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Gallstone disease is quite common and troublesome. It may be asymptomatic, but it is more often accompanied by symptoms such as epigastric pain, heartburn, nausea, vomiting. Unhappy owners of gallbladder stones often have a dilemma: go to surgery or not. What do you need to know in order not to get in more trouble?

The gallbladder , commonly known asgallbladder , is a store of bile produced by the liver and needed to metabolize fats. During digestive processes, it is constantly transported through the bile ducts to the duodenum. In some people, it is not known exactly why, cholesterol and bile s alt crystals precipitate in the bladder, which clump into bile deposits, the so-called bile deposits. stones. Most often they have a mixed composition, but sometimes they are homogeneous.

Who suffers most often from gallstone disease?

Women get sick 2-3 times more often than men. It is only after the age of 70 that gallstone disease occurs equally often in both sexes. Women who have given birth, take hormonal contraceptives or use hormone therapy are at greater risk. Stones more often happen to obese people who use drastic slimming diets and, for example, with diabetes. There is also a hereditary tendency to urolithiasis.

Symptoms of gallbladder stones

Often, urolithiasis does not make itself felt, and we find out about the disease by accident during ultrasound of the abdomen. Some patients complain of feeling of fullness or crushing in the epigastrium or right hypochondrium area, belching, flatulence.

Ailments most often appear after eating a hard-to-digest food and pass by themselves. The problem begins when a tartar temporarily blocks the exit to the cystic duct, disrupting the outflow of bile. Then it comes to hepatic colic.

There is severe pain in the upper abdomen or under the right costal arch that can radiate to the back, right shoulder blade and shoulder, even to the neck and collarbones. The spines are accompanied by nausea, sometimes vomiting. The symptoms may last from 10 minutes to 3 hours. An attack often occurs as a result of a dietary error, but it may also be unrelated to eating.

The bubblebiliary - colic

If the attacks of pain persist, there is a high probability that acute inflammation of the follicle will develop. Usually, the pain is accompanied by vomiting, gas, chills and fever. As a result of blocking the outflow of bile, an inflammatory fluid accumulates in the sac. The bubble expands, is taut, hard.

As bile pigments are systematically absorbed into the blood, a watery fluid (vesicle hydrocele) eventually remains in the pouch. When its contents are infected, an empyema is formed. Acute cystitis can lead to inflammation of the bile ducts, pancreatitis, and peritonitis. If the colic persists for more than 3 hours, you will need to call an ambulance.

Lime in the bile duct

If your doctor suspects that a gallstone has entered the bile duct (it rarely forms), a test called retrograde cholangiopancreatography (ERCP) is performed to confirm the diagnosis.

The doctor inserts the endoscope through the mouth (where the bile ducts enter the duodenum) and observes the bile duct on the screen.

If the diagnosis is confirmed, she cuts the biliary sphincter and small stones fall into the duodenum. The larger ones are removed with a special basket (sometimes you have to crush them). The procedure is performed under general anesthesia. It brings relief immediately, but does not solve the problem, because subsequent stones can block the bile ducts. Therefore, after some time, you need to remove the bubble with stones.

Occasionally, stones from the bile ducts are surgically removed.

Gall bladder stones - research

Already on the basis of the classic symptoms, the doctor recognizes the inflammation of the follicle. But the conclusive study is the ultrasound of the abdominal cavity. It allows you to assess the size of the bladder and the thickness of its walls, the location and size of the stones, and the patency of the bile ducts.

Important are also the so-called liver tests. In urolithiasis without complications, the results are usually normal. However, in people with inflammation of the gallbladder or bile ducts, an increase in biochemical indicators and the number of leukocytes in the blood is found. If the doctor has difficulty locating the stones or suspects a follicular tumor, a CT scan is also required.

Gall bladder stones - treatment

The choice of method depends on symptoms, plaque location and complications. If the colic occurs sporadically and is not too strong, you can use over-the-counter antispasmodics, choleretic and anti-inflammatory agents. Relief is brought, for example, by infusion of St. John's wort and mint. However, you have to take into accountthat attacks will repeat even if we avoid fatty foods.

It is better to remove the follicle before there are complications, such as inflammation or tartar displacement into the bile duct. The operation is performed immediately for hydrocele and empyema of the sac.

Acute inflammation first tries to heal itself. Only when it subsides, surgery is proposed. Sometimes you have to operate "acutely", which may lead to complications.

Gall bladder stones - operation

An uncomplicated follicle is usually removed with a laparoscope. Although the procedure is performed under general anesthesia like a classic operation, it is much less invasive. Instead of a big cut, only 4 small cuts are made to the skin on the abdomen.

You can walk on the day of the operation, and leave the hospital on the second day. After 10 days, the seams are removed, and after 2 weeks, you can go back to work.

After the traditional surgery, the hospital stay is not much longer, but the convalescence lasts about 4 weeks. Until the wound is completely healed, there is usually pain in the abdomen, which remains a permanent reminder of a scar.

Laparoscopy is not used in the acute stage. Postoperative adhesions can also be an obstacle. The doctor always informs the patient that, if necessary, he will change to the traditional method during the procedure.

Diet after gallbladder removal

Before the digestive system gets used to the new situation (bile flows from the liver directly to the duodenum), for 4-6 weeks you need to follow an easily digestible diet (boiled, stewed, baked), lean food. You should eat in small portions 4-5 times a day, drink 2.5 liters of water.

Avoid bloating vegetables, raw onions, strong coffee, coarse grains. Then you can gradually enrich the menu. Most people return to a normal diet after a while.

Can stones in the gallbladder be dissolved?

Most doctors are skeptical about this type of therapy. The stones dissolve slowly, so it takes months, even years, to heal. Only small cholesterol deposits are dissolved without calcification, and not all of them.

If the treatment is successful, there is no guarantee that new stones will not form. In 10-15 percent new deposits are formed within a year, in 50 percent. 5 years after the end of the treatment.

What to do when plaques are asymptomatic?

The indication for surgery is type 2 diabetes (promotes inflammation) and the presence of thickened walls of the follicle on ultrasound (this may indicate chronic inflammation, which sometimes leads to the development of cancer).

Surgery is recommended when calcium s alts are depositedin the bag wall and when the deposits are more than 3 cm (higher risk of follicle cancer). It should be removed prophylactically when there has been a family history of biliary neoplasms.

Urolithiasis can always activate, so some people believe it is better to remove the pouch to avoid complications.

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Category:

Gastrology