Gallstones

The gallbladder is responsible for storing the bile fluid produced by the liver. This fluid helps digest fats found in the foods we consume. Resembling a pear in shape, the gallbladder is located in the upper right part of the abdomen, just below the liver. It is one of the important components of the digestive system. Bile is a mixture of bilirubin, bile salts, and cholesterol. Gallstones are among the most common gallbladder problems. Generally harmless, gallstones can sometimes cause abdominal and back pain. Especially after consuming fatty foods, symptoms such as pain, nausea, and vomiting may occur. The widely used method for treating gallstones is the surgical removal of the gallbladder and gallstones. Op. Dr. İbrahim Çolhan, serving his patients in Adana, explained what gallstones are, their symptoms, and diagnosis and treatment methods. 

What is the Gallbladder?

The gallbladder is an organ responsible for storing and, when needed, secreting bile fluid produced by the liver, which aids in breaking down and digesting fatty foods. Resembling a pear in shape, the gallbladder is located in the upper right part of the abdomen. It is one of the important elements of the digestive system.

If there is an obstruction or damage in the gallbladder, pain and discomfort may occur.  Gallstones are among the most common health problems seen in the gallbladder.

What Does the Gallbladder Do?

The gallbladder stores and concentrates the bile fluid produced by the liver in the body, and when needed for digestion, it releases this fluid into the small intestine. This bile fluid facilitates the breakdown and digestion of fats in the foods we consume. It enables the body to obtain energy from these fats. It is one of the important components of the digestive system.

When we eat, the gallbladder delivers the bile fluid it stores to the small intestine via the bile duct. It secretes bile fluid according to the amount of fat consumed. If the gallbladder does not function as it should, bile fluid cannot reach the small intestine and begins to accumulate in the blood. This leads to the inability to digest fatty foods.

What Are Gallstones?

Gallstones are accumulations of cholesterol or bilirubin that build up in the gallbladder. They are hard, pebble-like bile deposits. They cause symptoms such as vomiting, nausea, and pain in the person. The severity of symptoms varies according to the size of the stone. If necessary, they can be treated with surgical intervention.

Why Do Gallstones Occur?

Gallstones form due to an excessive accumulation of bilirubin or a high level of cholesterol in the gallbladder. Insufficient bile salt or the inability of the gallbladder to empty completely can also lead to gallstones.

• High levels of cholesterol in the gallbladder
• Excessive accumulation of bilirubin
• Inability of the gallbladder to empty and its fullness can cause gallstones.

What Are the Symptoms of Gallstones?

If gallstones obstruct the bile duct, they cause severe pain in the upper right abdomen and around the rib cage. These pains can sometimes spread to the upper back. They lead to symptoms such as gas-related belching, nausea, and vomiting.

If gallbladder disease is present, symptoms such as the following occur, especially after consuming fatty foods:

• Suddenly developing and increasing pain complaints in the upper right abdomen
• Nausea and vomiting
• Pain radiating to the back and shoulder blade areas
• Heartburn
• Indigestion
• Belching
• Dark colored urine
• Jaundice in the skin and whites of the eyes
• Loss of appetite
• Light-colored stools
• Mild fever
• Increased heart rate
• Diarrhea

If gallstones start to move again, it means that the bile ducts are no longer blocked. In this case, the pain stops. However, if any of the bile ducts remain blocked for longer than a few hours, a pancreatitis attack can occur. In such cases, it is necessary to go to the hospital without delay.

What Are the Symptoms of Gallbladder Sludge?

When the gallbladder cannot empty completely, cholesterol monohydrate crystals, calcium bilirubinates, or various calcium salts in the bile can thicken to form gallbladder sludge. This can cause some symptoms in the patient. The most common findings in cases of gallbladder sludge are shoulder, upper right abdominal, and chest pain. If we need to list the symptoms of gallbladder sludge;

• Pain in the upper right abdomen
• Pain radiating to the shoulder area
• Accompanying chest pain
• Abdominal bloating
• Nausea
• Vomiting
• Fatty and clay-like stools

How Are Gallstones Diagnosed?

For gallstones, a physical examination is first performed by a specialist doctor. During this examination, color changes in the patient's eyes and skin are examined. The appearance of jaundice in the skin and whites of the eyes indicates an excessive amount of bilirubin in the person's body. If a yellowish tint is observed on the person's face, gallstones can be diagnosed. In addition to physical examination, the tests requested for gallstone diagnosis are as follows:

• Ultrasound
• Blood test
• Magnetic Resonance Cholangiopancreatography (MRCP)
• Endoscopic ultrasound
• CT Scan
• Cholescintigraphy

How Is Gallbladder Surgery (Cholecystectomy) and Treatment Performed?

Gallbladder surgery, usually performed using the laparoscopic surgical method, is located in the upper abdomen, just below the liver. It ensures that the bile produced by the liver is stored until it is needed for digestion. Gallbladder surgery is usually completed within one to two hours.

Even after the gallbladder is removed from the body with gallbladder surgery, the person can continue to live a healthy life.

Laparoscopic Cholecystectomy Surgery

In gallbladder surgery, laparoscopic cholecystectomy is generally preferred. Minimal incisions are made during the surgery, and a narrow tube called a laparoscope is inserted into the patient's abdomen. Images obtained with the small, lighted camera inside the tube guide the surgeon during the operation. The doctor removes the gallbladder from the body with special surgical equipment. Patients can be discharged on the same day after gallbladder surgery.

Open Cholecystectomy Surgery

In open cholecystectomy surgery, the surgeon makes larger incisions in the abdominal wall to remove the patient's gallbladder. After the surgery, the patient needs to be kept under observation in the hospital for a few days. Open gallbladder surgery is preferred if there is a bleeding disorder or severe gallbladder disease, or if the patient is overweight.

How to Prevent Gallstone Formation?

Here are the measures you can take to prevent gallstone formation in the gallbladder:

• Do not skip meals
• If you need to lose weight, lose it slowly and gradually
• Eat foods rich in fiber
• Maintain a healthy body weight