Vesicular Lithiasis: Causes, Symptoms, Risk Factors, Diagnosis and Treatment

Gallstones are crystalline deposits that develop in the gallbladder (a small pear-shaped organ that stores bile).

These deposits can be as small as a grain of sand or as big as a golf ball, they can be hard or soft, smooth or jagged. You may have several gallstones or just one.

Some 30 million adults suffer from gallstones. However, most of those with the condition do not realize it. In this case, what you do not know will probably not hurt you.

Gallstones that are simply floating inside the gallbladder usually do not cause symptoms or damage.

These “silent” stones generally go unnoticed unless they appear on an ultrasound examination performed for some other reason. However, the longer a stone is in the gallbladder, the more likely it becomes problematic.

People who have gallstones without symptoms have a 20% chance of having a pain episode during their life.

When symptoms occur, it is usually because the gallstone has moved and lodged in a duct that carries bile , such as the cystic duct, a small tube that connects the gallbladder to another duct called the common bile duct.

The typical symptom is abdominal pain, perhaps accompanied by nausea, indigestion or fever. Pain, caused by the contraction of the gallbladder against the lodged stone, usually occurs one hour after eating a large meal or in the middle of the night.

The stones can also block the common bile duct, which carries bile to the small intestine, and the hepatic ducts, which remove bile from the liver.

Obstructions in the bile duct can cause a duct to become inflamed and possibly become infected. Blockage of the common bile duct, which fuses with the pancreatic duct in the small intestine, can also lead to inflammation of the pancreas ( pancreatitisdue to gallstones).

In a rare but dangerous condition that occurs more frequently in older women, gallstones migrate into the small intestine and block the passage to the large intestine; Symptoms include severe and frequent vomiting.

Although gallstones are present in approximately 80% of people with gallbladder cancer, it is not clear if gallstones play a role, except when really large stones (more than 3 centimeters in diameter) are present.

For reasons that are still unclear, women are twice as likely as men to be affected.

Gallstones are also more common in people over 60, in those who are obese or who have lost a lot of weight in a short time, in those who have diabetes or sickle cell disease, and in women who have had multiple pregnancies and who take hormone replacement therapy or birth control pills.

What Causes Vesicular Lithiasis?

The main function of the gallbladder is to store bile, a brown or yellowish liquid that helps the body break down fatty foods. When you eat a meal, the gallbladder releases its bile stored in the cystic duct.

From there, the fluid passes through the common bile duct and into the small intestine to mix with the food. The main ingredients in bile are cholesterol and bile acids.

Normally, the concentration of bile acids is high enough to break down the cholesterol in the mixture and keep it in liquid form.

However, a diet high in fat can tip this delicate balance, causing the liver to produce more cholesterol than bile acids can handle.

As a result, some of this excess cholesterol begins to solidify into crystals, which we call gallstones.

About 80% of all gallstones are called cholesterol stones and are created in this way. The remaining 20% ​​consists of calcium mixed with the bilirubin of the bile pigment and are called pigmentary stones. Gallstones can be formed even in people who eat properly.

And as researchers have discovered, a diet extremely low in fat can also contribute to the formation of stones: with little fatty food to digest, the gallbladder is used less often than usual, so that cholesterol has more time to solidify.

Other factors that can reduce activity in the gallbladder, possibly leading to the formation of gallstones, include cirrhosis , the use of birth control pills or hormone replacement therapy and pregnancy.

Family history, diabetes, sudden weight loss, and medications for cholesterol and old age can also increase the risk of gallstones.

symptom

The gallbladder is not an organ that attracts much attention, unless it is causing pain.

The gallbladder is a small sac that stores bile from the liver and is located under the liver.

The gallbladder releases bile, through the cystic duct, into the small intestine to help break down the foods you eat, particularly fatty foods.

Usually, the gallbladder does not cause too much trouble or much concern, but if something slows down or blocks the flow of bile from the gallbladder, several problems can arise.

What can go wrong?

Some common problems of the gallbladder include:

Gallstones (cholelithiasis) : this is the condition when small stones, or some larger ones, develop inside the gallbladder.

Gallstones can cause pain known as biliary colic, but about 90 percent of people with gallstones will have no symptoms.

The majority of symptomatic gallstones have been present for several years.

For unknown reasons, if you have gallstones for more than 10 years, they are less likely to cause symptoms.

Biliary colic : this is the term often used for severe episodes of pain that can be caused by biliary blockage of the cystic duct.

The gallbladder contracts vigorously against the blockage, causing severe spasmodic (or sometimes constant) pain.

Episodes of biliary colic usually last only one or two hours. They may reappear infrequently, often years apart.

Inflammed gallbladder ( cholecystitis ) : Inflammation of the gallbladder can be caused by gallstones, excessive use of alcohol, infections or even tumors that cause the accumulation of bile.

But the most common cause of cholecystitis is gallstones. The body can react to irritation of gallstones by making the walls of the gallbladder swell and hurt.

Episodes of inflammation can last several hours or even a few days. The fever is not unusual.

Approximately 20 percent of the time, the inactive and inflamed gallbladder is invaded by intestinal bacteria and becomes infected.

Occasionally, the gallbladder actually ruptures, which is a surgical emergency. Suspicious episodes of cholecystitis always require medical attention, especially if there is a fever.

Dysfunctional gallbladder or chronic gallbladder disease : here, the gallbladder may become stiff and scarred by gallstones and repeated episodes of inflammation.

The symptoms are more constant, but tend to be inaccurate, such as abdominal fullness, indigestion and increased gas. Chronic diarrhea is a common symptom, usually after meals, and up to 10 times a day.

Common Symptoms of Vesicular Lithiasis

The specific symptoms may vary depending on the type of gallbladder condition you have, although many symptoms are common among different types of gallbladder problems.

But most symptoms of the gallbladder start with pain in the upper abdominal area, either in the upper right or in the middle.

Here are the common symptoms of gallbladder disease:

  • Severe abdominal pain.
  • Pain that may extend below the right scapula or back.
  • Pain that gets worse after eating a heavy meal, particularly fatty or fatty foods.
  • Pain that feels dull, sharp or cramping.
  • Pain that increases when you breathe deeply.
  • Stomach acid, indigestion and excess gas.
  • Chest pain.
  • A feeling of fullness in the abdomen.
  • Vomiting, nausea, fever.
  • Trembling with chills.
  • Sensitivity in the abdomen, particularly in the upper right quadrant.
  • Jaundice (yellowing of the skin and eyes).
  • Stools of an unusual color (often lighter, such as clay) and dark urine, or both.

Some problems with the gallbladder, such as simple gallstones that do not block the cystic duct, often do not cause any symptoms.

Most often they are discovered during an x-ray or a CT scan that is done to diagnose a different condition, or even during abdominal surgery.

If you detect any symptoms of gallbladder problems, contact your doctor for a diagnosis and a quick treatment so that your digestive tract can function again without problems.

What are gallstones?

Gallstones can cause severe abdominal pain, or you may not have any symptoms. Gallstones, also called cholelithiasis, are a very common problem.

It is more common among women, people over 40 and Native Americans. The gallbladder is a sac that stores a substance called bile, which is produced by the liver.

After meals, the gallbladder contracts and releases bile in the intestines to aid in digestion.

Gallstones occur when one of the substances that make up the bile (usually cholesterol or a waste product called bilirubin) becomes too concentrated and forms a hard stone.

Often, gallstones simply sit on the gallbladder and do not cause problems. But sometimes block the exit of the gallbladder, called cystic duct.

When this happens, the gallbladder goes into spasms and becomes inflamed, a condition called cholecystitis.

An episode of cholecystitis can resolve on its own or it can progress to a more serious condition that involves bacterial infection of the inflamed gallbladder.

Risk factor’s

Risk factors for gallstones include:

  • A family history of gallstones.
  • Consumption of medications to reduce cholesterol levels.
  • Have diabetes
  • A rapid and important weight loss.
  • Use contraceptive pills or hormone replacement therapy.
  • Be pregnant.
  • Being overweight.
  • Eat a diet rich in fat and cholesterol and without enough fiber.

Diagnosis

If gallstones are suspected, your doctor may order an imaging test. This could include an ultrasound, which uses sound waves to visualize the area. Another procedure, called a HIDA scan, involves injecting a small amount of a harmless radioactive substance.

Occasionally, gallstones appear as an incidental finding in other tests, such as an ultrasound or computed tomography, which may show a structural change with the gallbladder.

Treatment of Vesicular Lithiasis

There are a number of options for treating gallstones, depending on the symptoms and how severe they are. Possible methods of treatment for gallstones include:

Surgery : The gallbladder is often removed surgically, but usually only if you experience severe symptoms.

Significant advances have been made with cholecystectomy or surgery to remove the gallbladder. Now it is a less invasive procedure that uses laparoscopic technology.

Small incisions are made, recovery is quick, and you may not even have to spend the night in the hospital after surgery.

Dietary changes : Your doctor may recommend that you switch to a healthier, lower-fat diet to help relieve gallstone symptoms.

Medications : Some types of medications, including oral bile salt therapy, work to slowly break down small gallstones to reduce pain and symptoms.

Analgesics : can be recommended to control pain during an acute attack of cholecystitis.