the wee hours of the night, you wake up with indigestion and a steady
pain in your upper abdomen. It quickly gets worse. When morning arrives,
it's still there, and in fact, has spread to your back, below your right
shoulder. Then nausea sets in. After a few hours, to your relief, the
pain and nausea subside—leaving you with a deeper sympathy for your
mother and grandfather, because you recognize the symptoms they used to
describe: You've inherited the family tendency toward gallstones.
Gallstones are made from bile—a liquid created in the liver and
stored in the gallbladder until it's needed to digest food. Bile can crystallize
into pieces of stony material, as small as a grain of sand or as big as
a golf ball. Gallstones can be found in the gallbladder or in any of the
ducts that carry bile between the liver, gallbladder, and pancreas. They
affect twice as many women as men, and though anyone can get them, they
often run in families.
And this is one family tradition you'd like to avoid!
Start by talking to your family physician about your symptoms. He or
she may order an ultrasound to see if you have gallstones. Ultrasound
uses harmless sound waves to make an X-ray-like image. The ultrasonographer
will slide a wand-like sound-wave transmitter over your upper abdomen,
and pictures of your gallbladder and surrounding organs will appear on
a monitor. Most stones can be seen with a routine ultrasound.
If this is your first attack, your family physician may prescribe medications
to dissolve your stones and possibly prevent them from coming back. He
or she will also recommend important dietary changes:
- Rule out fatty foods, especially saturated fats (the ones that are
solid at room temperature).
- Rule in high-fiber foods like whole grains, fruits, and vegetables.
If you continue to have gallstone attacks in spite of medication and
changing your diet, your physician may refer you to a gastroenterologist—a
specialist in digestive tract problems. This may also be necessary if
your symptoms continue, but no gallstones are found on your first ultrasound
"Sometimes the gallstones can't be seen by regular ultrasound," explains
Ingram Roberts, MD, chief of Gastroenterology at Bridgeport Hospital.
"Then more sophisticated tests are needed. One of the newest and most
effective is endoscopic ultrasound. For this test, the transmitter, in
the form of a flexible tube about half an inch in diameter, is passed
down the throat, while the patient is sedated for his or her comfort.
This enables us to take a closer look, and to reach places not visible
from outside the body."
Another new technique available at Bridgeport Hospital is endoscopic
retrograde cholangiopancreatography (koh-LAN-jee-oh-PANG-kree-uh-TAH-gruh-fee),
or ERCP. ERCP can not only locate, but also treat stones that have lodged
in the bile ducts.
With the patient under sedation, an endoscope—a long, flexible,
lighted tube—is passed down the throat. Through it, the physician
can see the inside of the esophagus, stomach, and duodenum (the beginning
of the small intestine). The physician guides the endoscope to the spot
where the ducts open into the duodenum, and then injects dye through it
so the ducts will show up clearly on X-rays. If the exam shows gallstones
in the ducts, the physician can often insert small instruments through
the scope to grasp and remove them.
If frequent gallstones lead to complications, such as cholecystitis or
pancreatitis (inflammation of the gallbladder or pancreas), surgery may
be the best option.
"The human body can get along quite nicely without a gallbladder, and
cholecystectomy (gallbladder removal) is one of the most common operations,"
says Bridgeport Hospital-affiliated surgeon Sean Duerr, MD, who was the
first physician in Connecticut to perform this procedure by "keyhole"
surgery. Keyhole, or laparoscopic, surgery means that instead of making
a large incision in the abdomen to reach the gallbladder, the surgeon
inserts tiny instruments through several small incisions. The result:
patients go home in one day instead of five, and recovery time is much
shorter than it used to be when your mother and grandmother needed this
Whether by medication, diet, surgery, endoscopy, or a combination of
the four, it should be possible for you to get rid of gallstones for good!
|Gallstones or Kidney Stones — What's the Difference?|
|Like gallstones, kidney stones are formed when a liquid crystallizes. However, kidney stones form in the urinary tract, while gallstones are found in the digestive tract. Here are the basic symptoms for each:|
|Severe pain in the lower back just under the ribs, lasting anywhere from a few seconds to a few hours, sometimes moving down into the groin area.
||Pain in upper right side, sometimes moving to upper back.
|Nausea and vomiting
||Nausea and vomiting
|Blood in urine
Only a qualified physician can determine what is causing your symptoms.
For a referral to an expert physician, call Bridgeport Hospital Services
Referral, 24/7, English/Spanish, at 888-357-2396.