Gallstones: Symptoms, Causes, Treatment and Cost

Gallstones are lumps or stones that form in the bile duct or gallbladder when specific chemicals solidify.

Gallstone pain, also known as biliary colic, is a type of abdominal pain that occurs when a gallstone becomes stuck in a bile duct. The bile duct is a small tube that carries bile, a digestive fluid produced by the liver, to the small intestine. When a gallstone becomes stuck in the bile duct, it can block the flow of bile, causing pain and other symptoms.

The pain associated with gallstones is usually severe and may come on suddenly. It may be described as a steady, cramping pain in the upper right abdomen, or it may be more severe and come in waves. The pain may also radiate to the back or the right shoulder blade.

In addition to pain, other symptoms of gallstone blockage may include nausea, vomiting, bloating, and fever. The symptoms may be worse after eating a meal, especially one that is high in fat.

Abdominal pain is one of the gallstones' most prevalent symptoms. A constant, extreme pain that frequently affects the upper right part of the abdomen in females with gallstones may also radiate to the back or shoulder blades.

Gallstones can make you feel nauseous. These signs and symptoms are frequently accompanied by abdominal pain and may get worse after eating fatty or oily foods.

The skin and eyes turn yellow under the diagnosis of jaundice. Gallstones may occasionally block the bile duct, which can result in an accumulation of the yellow pigment bilirubin in the blood. Jaundice may occur as a result of this and may be followed by pale stools and dark urine.

Women who have gallstones may feel bloated and uncomfortable in the belly, frequently with indigestion. These signs and symptoms can appear after eating, and they might become worse after eating fatty foods.

Cholecystitis, often known as gallbladder inflammation, can often be caused by gallstones. Fever, chills, and a generalised feeling of being sick may result from this.

• Do keep a healthy weight. Ask your doctor for assistance with modest, steady weight loss if you are overweight.
• If you have pain that you think might be brought on by gallstones, please inform your doctor. Get in touch with your doctor straight away once you are experiencing pain and a fever.

• Don't consume meals that are excessively large, heavy in fat, or that irritate your stomach. In response to fatty foods, the gallbladder contracts and may force a stone into the duct. Even more crucially, after eating a low-fat diet, stay away from meals heavy in fat.
• Don't go on a crash diet or a prolonged fast.

To allow a dye to concentrate in the gallbladder or bile ducts, an ERCP involves injecting it directly into the bile ducts or into the circulation. Ink is visible on X-rays.

The doctor will then be able to examine the X-rays and spot any gallbladder or bile duct conditions that might exist, like pancreatitis, pancreatic cancer, or gallstones. The X-rays will show the doctor whether the dye is getting to the gallbladder, intestines, liver, and bile ducts.

If the dye does not penetrate any of these regions, a gallstone is likely to be blamed for the obstruction. The gallstone's location will be more clear to an expert.

The ERCP procedure can be used by the doctor to find and get rid of bile duct stones.

This non-invasive X-ray creates images of the interior of the human body in cross-section. It helps the doctor in finding out if there is a gallstone in the gallbladder.

A modest dose of safe radioactive material is administered by a medical professional. This is taken up by the gallbladder, which is then induced to constrict by a medical expert. This examination could reveal aberrant gallbladder contractions or a bile duct occlusion.

If you think you may have gallstones, it is important to see a doctor for a proper diagnosis and treatment. Some types of doctors who may be able to diagnose and treat gallstones include:

• Primary care doctor: Your primary care doctor, such as a family medicine doctor or internist, can diagnose and treat gallstones. They may also refer you to a specialist if necessary.
• Gastroenterologist: A gastroenterologist is a doctor who specialized in the digestive system. They may be able to diagnose and treat gallstones or refer you to a specialist if necessary.
• General Surgeon: A surgeon may be involved in the treatment of gallstones if surgery is needed to remove the gallbladder or the stones.

There are several treatment options for gallstones that do not involve surgery:

• Medications: Medications called bile acid sequestrants can help dissolve cholesterol stones in the gallbladder. They may be recommended for people who have a high risk of developing gallstones or who have had multiple episodes of gallstone pain. These medications are usually taken by mouth and may take several months to work.
• Shock wave lithotripsy: This procedure uses shock waves to break up the stones into smaller pieces that can be passed through the bile ducts. It is typically used for stones that are too large to be dissolved with medication.
• Endoscopic retrograde cholangiopancreatography (ERCP): During this procedure, a small camera is inserted through the mouth and into the small intestine to visualize the bile ducts. The doctor can then remove the stones using specialized instruments.
• Other procedures: Other procedures that may be used to remove gallstones without surgery include percutaneous cholecystostomy (in which a small tube is inserted through the skin and into the gallbladder to remove the stones) and laparoscopic cholecystectomy (in which a small camera is inserted through a small incision in the abdomen to visualize and remove the stones).

It is important to note that these treatment options may not be suitable for everyone and may not be effective in all cases. Your doctor can help determine the most appropriate treatment option for you based on the size and type of the stones, your overall health, and other factors.

Bile acids found in the medications ursodiol link (Actigall) and chenodiol link (Chenix) help dissolve gallstones in some cases. Small cholesterol stones are the hardest to dissolve with these medications. To remove all stones, you might require months or years of treatment.

There are several surgical procedures that may be used to treat gallstones:

• Cholecystectomy: This is the most common surgical procedure for treating gallstones. It involves removing the gallbladder, which is the small organ located below the liver that stores bile. The gallbladder is not essential for digestion, so it can be removed without causing any major problems. Cholecystectomy can be performed through traditional open surgery or through laparoscopy, in which a small camera is inserted through a small incision in the abdomen to visualize the gallbladder and remove it using specialized instruments.
• Common bile duct exploration: This procedure is used to remove stones that are stuck in the common bile duct, a small tube that carries bile from the liver to the small intestine. The surgeon can remove the stones using specialized instruments or a small basket inserted through an endoscope (a thin, flexible tube with a light and camera on the end).
• ERCP (endoscopic retrograde cholangiopancreatography): This procedure involves inserting a small camera through the mouth and into the small intestine to visualize the bile ducts. The doctor can then remove the stones using specialized instruments.
• Shock wave lithotripsy: This procedure uses shock waves to break up the stones into smaller pieces that can be passed through the bile ducts. It may be used in combination with other procedures or as a standalone treatment.

There are two main types of cholecystectomy: open cholecystectomy and laparoscopic cholecystectomy. Both types of surgery involve making an incision in the abdomen to access the gallbladder.

During open cholecystectomy, the surgeon makes a large incision in the abdomen to access the gallbladder. The gallbladder is then carefully dissected free from the surrounding tissue and removed through the incision.

During laparoscopic cholecystectomy, the surgeon makes several small incisions in the abdomen. A small camera, called a laparoscope, is inserted through one of the incisions to visualize the gallbladder. Specialized instruments are then inserted through the other incisions to remove the gallbladder.

Both types of cholecystectomy are typically performed under general anesthesia, which means you will be asleep during the procedure. The surgery typically takes 1-3 hours to complete, depending on the complexity of the case.

After the surgery, you will be taken to a recovery room to be monitored. You may experience some pain and discomfort in the incision site and may need pain medication. Most people are able to go home within a day or two of the surgery. It is important to follow your doctor's instructions for post-surgery care, including taking any prescribed medications and avoiding strenuous activity until you have fully recovered.

Your abdomen is incised four times by the surgeon during a laparoscopic cholecystectomy. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. Your surgeon removes your gallbladder while using surgical instruments placed through additional abdominal incisions while keeping an eye on a video monitor in the operating room.

If your surgeon suspects gallstones or other issues with your bile duct, you may next go through an imaging test like an X-ray or ultrasound. You are then brought to a recovery area once your incisions have been sutured. A laparoscopic cholecystectomy can be done in one to two hours.

For some people, a laparoscopic cholecystectomy is not recommended. In rare circumstances, your surgeon may start with a laparoscopic technique and end up needing to create a bigger incision due to problems or scar tissue from prior surgeries.

During an open cholecystectomy, the surgeon makes a 6-inch (15-centimeter) incision in your abdomen on the right side, just below your ribs. Your liver and gallbladder are made visible after the muscle and tissue are pulled back. Your surgeon then removes the gallbladder.

You are then brought to a recovery area when the incision is sutured. In one to two hours, an open cholecystectomy is performed.

Pristyn Care uses the most advanced technology at its disposal to treat the patients of gallstones. They have a team of highly experienced surgeons and a great success rate in gallbladder surgery.

Typically, doctors would postpone surgery until an infection has begun to be treated by antibiotics and gallbladder inflammation has subsided. However, the study discovered that postponing surgery for longer than 72 hours resulted in a higher likelihood of problems and lengthier hospital admissions.

The average hospital stay is up to five days. Returning to regular activities can take about 3 to 4 weeks, and 6 to 8 weeks if your job is more physically demanding. In any case, you will need to make plans for somebody to transport you home from the hospital.

The cost of gallstones treatment in India can vary depending on several factors, including the type and severity of the condition, the type of treatment recommended, and the location of the hospital or clinic.

According to estimates, the cost of gallstones treatment in India can range from a few thousand rupees to several lakh rupees. Some specific costs may include:

• Medications: The cost of medications to dissolve gallstones can range from a few hundred to a few thousand rupees, depending on the type of medication and the length of treatment.
• Endoscopic retrograde cholangiopancreatography (ERCP): The cost of this procedure, which involves inserting a small camera through the mouth and into the small intestine to visualize the bile ducts and removing the stones, can range from around 50,000 to 1 lakh rupees.
• Shock wave lithotripsy: The cost of this procedure, which uses shock waves to break up the stones into smaller pieces that can be passed through the bile ducts, can range from around 50,000 to 1 lakh rupees.
• Laparoscopic cholecystectomy: The cost of this surgery, which involves removing the gallbladder through several small incisions in the abdomen using a small camera and specialized instruments, can range from around 50,000 to 2 lakh rupees.
• Open cholecystectomy: The cost of this surgery, which involves making a large incision in the abdomen to access and remove the gallbladder, can range from around 50,000 to 2 lakh rupees.

It is important to note that these estimates are general and may vary depending on the specific circumstances of your case. It is best to discuss the cost of treatment with your doctor or a hospital representative to get a more accurate estimate.

About 50% of patients who receive bile acid treatment experience stone recurrence within the first five years. Nevertheless, symptoms don't usually return and retreatment isn't always necessary. After cholecystectomy, a small proportion of patients may develop gallstones again in the bile duct.

Anyone diagnosed with gallstones can undergo the treatment. If you have pre-existing illnesses and take certain medications, let the doctor know in advance.

The following post-treatment recommendations should be followed for the best outcomes:

1. Afterwards, take a break: For two to three days, indulge your stomach with a simple-to-digest food. After introducing clear liquids, broth, and gelatin, progressively incorporate solid foods.
2. Choose smaller servings and avoid the menu items that are deep-fried: Large meals and high-fat foods might cause discomfort and bloating as your body adjusts to digesting fats without the help of a gallbladder. Your digestive system can tolerate smaller, lower-fat meals better spread out throughout the day; six is a good number.

   Avoid eating the following things in the weeks that followed gallbladder surgery:

   • High-fat meats, such as bologna, sausage, and hamburger
   • Cheese, ice cream, whole milk, and other high-fat dairy products
   • Pizza
   • Cream soups or sauces and meat gravies
   • Chocolate
   • Chicken or turkey skin

   Additionally, as they are more difficult to digest during your early healing phase, we advise you to stay away from foods with a lot of spice. To reduce fat and enhance flavour, stir-fry lean meats like skinless chicken breasts or lean steaks in a skillet with a spoonful of olive oil rather than deep-frying them.

3. Introduce foods that cause gas gradually: Although high-fiber foods are an essential component of a healthy diet, they may exacerbate the discomfort and cramps that might follow a cholecystectomy. While we don't advise you to avoid consuming fibre, we do advise incorporating it gradually into your post surgical diet over the course of a few weeks.

Foods that are natural gas producers and high in fibre include:

• Whole-grain bread
• Nuts and seeds
• Legumes
• Brussels sprouts, broccoli, cauliflower, and cabbage
• Some breakfast cereals, such as bran flakes

Keep in mind that one to four weeks after your cholecystectomy, any digestive side effects should go away. If your problems persist after 30 days, it's important to see a doctor.

You should say that the side effects arise very rarely and do not occur at all if the surgery has been done by a good surgeon. The benefits of the surgery simply outweigh the rare side effects it may cause. Moreover, the chances of these side effects are way less if the surgery is done by a good surgeon.

You might experience some abdominal gas and gas pain following laparoscopic surgery. After ERCP, this can also be performed. Both procedures inflate your organs and make them more visible in pictures by pumping gas into them. It will go in a day or so. Although they are rare, post-operative consequences can include hemorrhage, infection, and harm to the organs in the surrounding area.

While certain gallstone risk factors can be influenced by food, others are less so. Age, race, sexual orientation, and family history are examples of uncontrollable risk variables.

• Obesity-related risk factors in lifestyle
• A low-fiber, high-fat, or high-cholesterol diet
• Shedding pounds quickly
• Having type 2 diabetes nowadays
• Risk factors for having a girl child and being of Mexican or Native American ancestry
• Having gallstones running in one's family
• Being at least 60 years old
• Medical danger signs having cirrhosis and getting pregnant
• Taking certain drugs to reduce cholesterol
• Taking prescription drugs high in estrogen (like certain birth controls)

Despite the fact that some medications may raise your risk of gallstones, you shouldn't stop taking them before talking to your doctor and getting their approval.