP) may be performed to identify the gallstone and determine their size of it. As ERCP is an invasive procedure, gallstones detected during the ERCP can be removed during the procedure.

Blood tests may identify infection, jaundice, pancreatitis, or other gallstone-related complications.

Treatment

Doctors may advise patients to be on the lookout for signs of gallstone problems, such as increased pain in the upper right abdomen. Based on the symptoms and the results of diagnostic tests, the doctor will assess if gallstone therapy is necessary.

Gallstone treatment options include:

Surgical removal of the gallbladder (cholecystectomy). Because gallstones frequently recur, the doctor may recommend surgery to remove the gallbladder. After surgery, bile flows directly from the liver into the small intestine. Gallbladder removal has no effect on a patient’s ability to digest meals, but it can induce temporary diarrhoea.

Some medications may aid in dissolving the gallstones. However, gallstones will most likely form again after the medications are stopped.

Dr. Giridhar Reddy
Consultant Gastroenterologist

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