Cholelithiasis

What is cholelithiasis? Cholelithiasis also known as gallstones is defined as hardened deposits of digestive fluid which form in one's gallbladder. The gallbladder is located on the right side of the abdomen, below the liver. Its main function is to hold digestive fluid (bile) which is then released into the small intestine. What causes cholelithiasis? It is unclear what causes gallstones to form, but scientists believe that there are three main reasons. First, if the liver excretes more cholesterol than the bile can dissolve, the excess cholesterol can turn into crystals and eventually stones. Second, gallstones can be produced when there is too much bilirubin in one's system. Bilirubin is a chemical produced when red blood cells are broken down, but certain conditions such as biliary tract infections can cause the liver to make an excess amount. Lastly, if the gallbladder does not empty often, this can lead to a higher bile concentration which contributes to the formation of gallstones. Who does cholelithiasis affect? Gallstones are very common and affect 10 to 15 percent of the US population, 25 million people. Certain groups are at a higher risk of developing gallstones: women, older aged people, those with high triglyceride levels, and low cholesterol levels. What are the types of cholelithiasis? There are two types of gallstones, cholesterol stones, and pigment stones. Cholesterol stones make up 75 percent of gallstones and are typically yellow-green. These types of gallstones are mainly made up of undissolved cholesterol but could include other components. Pigment gallstones are dark brown or black in color and form when your bile contains too much bilirubin. How does this affect people/symptoms? Silent gallstones can cause no sign or symptoms, but if it lodges in a duct and causes a blockage it can lead to agonizing pain in the upper, right abdomen which lasts several hours. Additionally, pain between the shoulder blades and vomiting can occur. How is cholelithiasis diagnosed? To diagnose cholelithiasis, doctors perform a series of tests to determine the number of gallstones and their location. These tests include blood tests, abdominal ultrasound, and endoscopic ultrasound. Blood tests are used to check for signs of blockage or infection, to rule out other possible conditions. An abdominal ultrasound involves moving a transducer across the abdomen. A transducer is a device that sends signals to the computer, which then creates images illustrating the structures within the abdomen. Endoscopic Ultrasound (EUS) is a procedure where a transducer is attached to a tube that goes through the mouth and digestive tract. The transducer can send signals which create precise images of the surrounding tissue, to identify smaller stones that may be lodged in a duct. How is cholelithiasis treated? Silent gallstones typically don’t need treatment, but if the pain intensifies some options include: medications or laparoscopic cholecystectomy. Medications are used to dissolve gallstones, but there are many complications as the treatment takes months or even years. Additionally, if the treatment is stopped, gallstones may reoccur again. When medications don’t work, the next option is laparoscopic cholecystectomy. This procedure involves removing the gallbladder so bile can directly flow to the small intestine. The gallbladder is not a necessary organ but without it, the body struggles to digest fat. How do you prevent cholelithiasis disease? To prevent cholelithiasis, it is important to lead a healthy lifestyle. This includes daily activity, eating fiber-rich foods, and avoid skipping meals.

Sources: “Definition & Facts for Gallstones.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Nov. 2017, www.niddk.nih.gov/health-information/digestive-diseases/gallstones/definition-facts. “Gallstones.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 23 Jan. 2021, www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214. “Gallstones: Picture, Symptoms, Types, Causes, Risks, Treatments.” WebMD, WebMD, www.webmd.com/digestive-disorders/gallstones. “Symptoms & Causes of Gallstones.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Nov. 2017, www.niddk.nih.gov/health-information/digestive-diseases/gallstones/symptoms-causes.