Gallstones predominantly affect women, especially those over 40 years old. These are solidified accumulations of digestive fluids forming in the gallbladder. Composed of varying substances like cholesterol and bilirubin, their size can range from minute grains of sand to as large as a golf ball. The number of stones can also differ, from just one to several hundred.
What Are Gallstones Made Of?
Types of Gallstones
- Cholesterol Stones: Making up about 80% of gallstones, these are predominantly cholesterol-based. They usually appear white, yellow, or green and occur when excess cholesterol accumulates in the gallbladder bile.
- Pigment Stones: These are generally smaller and darker in comparison to cholesterol stones. They mostly develop in people with conditions like cirrhosis, thalassemia, or G6PD deficiency.
Factors Contributing to Gallstone Formation
- Genetic Predisposition: A family history of gallstones increases the risk.
- Body Weight: Obesity heightens the levels of cholesterol in bile.
- Hormonal Factors: Elevated levels of oestrogen during pregnancy or due to birth control pills can increase cholesterol and decrease gallbladder movement.
- Age and Gender: Older individuals and women are more susceptible.
- Diabetic Conditions: Diabetes can raise triglyceride levels and lower gallbladder motility.
- Quick Weight Loss: Rapid weight reduction can lead to excessive cholesterol secretion from the liver.
- Dietary Habits: A diet rich in cholesterol and low in fibre contributes to gallstone formation.
Recognising Symptoms of Gallstones
Gallstones often go unnoticed until diagnosed during a check-up for another condition. When symptoms manifest, they can include:
- Intense upper abdominal or right-side abdominal pain, potentially radiating to the right shoulder or scapula
- Vomiting and nausea
- Digestive disturbances such as bloating, indigestion, and heartburn
- Acute gallbladder inflammation causing fever, right hypochondriac region pain, skin and eye yellowing, and dark urine
Diagnostic Procedures for Gallstones
- Comprehensive patient history and physical assessment
- Liver function blood tests
- Abdominal ultrasound examination
Treatment Options for Gallstones
- Gallbladder removal surgery
- Laparoscopic cholecystectomy
- Endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stones
Post-Surgical Complications for Gallstones
After the gallbladder is excised, bile flows directly from the liver to the small intestine, albeit in a less concentrated form. Around 10% of patients may experience post-surgical diarrhoea due to excessive bile flow.
Laparoscopic cholecystectomy should be performed by experts to minimise complications such as accidental common bile duct injury, bile leakage, or duct blockage.
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