Gall stones

Gall bladder problems include gall stones, gall bladder polyps or cancers.
A gallstone is a stone formed within the gallbladder as a concretion of components of bile. Gallstones are formed in the gallbladder due to infections or problems with bile solubility, they may also pass from the gallbladder into other parts of the biliary tract such as the cystic duct or the common bile duct. Occasionally gallstones can enter the small bowel and cause obstruction of bowel.
Gallstones may be asymptomatic and if the population is screened many people will be found to have gall stones. These do not require surgical treatment. Biliary colic is the characteristic symptom of gallstones with intense pain in the upper-right side of the abdomen, often accompanied by nausea and vomiting. The pain may radiate to the back or to the right shoulder. The attacks may occur after fatty meals or at night time.
Gallstones may also lead to cholecystitis. This is an inflammatory process leading to biliary stasis and infection of bile and thickening of gallbladder wall. Presence of gall stones in bile duct can lead to sever infection like cholangitis and blockage of pancreatic duct can cause life threatening pancreatitis.
All patients with gall stones do not require surgical treatment. Recurrent attacks of biliary colic, cholecystitis or complications associated with gallstones necessitate treatment.
Ursodeoxycholic acid has been used for dissolving gallstones but results are poor and recurrence is common. Acute cholecystitis is usaually treated with antibiotics. ERCP may be needed if a stone is stuck in the bile duct.
Laparoscopic cholecystectomy is the standard treatment for gallstones. It is accepted that early cholecystectomy can prevent repeated admissions and complications.

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