Cholelithiasis: Symptoms, Causes & Treatment

What is Cholelithiasis?

Picture this: small, pebble-like stones forming in your gallbladder. This is cholelithiasis, also known as gallstones – a medical condition that can cause discomfort and pain. These stones can vary in size, with some as small as a grain of sand and others as large as a golf ball. But no matter their size, the discomfort they can cause is anything but small. The gallbladder is a small organ in the body that stores bile, a fluid that contains different substances like cholesterol, bilirubin, bile salts, and lecithin. These stones are generally composed of cholesterol or bilirubin, which gradually collect in the gallbladder until they harden into stones. This can create a blockage and cause a range of uncomfortable symptoms. Continue reading to know more about it.¹

Symptoms of Cholelithiasis

In some cases, cholelithiasis or gallstones may not cause any noticeable symptoms. However, at other times, they can cause the following symptoms: ^2-4

• Cramping pain in the middle to the right upper abdomen lasting for several hours
• Nausea and vomiting
• Low-grade fever or chills
• cYellowing of the skin, known as jaundice
• Tea-coloured urine and light-coloured stools
• Back pain between the shoulder blades
• Pain in the right shoulder

If you notice any of these symptoms, you should contact your doctor right away.

Causes of Cholelithiasis

Gallstones are caused by excess bilirubin and cholesterol in the bile fluid. According to their cause, gallstones are divided into two types: ¹

• Cholesterol Stones: These are the most common type of gallstones and are unrelated to blood cholesterol levels.  
• Bilirubin Stones: These are known as pigment stones formed due to an excess of bilirubin. 

Several risk factors increase the likelihood of developing gallstones. These include:⁴

• Bone marrow or solid organ transplant
• Diabetes
• Gallbladder failure to empty bile properly during pregnancy
• Liver cirrhosis and biliary tract infections
• Long-term use of birth control pills

It’s always best to consult with a healthcare provider if you’re experiencing symptoms or have concerns about your risk of developing gallstones. 

Complications

Gallstones can cause serious health problems. Here are some of the complications: ^1,4

• Gallbladder disease: Gallstones are the main cause of gallbladder diseases such as biliary dyskinesia and gallbladder cancer. They can block the flow of bile, causing inflammation and scarring of the gallbladder.
• Liver disease: When bile backs up into the liver, it can cause inflammation and scarring. This can result in long-term liver damage.
• Gallstone pancreatitis: A blocked pancreatic duct due to a gallstone can cause inflammation in the pancreas.
• Jaundice: When accumulated bile leaks into the bloodstream, it can cause yellowing of the eyes and skin. This happens because bilirubin, a yellow pigment in bile, builds up in the body.

Read More: Home Remedies For Gall Bladder Stone

Diagnosis

1. Blood tests:

• Bilirubin test: measures the amount of bilirubin in your blood to know about blockages in the bile ducts.
• Liver function tests: assess the health of your liver and detects blockage in bile ducts.
• Complete blood count: measures the number of white and red blood cells in your blood.
• Pancreatic enzyme test: checks the level of pancreatic enzymes in your blood, which can indicate inflammation or injury to the pancreas.

2. Imaging tests: ^1-3

• CT scan and abdominal ultrasound: The most commonly used test to detect gallstones.
• Endoscopic ultrasound: Helps in identifying smaller stones that were undetected by ultrasound and CT scan.
• Magnetic resonance cholangio-pancreatography (MRCP): This non-invasive test visualises the bile ducts and creates clear images of the bile ducts.

Read More: Can You Exercise With Gall Bladder Stone

Treatment

Gallstones can be treated in various ways depending on the size of the stone and your physical condition. Your doctor is the best person to guide you on which mode of treatment is suitable for you. Here are some options for treating gallstones: ^1-4

1. Medication:

Some gallstones can be treated with medicines that help dissolve the stones. However, it may take months or years of medication to completely dissolve the stone. This option is not common and is only suggested to people who cannot undergo surgery for some reason.

2. Surgery:

• Open Cholecystectomy: This surgery removes your gallbladder completely through open surgery. This surgery is advised when your gallbladder is severely inflamed. It is also known as cholecystitis.
• Endoscopy: Gallstones in your bile ducts can be removed by endoscopy. This procedure doesn’t require any incisions. The gallstones are expelled through the long tube that has been inserted down your throat.
• Laparoscopy: Laparoscopic cholecystectomy uses small incisions in your abdomen to operate with the aid of a small camera called a laparoscope. The laparoscope is inserted through one incision and removes your gallbladder through another. This method has a faster recovery time and is less painful. It is the most commonly performed procedure now.

Frequently Asked Questions (FAQs)

References:

1. Gallstones (cholelithiasis): Symptoms, causes & treatment [Internet]. Cleveland Clinic. 2022. Available from: https://my.clevelandclinic.org/health/diseases/7313-gallstones  
2. Symptoms & causes of gallstones – NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. U.S. Department of Health and Human Services; 2017. Available from: https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/symptoms-causes  
3. Gallstones [Internet]. Mayo Clinic. Mayo Foundation for Medical Education and Research; 2021. Available from: https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214  
4. Gallstones [Internet]. Pennmedicine.org. 2021. Available from: https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/gallstones  

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