– by Dr. Manas Ranjan Tripathy, General and Laparoscopic Surgeon, Apollo Spectra Hospital, Bangalore
Gall stones are one of the most common ailments among adults. Gall stones or Cholelithiasis is a condition that develops in the gall bladder, an organ that stores the bile juice essential for digestion. When the digestive juices form a deposit in the gall bladder and become solid and hard is known as gall stones. This condition was earlier detected commonly among adults of 30-40 years of age, however, it is being increasingly detected amongst children recently.
The gall stones vary in size; most commonly it is about 5-10mm in diameter. Gall stones are mostly asymptomatic and the patients wouldn’t even realise that one has this condition. Some patients however experience severe shooting pain on the right side of the abdomen that can shift to the back and shoulders as well. The presence of pain is a key sign for one to immediately visit the doctor.
Causes of Gall Stone
Bile juice consists of components like cholesterol and bilirubin. The gall stones are caused when there is an imbalance in the chemical components of the bile juice providing an excess of cholesterol or bilirubin, which then gets accumulated in the gall bladder and gets solidified.
The gall stones can be broadly classified into two types:
Cholesterol Gall Stone:
It is formed by the excessive presence of cholesterol and less amount of bile salt present in the bile juice. The less amount of salt leads to difficulty in the breakdown of the cholesterol and ultimately causes accumulated cholesterol to form into crystals in the gall bladder. It forms yellow-colored stones which is the most common type of gall stone.
Pigment Gall Stone: Pigment gall stones are formed with the excessive bilirubin present in the bile juice by the combination of calcium and bilirubin. These stones are dark and pigmented in colour and are most common among people with underlying liver conditions.
Apart from excess cholesterol and bilirubin, gall stones can also be caused if the gall bladder doesn’t empty completely. In such conditions, the bile gets concentrated in the gall bladder leading to the formation of stones.
Other factors that contribute to the risk of gall stones are obesity, inactive lifestyle, age, diet, heredity, gender, and underlying health conditions like diabetes, Liver problems, blood disorders like anaemia, leukaemia etc.
Treatment of Gall Stones
The gall stone can cause complications like severe abdominal pain, nausea, fever, and pain in the back and the shoulders and if the gall stones enter the bile duct it can cause jaundice and high fever. The gall stones can also cause inflammation in the gall bladder which can lead to blockages in the pancreatic duct and the bile duct.
The treatments are usually suggested only to patients with severe symptoms. If the pain intensifies and becomes regular then the doctor recommends surgical or non-surgical treatment methods.
Non-surgical Treatments
1. Medication: The patient will be prescribed medications if the stones are not formed by calcium. These medications help in dissolving the stones. The method however takes longer duration and also has a high chance of recurrence of the stones.
2. Shock Waves: Shock wave treatment is used if the stone is smaller than 2 cms. The shock waves are used to break down the stones and the technique is called Extracorporeal Shock-wave Lithotripsy. Even this technique has a higher chance of recurring stone.
Surgical Method:
The surgical techniques are sought after and commonly used. It is a risk-free process and the patients can get discharged within two days of surgery. In these processes, the gall bladder is surgically removed as it isn’t crucial for the digestive process.
1. Open cholecystectomy: It is a surgical procedure to remove the gall bladder performed under general anaesthesia. The surgeon makes an incision under the rib cage to reveal the gall bladder and, it is surgically removed.
2. Laparoscopic cholecystectomy: It is the most common procedure to remove the gall bladder in a less invasive manner. The laparoscope is inserted through one incision to view the gall bladder. Then the surgical instrument is inserted from another incision to remove the gall bladder. It has faster recovery rates.
Conclusion
Although most cases of gall stones are asymptomatic, it is still a very common ailment among the general population. It is found more amongst women than men. It is advised to prevent the occurrence of stones by opting for a healthy lifestyle and a healthier diet. The symptoms of gall stones however need to be looked out for. If there is an occurrence of unbearable pain in the abdomen visit the doctor at the earliest.
