gallstones, Dr. Dave

[Guest guest]

An interesting letter from:

http://www.drdaveanddee.com/gallstones1.html

Of coures, he is just an MD, do not expect from an MD any reference to

flush, diet, watercure, lecithine, lamon-oliveoil, flaxseed oil-cottage

cheese, herbs, castor oil packs, Epsom salt, and the other similar

" quackery " .

Quite many people with inflamed gallbladder manage to cure it with better

diet and flush.

-----------------------------------------------------------

Dear Dr. Dave,

I'm confused. I've had abdominal pains for a number of years. Recently my

doctor diagnosed me with gallstones. She referred me to a surgeon who

recommended elective surgery. I can't decide whether or not to have the

surgery. I've been told that's the only way to fix the problem. What's the

gall bladder for? Do they have to take out the whole thing, or can they

just remove the stones?

Signed,

Confused

Dear Confused,

Having gallstones doesn't always mean that surgery is indicated. The need

for urgent intervention depends largely on the location of the stones, and

whether or not the gallbladder is inflamed. If the stones have moved from

the gallbladder and are blocking vital organs such as the liver or

pancreas, or if the gallbladder is inflamed, then urgent intervention is

indicated.

But most of the time, people with gallstones aren't experiencing any of

these complications. They have intermittent bouts of abdominal pain, which

may be brought on by a fatty meal. The pain may last a number of hours, but

then spontaneously goes away as mysteriously as it came, and stays gone for

a period of days, weeks or months. These painful episodes with no other

complications are called " biliary colic " .

Surgery for simple biliary colic is usually elective. Whether or not to

have surgery for simple biliary colic is up to the individual patient. The

benefits of getting rid of the intermittent pain episodes must be carefully

weighed against the risks of having surgery. The only way to make this

decision is to be completely informed. Always make sure and obtain from

your physician a detailed explanation and analysis of the potential risks

and benefits of any medical or surgical procedure before going ahead.

WHAT IS THE GALLBLADDER?

The gallbladder is a small pouch, located beneath the liver, which stores

bile. Bile is produced by the liver and is used by the body to aid in the

digestion of fat. After a fatty meal such as a nice big pizza, the

gallbladder contracts, ejecting its bile contents into a small duct which

leads to the intestinal tract. When the bile gets into the intestine it

helps dissolve fat in the food, which makes it easier for your body to

absorb it.

WHAT ARE GALLSTONES?

Normally there are no solid particles in the bile, so bile flows easily

through the duct down to the intestine. But some people form gallstones

which may have the potential, at some time, to block flow through the duct.

Gallstones are formed from tiny crystals which form in the bile when there

are imbalances in the concentration of the substances which make up the

bile. Gallstones grow slowly over a period of months and years. They may be

the size of grains of sand, pebbles or marbles. They tend to lay on the

bottom of the gallbladder where they can go unnoticed for years.

But one day, when the gallbladder contracts after a fatty meal and ejects

its bile, it may also eject a stone. If the stone obstructs the bile duct,

then this causes the immediate onset of severe abdominal pain. The pain

will persist until the obstruction is relieved.

SURGERY DEPENDS ON LOCATION:

With gallstones, as in real estate, it's " location, location, location. "

How sick you become, and whether or not you need to undergo surgery or a

procedure, depends on where the stone gets stuck.

Pain from a gallstone which obstructs only the opening at the top of the

gallbladder will tend to be transient, lasting only until the gallstone

drops back into the bottom of the gallbladder. This may take minutes or

hours. But when the stone drops back down to the bottom of the gallbladder

the pain disappears (biliary colic episode).

Stones which pass out of the opening at the top of the gallbladder and

enter into the bile duct system can be an entirely different story. The

stone can get stuck anywhere in the duct between the gallbladder and

intestine . If it gets stuck in a location which blocks the liver or

pancreas , then it's a major problem (common bile duct stone).

Common bile duct stones blocking the liver or pancreas can make a person

seriously ill, and usually require urgent intervention. Common bile duct

stones may be removed surgically, or by a procedure called ERCP.

These conditions need to be ruled out. That's one of the reasons why it's

always important to go be seen by a doctor if you're experiencing abdominal

pain. Your doctor will know which tests need to be done to rule out serious

conditions.

CAN THEY JUST REMOVE THE STONES?

Generally, removal of gallstones from the gallbladder, without removing the

gallbladder, hasn't yet proven effective. Removal of the gallbladder

(cholecystectomy) remains the usual treatment for gallstones. The body

seems to get along well enough without the gallbladder, since, after it's

removal, bile still flows normally from the liver to the intestine.

Cholecystectomy may be performed through an operating scope placed through

tiny incisions in the abdomen, without opening the abdomen (laparoscopic

cholecystectomy). In some cases the old fashioned open surgery may be

needed. This is done through a fairly large abdominal incision. Recovery

time from laparoscopic cholecystectomy is a faster process than from open

cholecystectomy.

INFLAMMATION OF GALLBLADDER:

How sick a person becomes also depends on whether or not their gallbladder

is inflamed. Acute inflammation or infection of the gallbladder, called

cholecystitis, is a serious condition. Acute cholecystitis is an indication

for removal of the gallbladder.

Painless gallstones in bottom of gallbladder.

Painful gallstones: location, location, location.