Conditions - Gallstones
Gallstones are solid material that forms
in the gallbladder and very occasionally in the bile duct.
They form inside the gall bladder because cholesterol and
bile salts precipitate out of solution due to changes in their
relevant concentrations and as a result of biliary stasis.
Most stones have predominantly cholesterol within them. The
exact composition of the stones is not particularly important
as they can all cause symptoms.
Risk factors for gallstones include female
gender as women between 20 and 60 are twice as likely to develop
gallstones as men. Obesity is also a major risk factor especially
in women. Estrogen excess from pregnancy, HRT or the OCP is
also implicated. Cholesterol lowering drugs, diabetes and
rapid weight loss increase the amount of cholesterol in bile
and this can contribute to formation of gallstones.
Most people with gallstones do not have
symptoms. They may have the diagnosis made incidentally and
in this situation is not essential to have the gallbladder
removed. Most people, when they develop symptoms have pain
which is usually in the upper abdomen centrally or to the
right side. It is common for the pain to be referred through
to the back. The pain is usually colicky in nature but can
be constant. There are a number of nonspecific symptoms that
are often associated with gallstones including upper abdominal
bloating, nausea, belching and intolerance to fatty foods.
Occasionally patients will present with
complications of the stones. These include cholecystitis which
is infection within the gallbladder secondary to stones obstructing
the outflow from the gallbladder. Gallstones can escape from
the gallbladder and then cause problems within the bile duct.
Cholangitis is infection within the bile duct that can ascend
into the liver. Pancreatitis is inflammation of the pancreas
gland. This occurs when gallstones travel down the bile duct
and temporarily occlude the duct that drains the pancreas.
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