Cholelithiasis is a condition characterized by the formation of “stones” in the gallbladder. These stones, commonly referred to as gallstones, are hardened deposits of bile that form in the gallbladder or in the common bile duct.
Bile is a digestive fluid that consists of different compounds including bile salts, cholesterol, bilirubin, water, and electrolyte chemicals. It is produced by the liver and stored in the gallbladder that helps in fat digestion. Cholelithiasis occurs when there is an imbalance in some of these compounds in the bile.
Below are the three main ways in which gallstones can occur.
Gallstone risk is influenced by a number of genetic and lifestyle factors. As mentioned above, the risk factors are typically related to increased cholesterol or bilirubin concentrations in bile or reduced gallbladder motility, which promote crystallization and subsequent gallstone formation. Below are the common risk factors:
Cholelithiasis is generally asymptomatic. About 80% of patients with gallstones do not experience any symptoms at all. In fact, most people don’t even realize that they have it until the stones are found incidentally while getting treatment for another condition.
Symptoms of cholelithiasis usually only occur when the gallstone lodges in one of the tubes, called ducts, and cause temporary obstruction. In which case, you may experience any of the following symptoms:
The pain experienced in cholelithiasis is usually short-lived are not cause for alarm unless it progresses to further complications.
Gallstones can cause serious problems, including:
Due to the potential danger of these complications, individuals it is recommended to seek medical attention if gallstone pain does not resolve over time or if fever, jaundice, or persistent nausea and vomiting develop.
In general, asymptomatic gallstones do not require treatment. If gallstones have been discovered incidentally and do not cause any trouble at all, your doctor may observe and monitor your symptoms first before treatment is considered.
On the other hand, gallstones that cause symptoms or complications are usually treated by surgery or non-surgical procedures that dissolve or fragment the stones.
Surgery. The primary treatment for people with recurring gallstones is gallbladder removal, or cholecystectomy. Different techniques to remove the gallbladder may be recommended depending on its site, size, and other factors.
Laparoscopic method (laparoscopic cholecystectomy) is the preferred approach to remove a gallbladder. This surgical approach is minimally invasive in which the surgeon only performs small cuts in the abdomen and uses a narrow surgical telescope to magnify the organs in the abdominal cavity. The procedure takes only one or two hours, and many patients are discharged on the same day as the surgery.
People with complications who make organ removal difficult are usually advised to undergo a traditional operation to remove the gallbladder. This traditional operation is called open cholecystectomy which requires a larger cut through the abdominal muscle to allow access to the gallbladder and bile duct.
Medication. One of the non-surgical methods to treat gallstones is the oral intake of ursodeoxycholic acid, a bile acid that reduces the secretion of the cholesterol by the liver and eventually dissolves cholesterol crystals in the gallstone. The intake of ursodeoxycholic acid is best suited for people with smaller stones (5 mm in diameter or smaller).
Shockwave lithotripsy. Cholesterol gallstones can be fragmented through shockwave lithotripsy. According to Understanding Normal and Clinical Nutrition by Sharon Rolfes et. al., “this technique uses high amplitude sound waves (called shock waves) to break gallstones into fragments that are small enough to either pass into the intestine or be dissolved with ursodeoxycholic acid. Shockwave lithotripsy can only be performed in patients with few gallstones”.
The gallbladder serves as a storage facility for bile, the substance essential for fat digestion. When you eat, the gallbladder releases bile into the small intestine to break down fats. When the gallbladder is removed, there’s no place for bile to collect. What happens then is that the liver just releases bile straight into the small intestine instead of storing it first in the gallbladder, so that you can still digest most foods. However, it will be hard to digest large amounts of fatty, greasy, or high-fiber food which may lead to gas, bloating, and diarrhea. People can survive without a gallbladder, but we need to change out lifestyle such as going low-fat.
Cholelithiasis cannot be entirely prevented, but you can decrease your chances of developing it by following the healthy lifestyle tips below.