Definition:
Gallstone is a solid crystal deposit which is formed due to cholesterol, calcium ions and bile pigments in the bile duct or gallbladder. Cholelithiasis is the presence of gallstones in gallbladder. Choledochollthlasis is the presence of gallstones in the bile ducts.
Formation of Gallstones:
Normally. cholesterol present in the bile combines with bile salts and lecithin, which make the cholesterol soluble in water. Under some abnormal conditions, this water-soluble cholesterol precipitates resulting in the formation of gallstone.
Initially, small quantity of cholesterol begins to precipitate forming many small crystals of cholesterol in the mucosa of gallbladder. This stimulates further formation of crystals and the crystals grow larger and larger. Later, bile pigments and calcium are attached to these crystals, resulting in formation of gallstones.
Causes for Gallstone Formation:
- Reduction in bile salts and/or lecithin
- Excess of cholesterol
- Disturbed cholesterol metabolism
- Excess of calcium ions due to increased concentration of bile
- Damage or infection of gallbladder epithelium. It also alters absorptive functions of mucous membranes of the gallbladder. Sometimes, there is excessive absorption of water or even bile salts, leading to increased concentration of cholesterol, bile pigments and calcium ions.
- Obstruction of bile flow from the gallbladder.
Diagnosis of Gallstone:
Presence of gallstone is diagnosed by ultrasound scanning and cholangiography. Cholangiography is the radiological study scheme of biliary ducts of a contrast medium after the administration.
Features:
Common feature of gallstone is the pain in stomach area or in upper right part of the belly under the ribs, Other features include nausea, vomiting, abdominal bloating and indigestion.
Treatment for Gallstone:
Simple cholesterol gallstones can be dissolved over a period of one or two years by giving 1 to 1.5 gm of chemodeoxycholic acid daily. This increases the concentration of bile acids. So, excessive concentration of bile does not occur.
In severe conditions, the gallbladder has to be removed (cholecystectomy). Laparoscopic surgery is the common method.