The gallbladder is an organ that is located on the inside on the right side of the stomach just below the liver and functions to store bile which can aid digestion. When a person experiences sudden pain due to the appearance of stones in the gallbladder, the condition is called gallbladder stone disease.
Types of gallbladder stones
Cholelithiasis is a disorder in which there are stones in the gallbladder. The presence of stones in the sac sometimes does not cause any symptoms or is asymptomatic but can also cause symptoms or be symptomatic, both mild, such as symptoms of stomach ulcers, which can cause severe symptoms such as jaundice and severe infection. Often patients feel that they have stomach ulcers or gastritis but do not get better by taking gastric medicine. Therefore it is important for us to be able to recognize gallbladder stones.
There are 3 types of gallbladder stones that we usually find, namely cholesterol stones, pigment stones / infection stones, or a mixture of cholesterol stones and infection . Cholesterol stones are the most common stones found in the gallbladder. Cholesterol stones are formed due to an excess of cholesterol compared to the amount of bile which is responsible for dissolving fat, resulting in supersaturation of bile and forming crystals which turn into stones over time. Pigment stones can be formed due to the release of bilirubin, a yellow substance resulting from the breakdown of blood, from the bile ducts whose water-insoluble components combine with calcium to form stones.
Risk factors for gallbladder stones
Risk factors for gallbladder stones include:
- Woman,
- Age over 40 years,
- Obesity,
- Likes to eat fatty foods, and
- Pregnancy history.
Signs and symptoms of gallbladder stones
Some patients with gallbladder stones feel nothing. The presence of stones is often found accidentally during other health checks. The main complaint of patients suffering from gallbladder stones is pain in the abdomen in the upper right area. Severe pain that comes and goes in the solar plexus or upper right side of the abdomen that radiates to the right back. Pain appears mainly 1-2 hours after eating, especially after eating fatty foods. Whenever pain appears, its duration can last from 30 minutes to 6 hours, sometimes accompanied by nausea and vomiting.
In addition to the above characteristics, it should be noted that the patient must immediately go to the hospital if there are symptoms of yellow eyes, urine/urine becomes like tea, feces/feces become pale in color. Sometimes accompanied by high fever. If this condition occurs, immediately go to the hospital for further treatment. This condition occurs due to a severe infection involving the bile duct or a stone that enters the bile duct and causes an obstruction to the flow of bile. It is hoped that the patient has undergone therapy or action before severe symptoms occur.
Examination of gallbladder stones
On physical examination, no abnormalities can be found in the stomach, but pain can also be felt when pressed in the solar plexus or in the upper right side of the abdomen. Sometimes there is fever, nausea, vomiting and the body turns yellow. The doctor will then recommend blood tests to see signs of inflammation and signs of bile duct obstruction. An important and fast radiological examination to make a diagnosis is abdominal ultrasound. If needed, further radiological examinations can be carried out in the form of MRCP (Magnetic resonance cholangiopancreatography) according to indications. MRCP is performed if there are symptoms of jaundice or increased blood bilirubin levels.
Governance
In gallstones that do not cause symptoms, management without surgery can be considered. The consideration depends on the benefits compared to the risks of the operation. What patients need to understand is that as long as there are stones in the gallbladder, these symptoms can recur. If gallstones cause complaints, the management is by surgery. With advances in technology, there are two options for surgery, open/conventional and minimally invasive/laparoscopic. The operation is performed mainly by laparoscopy if the hospital has facilities and there are doctors who are competent to perform laparoscopy, namely by making a small incision in the abdomen to insert a camera and equipment. other operations such as scissors and tissue holders for surgery. The advantage is that the surgical scar is minimal/small so that it is cosmetically better and the patient can quickly return to their activities. In conditions with complications, laparoscopic surgery can be converted / changed to surgery with wide incisions to be able to control complications.
Before getting gallbladder stones, it's a good idea to take some precautions such as a regular diet with balanced nutrition, not going on extreme diets, and maintaining an ideal body weight.
This article was written by dr. Seno Budi Santoso, Sp.B-KBD (Consultant Digestive Surgeon at EMC Pulomas Hospital).