Gallstones: Causes, Symptoms, Diagnosis and Treatment Vitamin Fruit

Overview of Gallstones

Gallstones are one of the digestive tract diseases that occur when cholesterol stones, bile pigment stones or mixed stones appear in the gallbladder and the bile duct system in the liver, the common bile duct.

About 80% of gallstones are mainly due to the amount of cholesterol in the bile increasing excessively, exceeding the solubility of bile salts. The remaining 20% may have bile pigment stones related to abnormally high concentrations of bilirubin bile pigment.

Normally, the gallbladder stores bile to help digest fats in food from the liver. When we eat, the gallbladder performs its function by contracting and secreting bile into the small intestine. However, if liver function is impaired, bile duct movement is poor, causing cholestasis or inflammation, the components in the bile will be disturbed and coagulate to form gallstones. The presence of gallstones obstructs the flow of bile, increases pressure in the bile duct every time the gallbladder contracts or causes inflammation and damage to the bile duct and gallbladder.

Gallstones can cause bile obstruction in episodes, if prolonged, it will lead to acute or chronic inflammation of the bile duct and gallbladder (90% of patients with bile duct stones are hospitalized due to acute or chronic inflammation of the bile duct and gallbladder), acute pancreatitis, and more severe shock due to biliary tract infection, gallbladder necrosis, peritonitis, sepsis, etc. If not treated promptly and promptly, it can even cause death.

Hepatoliths can cause bile stasis in the liver, causing liver abscesses, cirrhosis leading to liver failure, reducing the body’s ability to metabolize.

Causes of Gallstones

General causes of gallstones can include:

Fasting: causes the gallbladder to not secrete as it should
Rapid weight loss: causes the liver to make more cholesterol, which can lead to gallstones
High blood cholesterol levels
Obesity: is one of the biggest risk factors. Obesity can increase cholesterol levels and make it difficult for the gallbladder to empty.
Taking birth control pills, using hormone replacement therapy for menopausal symptoms, or being pregnant: can increase blood cholesterol levels and increase the risk of cholestasis in the gallbladder.
Chronic diseases: such as diabetes, …
Hematological diseases: hemolytic anemia, …
Genetic

Causes of cholesterol stones:

Old age
Eating a lot of foods high in cholesterol, high in animal fat
Due to giving birth many times (women)
Due to complications from some digestive diseases such as Crohn’s disease, ileal resection, …
Due to using a lot of some drugs such as clofibrate, estrogen, …

Causes of pigment gallstones:

Old age
Biliary tract diseases: bile stasis, bacterial or parasitic infections of the bile duct
Other diseases: cirrhosis, hemolytic anemia, Mediterranean anemia, sickle cell anemia

Symptoms of Gallstones

Signs of gallstones are often non-specific and easily confused with other diseases such as stomach diseases, often including:

Abdominal pain

Where does gallstone pain occur? Most cases of gallstones have pain in the right hypochondrium, but there are also many cases where the pain appears in the epigastric region (the area above the navel and below the sternum).

Gallstone pain often occurs after meals, especially when eating a lot of fat or at night, causing the patient to lose sleep. The pain is severe and continuous, lasting from 30 minutes to several hours.

Depending on the location of the stone, the nature of the pain will be different:

Gallbladder stones: when the stone is stuck in the neck of the gallbladder, the patient often has severe abdominal pain in the right hypochondrium in bouts.
Gallbladder stones or common bile duct: the patient has colic pain in the right hypochondrium, spreading to the right shoulder or back, epigastric region.

Digestive disorders

Gallstones obstruct the flow of bile into the digestive tract, leading to bloating, indigestion, loss of appetite, and fear of greasy foods.

Symptoms of digestive disorders often appear after meals, and may be accompanied by nausea and vomiting.

Patients should go to the hospital for treatment as soon as possible when one of the following signs appears:

Severe abdominal pain lasting for many hours and not relieved even with pain medication.
High fever above 38 degrees Celsius, accompanied by chills and sweating.
Nausea and vomiting with a feeling of bloating.

Subjects at risk of gallstones

Women: women are at much higher risk of gallstones than men because the female hormone estrogen stimulates the liver to increase cholesterol production and excrete it into bile
A diet high in saturated fat, low in fiber and green vegetables
Overweight or obesity: overweight people with a body mass index (BMI) > 25 are at high risk of gallstones
Age 40 and older: the older you are, the more likely you are to have gallstones
People with digestive disorders or chronic inflammatory bowel disease: make the body reabsorb bile salts poorly, increasing the risk of gallstones
Family history of gallstones
Rapid weight loss
Decreased bile duct motility: people who work in offices, are sedentary, sit a lot or people who are fed intravenously for a long time (vegetative people) are very susceptible to this condition
Constipation also creates an opportunity for intestinal bacteria to develop, leading to duodenitis, gallbladder and bile ducts, making bile easy to settle into stones
Pathology: metabolic disorders, diabetes, chronic liver disease (fatty liver, hepatitis, cirrhosis, increased liver enzymes, …), dyslipidemia
Pregnancy: due to hormonal changes and reduced gallbladder contractility due to the size of the fetus
Using drugs:

Long-term use of birth control pills increases estrogen, thereby increasing cholesterol excretion in bile

Using cholesterol-lowering drugs (lowering blood lipids) increases cholesterol excretion in bile

Prevention of gallstones

Prevention of gallstones is mainly by changing the diet:

Reduce fat: need to limit foods rich in cholesterol such as animal organs, eggs …
Increase protein to increase the creation of damaged liver cells, prevent fatty degeneration of liver cells.
Rich in carbohydrates: this food is easy to digest, does not affect bile and is rich in fiber to help digestion and avoid constipation.
Rich in vitamin C and vitamin B (to increase fat and carbohydrate metabolism) found in fresh vegetables and fruits
The ratio between nutrients protein, fat, sugar in normal adults is 1/0.75/5, while in people with gallstones it should be 1/0.5/5.
Foods to avoid: tea, coffee, cocoa, chocolate, fatty fish and meat, palm oil, coconut oil…
Foods to eat: Juices, fresh fruits of all kinds, fresh vegetables, candies with little butter and eggs, lean meat and fish such as pork loin, beef, snakehead fish, carp, beans such as soybeans, green beans, black beans. In addition, there are some foods that are good for the gallbladder such as turmeric and lemon leaves that can be used.
To stimulate the gallbladder to contract gently, you can use a little easily digestible fat such as butter, herbal oil, chicken and duck fat.
Divide into many small meals, eat many times a day

Diagnostic measures for gallstones

Blood tests: help assess liver function and cholesterol levels in the blood.
Imaging diagnosis: abdominal ultrasound, abdominal X-ray, abdominal CT scan are effective methods in diagnosing gallstones

Cholesterol stones are usually single, light-colored and do not block X-rays, so they are not visible on X-rays but can be seen on ultrasound. Pigment gallstones are mainly calcium bilirubinate, dark in color, often forming clusters of stones, blocking X-rays so they can be observed on X-rays.

Treatment measures for gallstones

How to temporarily relieve gallstone pain:

Apply warm compresses to the abdomen: with a heat pack or a warm water bottle
Drink fruit juice: drink orange juice, lemon juice or vegetable juice. These vitamin-rich drinks are not only good for your health but also delicious, helping to cheer up your spirit and relieve pain caused by gallstones.

Long-term treatment solutions:

Treatment of gallstones depends on the composition of the stones and the severity of the disease. There are many ways to treat gallstones: using drugs, using vibration waves to break up the stones outside the body, surgery to remove the stones, changing the diet. If the stones are silent and asymptomatic, there is no treatment, only treatment when the stones have symptoms, however, bile duct stones must be treated even if there are no symptoms.

Oral medicine to treat gallstones:

Due to the complex nature of the structure, location, and type of stones, there is no general treatment for all types of stones. Only cholesterol stones can be eroded by drugs with components similar to bile acids.

Conditions for taking oral medication to treat gallstones:

Stones are not larger than 1cm
The volume of all stones in the gallbladder is not larger than 1/3 of the gallbladder volume
Gallbladder function is still good
The bile duct is not blocked
The patient is not taking fat-reducing or stomach medications

The medication should be taken in the afternoon, because in the evening the liver often produces bile, which promotes the stone formation process.

Treatment of gallstones with medication can last from 3 months to 2 years, with a success rate of 40-70%. Women must avoid pregnancy while taking the medication.

Extracorporeal shock wave lithotripsy:

This method has been used since 1985. The purpose of this method is to reduce the size of the stones without surgical intervention. This technique is suitable for single gallstones or stones stuck in the bile duct that cannot be removed by endoscopy.

However, the lithotripsy method has limitations because it is only used for the following patients:

Single stones, not calcium stones, with a diameter of less than 2cm
Normal blood clotting function
No cholecystitis or pancreatitis
Not for pregnant women

After lithotripsy, medication can be used to dissolve the stone fragments, the patient can be completely cured after a few months, with a success rate of about 60-90%.

Surgery to treat gallstones

This is a common and safe surgery, however, some patients may still have complications. About 25% of patients still have uncomfortable symptoms after surgery. Therefore, gallstones should be treated conservatively, only when the above methods fail, surgery is the last resort.

Gallstones can now be removed by endoscopic procedures, thus avoiding major surgery and shortening hospital stays.

Healthy diet

This helps reduce gallstone symptoms such as bloating and indigestion, and also partially prevents the risk of gallstones increasing in size.

Eat a variety of fresh fruits and vegetables and drink enough water.
Limit foods high in cholesterol such as offal, fried foods, and fast food.

Tags #Gallstones