What
are gall stones?--
Gall stones are the stones that form in the biliary system.
(system associated with the transport of bile). These could be small
or large. small ones are often silent & are excreted with bile
without any problem. Large ones can get lodged in the ducts &
cause a colic.
What
is bile ?-
Dead & worn out red blood cells in the body are broken down. The
hemoglobin in these cells is converted to compounds that constitute
the bile. Bile is formed in the liver &stored in the gall bladder
,transported to the intestines. This bile is essential for digestion
of fats.
Symptoms--
Pain
in the right upper abdomen.
Pain
may radiate to the right shoulder tip.
Belching,
flatulence, bloating sensation
These
symptoms are increased by fatty meal
Some
patients just complain of intolerance to fatty meal.
These
symptoms are recurrent in case of chronic cholecystitis.
How
are the gall stones diagnosed?
The
gall stones can be seen using ultrasonography.
Treatment--
Gall stone Surgery.
Surgery remains the best treatment symptomatic gall stones. Laparoscopic gall stone
surgery decreases the hospital stay, recovery time & is better
cosmetically.
ESWL--Extra
Corporeal Shock Wave Lithotripsy--
Contact
dissolution therapy
---Catheter is introduced into the gall bladder. Methyl tert butyl
ether is introduced & the gall stones are dissolved.
Oral
dissolution therapy---Ursedeoxycholic
acid is used. Taken orally, it helps to dissolve the gall stones.
Selection criteria include--small(<20mm in diameter) radiolucent
stone in functioning gall bladder. Side effects include diarrhea
& reversible elevation of hepatic enzymes.
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