Gallbladder disease has become a very common condition these days. It is estimated that 1 million Americans are diagnosed with gallstones every year by imaging tests. Fortunately, only few will develop symptoms that require treatment.
Most people know someone who has been diagnosed and treated or they have been diagnosed and treated themselves. Therefore, it is important to consider certain preventive measures to avoid surgical intervention if possible and to be aware of what events might happen before and after surgery to prevent unnecessary complications.
The increasing frequency of symptomatic gallstones in our population is associated with the obesity epidemic. Formation of gallstones occurs because of a chemical imbalance due to diet, metabolism and genetics.
How can I avoid forming gallstones or symptoms if I already have gallstones?
Eat scheduled well-balanced high-fiber low-fat meals so the gallbladder empties. Exercise at least 30 minutes per day and maintain an ideal body weight.
How would I know if I have gallstones?
Most people who have gallstones never experience symptoms and may not know they have gallstones. People who have symptoms are evaluated for gallstones with an ultrasound of their abdomen. Blood work is recommended to evaluate for infection and abnormalities with the liver and pancreas.
Who is at most risk of developing symptomatic gallstones?
Women, over 40, family history, pregnancy, obesity, frequent fasting, rapid weight loss, lack of physical exercise, diabetes, sickle cell disease, and some medicines that contain the hormone estrogen (like birth control pills).
What conditions are caused by gallstones?
Biliary Colic: Is the result of transient obstruction of the gallbladder from a gallstone in the neck of the gallbladder or cystic duct often after a fatty meal. The pain goes away within hours. Telling your doctor is recommended.
Acute Cholecystitis: Is the result of a gallstone obstructing the gallbladder or cystic duct. The gallbladder becomes inflamed leading to right upper quadrant abdominal pain that is prolonged and severe. Urgent medical evaluation is recommended.
Gallstone Pancreatitis: This happens when a small gallstone migrates out of the gallbladder and obstructs the pancreatic duct. This condition causes severe epigastric abdominal pain with radiation to the back, loss of appetite, nausea, and vomiting. Emergent medical attention is recommended.
Ascending Cholangitis: This condition happens when a gallstone migrates out of the gallbladder blocking the common bile duct causing liver inflammation and sometimes infection. Bile duct obstruction causes epigastric abdominal pain. Jaundice my develop leading to yellow eyes and skin. Loss of appetite, nausea, and vomiting are common symptoms. Emergent medical attention is recommended.
If I have symptoms what is the standard treatment?
Symptomatic gallstones are usually treated with surgery called cholecystectomy. The surgery involves removing the gallbladder with the gallstones. Today the procedure is performed with a minimally invasive technique called laparoscopy. Patients often go home the same day and enjoy a speedy recovery.
Dr. Miller is a minimally invasive general surgeon at Contra Costa Regional Medical Center.
Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at firstname.lastname@example.org. For more health information, go to www.cchealth.org.