Where Are Gallstones Located
To understand whether gallstones pass through urine or stool, you have to imagine the gallbladders location and anatomy of the gallbladder .
Gallstones are small-sized . They form inside the gallbladder .
The gallbladder serves as a storage site for bile produced inside the liver. Your gallbladder contracts after meals to empty its contents of bile to the duodenum.
When a small stone is formed inside the gallbladder, it may pass through the bile ducts into the duodenum.
The duodenum is the first part of your small intestine. Contents of the duodenum travel throughout the intestine to reach the colon and finally pass out as a stool.
A Sign You May Need Your Gallbladder Removed
Gallbladder polyps are growths on the inside of the gallbladder wall. They show up on ultrasounds, often when healthcare providers are investigating unrelated problems.
Most of the time, they’re nothing to worry about. But people with big polyps have a higher risk of developing gallbladder cancer, Dr. Silverman said.
“I would emphasize that these are very large polyps, not tiny ones,” Dr. Silverman added.
As a preventative measure, a healthcare provider may recommend gallbladder removal.
How Gallbladder Stone Pain Differs From Kidney Stone Pain
Gallbladder stone pain can be easy to mistake for kidney stone pain. Thats because both conditions can cause stomach discomfort and share other symptoms. The similarities extend further between kidney stones and gallbladder stones, which are also known as gallstones. Both can be as small as a grain of sand, or much larger. Both can cause blockages that disrupt important bodily functions. There is also a connection between gallstones and kidney stones. Gallbladder stones may increase the risk of kidney stones and vice versa, according to a study in the journal Nature.
Can gallbladder pain be mistaken for kidney stones? Telling the difference comes down to knowing where else besides the stomach discomfort is coming from, as well as what symptoms they dont have in common. Imaging plays a key role in diagnosing both conditions. In fact, gallbladder stones and kidney stones are two things ultrasound can detect.
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Complications Of Gallbladder Disease
Without treatment, gallbladder problems can become life-threatening. Gallbladder disease can cause infection that may spread to other parts of the body. Its important to seek immediate medical attention if you experience an unexplained fever. This may be a sign of infection.
A bile duct blockage can cause jaundice. Yellow-tinted skin is a warning sign that you may have a blockage in your bile duct. Chronic diarrhea is also a complication of gallbladder disease.
Laparoscopic Exploration And Cholangiography
Surgeons are now increasingly using laparoscopy with cholangiography instead of ERCP when common duct stones are suspected. Laparoscopy with cholangiography should only be done in centers with expertise in this procedure. This procedure should be done for the following reasons:
- As an alternative to ERCP before gallbladder surgeries, when there is a high suspicion of common bile duct stones.
- During gallbladder surgeries when common duct stones are detected or highly suspected.
The procedure usually involves the following steps:
- The initial approach is the same as with laparoscopic cholecystectomy. One or two 10 to 12 mm incisions and three 5 mm incisions are made in the abdomen.
- A tiny opening is made in the cystic duct that connects the gallbladder to the bile duct, and a thin tube is introduced to perform a cholangiography.
- If stones are identified, the surgeon inserts a tube with an inflatable balloon to widen the duct.
- Stones are usually retrieved or withdrawn from the duct with either a balloon or tiny basket.
- If laparoscopy is unsuccessful, ERCP or open surgery is performed.
Experts are debating whether this procedure is better than ERCP. Many surgeons believe that laparoscopy is becoming safe and effective, and should be the first choice of treatment. Still, laparoscopy for common duct stones should be performed only by experienced surgeons.
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When Surgery Is Recommended
Once gallstones start causing problems, they are likely to continue forming and causing pain. In the majority of those cases, we would recommend surgical removal of your gallbladder. There is no other data-driven effective way to dissolve or remove gallstones, said Dr. deWolfe.
Gall bladder removal surgery is called a cholecystectomy and is one of the most common surgeries in America.
To determine if you need the surgery, you will likely have a blood test and an ultrasound. Further testing could include an MRI scan using a special dye to help clinicians see any blocked ducts, a HIDA scan to test your gallbladder function, and/or an endoscopy, which involves threading a tiny scope with a video camera attached into your digestive tract to get a detailed picture of the small intestine.
If your medical team determines surgery is necessary, the most common procedure is done by laparoscopic surgery, which is minimally invasive with a shorter recovery time, said Dr. deWolfe.
The procedure requires several small cuts in the abdomen through which a surgeon inserts a tiny scope with a video camera and surgical tools to locate the gall bladder and remove it. This is typically an outpatient procedure, and patients can go home afterward.
In some instances, your surgeon may recommend a more traditional surgery called an open cholecystectomy.
Either way you will likely never miss having a gall bladder.
Learn more about gallstones and acute pancreatitis.
Gallstones: How The Gallbladder Works
You know the gallbladder can be removed. So, what exactly is the gallbladder and how can it be removed and the body continue functioning properly?
The gallbladder is a small organ located just below your liver on the right side of the body. This organ holds a fluid called bile, which is formed in the liver and helps the body digest fats and some vitamins.
When you eat, your body signals the gallbladder to release bile to your small intestine to help you digest the food.
But while the gallbladder plays this key role in digestion, the body can function without one. If the gallbladder is removed, bile is stored in the bile ducts, which are the pathways bile travels from the liver to the small intestine.
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A Analgesic Abuse For Biliary Colic Is A Common Cause Of Kidney Affection
Gallstones itself doesnt affect kidney function. However, people with recurrent biliary colics may abuse analgesics such as ibuprofen or ketorolac. Analgesic overdose may affect your kidneys.
Chronic analgesics may affect your kidney function. Also, using a large dose of a Non-steroidal Anti-inflammatory medication such as ketorolac may result in acute kidney injury.
Be cautious with analgesics, and dont overdose unless prescribed by your doctor. Painkillers are riskier in patients with chronic kidney diseases or diabetes and hypertension.
Gallstone And Urine Color
As we mentioned before, uncomplicated gallstones dont change the urine color.
However, gallstones may slip into the narrow canal connecting the gallbladder to the duodenum . Some may pass into the duodenum, while others may get stuck inside the CBD and cause its obstruction.
The obstruction of the common bile duct will prevent bile secretion from the liver to the gut tract .
The obstruction of bile secretion from the liver will increase bilirubin levels in the blood, which results in:
- Darker color of your urine
- Yellowish discoloration of the skin.
- Yellowish discoloration of your eye whites.
- Triggering of biliary pain .
- Infection of the biliary system .
Changes in urine color is the only urinary symptoms associated with complicated gallstones. Gallstones dont lead to other urinary symptoms such as burning urine or increased urine frequency.
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How Gut Flora Can Impact Your Health
So wait, bacteria in the body can be a good thing? Absolutely! Your relationship with gut flora is primarily symbiotic, meaning both you and the bacteria benefit. Healthy colonies of gut flora in your digestive tract benefit your body in many ways, from proper digestion to a healthy immune system. If you follow easy steps on how to improve microbiome balance, youll benefit by supporting your health overall.
What Is The Skins Natural Ph Level
A healthy skin microbiome has a pH level of 5, which is slightly acidic to curb the growth of pathogens on the skin.
In case you donât remember from highschool chemistry, the term âpHâ in pH level refers to the âpotential of hydrogenâ and is measured on a scale of 0 to 14.
Levels ranging from 0 to 6 are considered acidic, levels from 8 to 14 are considered fundamental, and a pH of 7 is considered neutral.
However, it is essential to remember that the skinâs pH keeps on changing according to a personâs:
- Or when using harsh soaps and topical solutions.
Therefore, it is always recommended to use skincare products that are gentle and do not compromise the skinâs average pH level.
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Dietary Changes After The Gallbladder Removal Surgery
Here are a few dietary changes to avoid discomfort after gallbladder removal:
- Add solid food to your diet plan gradually: For the first few days after surgery, stick to a liquid diet. Then, gradually move to solid food in your routine.
- Go for a low-fat and smaller portion of meals: Avoid fried foods, high-fat foods, and take small frequent meals.
Eating the wrong things after gallbladder surgery can induce pain, bloating, and diarrhea. Consider reintroducing high-fiber food gradually- nuts, legumes, broccoli, cabbage, cauliflower, and cereals. Immediately including such a diet can lead to diarrhea, cramping, and bloating.
Common Gallbladder Disease Symptoms
In many cases, gallbladder disease can cause significant pain, typically following meals that contain fat. Sticking to a low-fat diet is one approach to easing gallbladder pain. However, doing so doesnt address the root of the problem you may need to have your gallbladder removed. Some of the most prominent symptoms of gallbladder disease include:
Gallbladder pain usually occurs in the middle to upper-right part of your abdomen. In some people, the pain is severe and frequent, while others may experience mild pain that comes and goes.
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What Tests Are Used To Diagnose Cholelithiasis
Ultrasound: An abdominal ultrasound is a simple and noninvasive test that requires no preparation or medication. Its usually all thats needed to locate gallstones. However, it doesnt visualize the common bile duct very well. If your healthcare provider suspects theres a gallstone hidden in there, they might need to use another type of imaging test to find it.
MRCP:Magnetic resonance cholangiopancreatography is a type of MRI that specifically visualizes the bile ducts. Its non-invasive and creates very clear images of your biliary system, including the common bile duct. Your provider might use this test first to find a suspected gallstone there. But if theyre already pretty sure its there, they might skip it and go straight to an ERCP.
ERCP: ERCP stands for endoscopic retrograde cholangiopancreatography. This test is a little more invasive, but its a useful one for finding gallstones because it can also be used to remove them from the ducts if they are stuck there. It uses a combination of X-rays and endoscopy, which means passing a tiny camera on the end of a long tube down your throat and into your upper GI tract.
__Endoscopic retrograde cholangiopancreatography can diagnose and sometimes treat gallstones.
Endoscopic ultrasound passes through the mouth to the common bile duct and gall bladder.
Bile And The Gallbladder
The formation of gallstones is a complex process that starts with bile, a fluid composed mostly of water, bile salts, lecithin , and cholesterol. Most gallstones are formed from cholesterol.
- Bile is important for the digestion of fat. It is first produced by the liver and then secreted through tiny channels that eventually lead into a larger tube called the common bile duct, which leads to the small intestine.
- Only a small amount of bile drains directly into the small intestine, however. Most flows into the gallbladder through the cystic duct, which is a side branch off the common bile duct. This system of ducts through which bile flows is called the biliary tree.
- The gallbladder is a 3 to 4-inch sac with a muscular wall that is located under the liver. Here, most of the fluid is removed from the bile , leaving only a few tablespoons of concentrated bile.
- The gallbladder serves as a reservoir until bile is needed in the small intestine to digest fats. This need is signaled by a hormone called cholecystokinin, which is released when food enters the small intestine.
- Cholecystokinin causes the gallbladder to contract and deliver bile into the intestine. The force of the contraction propels the bile down the common bile duct and into the small intestine, where it emulsifies fatty molecules.
- This part of the digestive process enables the emulsified fat, along with important fat-absorbable nutrients , to pass through the intestinal lining and enter the bloodstream.
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Immediately After Gallbladder Surgery
After a gallbladder operation, you can expect to:
- feel mild pain in your shoulder from the carbon dioxide gas
- receive pain-relieving medications
- be encouraged to cough regularly to clear your lungs from the general anaesthetic
- be encouraged to walk around as soon as you feel able
- stay overnight in hospital, if you had a laparoscopic cholecystectomy
- stay up to eight days in hospital, if you had open surgery.
What Causes Gallstones
Gallstones may form if bile contains too much cholesterol, too much bilirubin, or not enough bile salts. Researchers do not fully understand why these changes in bile occur. Gallstones also may form if the gallbladder does not empty completely or often enough. Certain people are more likely to have gallstones than others because of their risk factors for gallstones, including obesity and certain kinds of dieting.
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What Is Cholecystitis
Cholecystitis is a swelling and irritation of your gallbladder, a small organ in the right side of your belly near your liver.
The gallbladderâs job is to hold a digestive juice called bile. It releases bile into your small intestine when your body needs it to break down fats. But if the path to your small intestine is blocked, bile gets trapped. That backup can irritate your gallbladder. Thatâs how cholecystitis happens.
Nausea and vomiting are common symptoms. They often show up after youâve eaten a big or especially fatty meal.
Itâs easy to mistake cholecystitis for other health problems, but another telltale sign is intense pain — in your belly, in your back, or under your right shoulder blade.
If you donât see a doctor and get treatment, it can lead to dangerous infections or become a long-term condition. The most common solution is surgery to remove your gallbladder.
Who Else Is At Risk
Certain populations are predisposed to gallstones, Dr. Silverman said, including the Pima Indians in Arizona. But most cases aren’t related to genetics, Dr. Silverman added.
You are more likely to develop gallstones if you have obesity, especially if you are a female, have had fast weight loss, such as from weight-loss surgery, or have been on a diet high in calories and refined carbohydrates and low in fiber.
You are also more likely to develop gallstones if you have one of the following health conditions:
- Cirrhosis, a condition in which your liver slowly breaks down and stops working due to chronic, or long-lasting, injury
- Hemolytic anemias, conditions in which red blood cells are continuously broken down, such as sickle cell anemia
- Some intestinal diseases that affect normal absorption of nutrients, such as Crohn’s disease
- High triglyceride levels
- Metabolic syndrome, which can also raise the risk of gallstone complications
- Diabetes and insulin resistance
The majority of people who get gallstones don’t have any of the major known risk factors, Dr. Silverman said. “That would suggest that there are many things that we still really don’t understand.”
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Risk Factors In Women
Women at all ages are much more likely than men to develop gallstones. Gallstones occur in nearly 25% of women in the United States by age 60, and as many as 50% by age 75. In most cases, they have no symptoms. In general, women are probably at increased risk because estrogen stimulates the liver to remove more cholesterol from blood and divert it into the bile.
Pregnancy
Pregnancy increases the risk for gallstones, and pregnant women with stones are more likely to develop symptoms than women who are not pregnant. Surgery should be delayed until after delivery if possible. In fact, gallstones may disappear after delivery. If surgery is necessary, laparoscopy is the safest approach.
Hormone Replacement Therapy
Several large studies have shown that the use of hormone replacement therapy doubles or triples the risk for gallstones, hospitalization for gallbladder disease, or gallbladder surgery. Estrogen raises triglycerides, a fatty substance that increases the risk for cholesterol stones. How the hormones are delivered may make a difference, however. Women who use a patch or gel form of HRT face less risk than those who take a pill. HRT may also be a less-than-attractive option for women because studies have shown it has negative effects on the heart and increases the risk for breast cancer.
What The Doctor Says About Gallstones
There are a couple different types of gallstones cholesterol and pigment. Cholesterol gallstones contain undissolved cholesterol, while pigment gallstones are darker and occur when bile contains excess bilirubin. See a doctor if youre experiencing pain so intense you cant get comfortable, or if you notice any yellowing of the skin or a fever with chills.
If you are experiencing any of the above symptoms, talk with your doctor. If you think you may be experiencing kidney stones or need a second opinion book an appointment with Erlanger Urology today.
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