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Overview for Dietary and Lifestyle or Treatment info
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Gallstones are formed in the
gallbladder as stones from cholesterol, bile salts and calcium. They
are present in 10-20% of the population and are most common in women,
particularly those who are overweight. Most of these stones remain in
situ and cause no clinical problems. Problems arise when they move out
into the cystic duct where they tend to become impacted causing inflammation
of the gallbladder (cholecystitis).
Gallstones come in two main types:
The cholesterol stone, composed mainly of cholesterol, accounts for
80% of all stones removed from patients in the Western world. These
stones form in the presence of bile, which has an excess of cholesterol
relative to bile salts and other constituents.
Pigment stones, are mainly composed of compounds containing bilirubin
polymers and calcium bilirubinate complete the second category.
Symptoms of gallstones may include:
Acute cholecystitis results in constant severe pain in the upper
right abdomen near the ribcage. This pain usually radiates to the back
and commonly to the tip of the right shoulder and is often accompanied
by a high temperature. There may be vomiting, jaundice and certainly
nausea. On examination the classical Murphy's sign can be elucidated
- pain under the right ribcage which is worse on inhalation. Acute cholecystitis
patients may not necessarily have gallstones but often do. Urine will
be examined for any change in colour and further investigations in hospital
may be arranged. If jaundice is marked, indicating an almost certain
obstruction, urgent admission to hospital will be carried out.
Chronic cholecystitis which is also known as biliary colic is
a chronic inflammation of the gallbladder. It is often found in association
with the gallbladder but, may not produce symptoms and therefore, removal
of the gallbladder is not advocated unless the condition proceeds to
the acute phase. Symptoms include pains in the center the upper abdomen,
or on the right side below the ribs. Nausea and vomiting may sometimes
present. The pain can radiate to in between the shoulder blades or the
right shoulder. Episodes may be, but are not always triggered by eating
fatty foods.
Jaundice may result if there is blockage of the flow of bile
to the liver. It presents as a yellowing of the skin and whites of the
eyes. Pale stools and dark urine may also be features. Not all cases
of jaundice are due to gallstones.
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