Some people may not be aware of an organ called “gallbladder” up until they have been diagnosed with gallstones. Gallstones resemble pebbles—they are hard clumps made up of bilirubin or cholesterol that may be as tiny as a grain of rice or as big as a pingpong or golf ball. Gallstones do not usually exhibit any symptoms, but when they do, an individual may feel an abrupt piercing pain around the upper right part of the abdominal area. When this happens, our recommendation is to remove the gallbladder at Alpine Surgical Practice.
Dr Aaron Poh, the Medical Director at Alpine Surgical Practice, is a specialist in General Surgery that is highly experienced in treating and removing gallstones. To understand the function of the gallbladder and conditions that affect it, this article will tackle the following topics:
- The gallbladder and its purpose
- Gallstones and how they are formed
- Ways to treat gallstones
The gallbladder and its purpose
The gallbladder is a tiny pocket that is located right under the liver. This is where the bile that is produced by the liver is kept. When our body consumes fats, the gallbladder releases the bile from its storage and sends it to the small intestine to aid in fat digestion.
Gallstones and how they are formed
Gallstones begin to develop inside the gallbladder once the chemical balance of the bile contained in the pouch gets disrupted. The main cause of this imbalance is not known yet, but researchers associate this occurrence to having an excess amount of bilirubin or cholesterol in the bile.
A person is at risk of developing gallstones when:
- They are past the age of 40
- They are in the obese spectrum
- They are diagnosed with cirrhosis of the liver
- They are diagnosed with diabetes or an intestinal disease
- They follow a diet that is low in fibre and high in fat
- They have a family history of having this condition
- They have no exercise
- They take medications to decrease the amount of cholesterol in their body
- They suddenly lose a huge amount of weight in minimal time
Women are at greater risk in getting this condition as compared to men, especially when they are pregnant, use hormone replacement therapy, or take birth control pills.
Gallstones can be classified into two:
- Cholesterol stones
- Pigment stones
A cholesterol stone is yellow-green in colour. This is the most common type of gallstones among patients. A pigment stone is made up of bilirubin. Its colour is darker than a cholesterol stone and is smaller in size.
Normally, gallstones can remain undetected unless they are discovered through routine medical examinations or when symptoms are present. These are the tell-tale signs that an individual may have gallstones:
- Bloating
- Heartburn
- Pain that is felt in the right part of the back or right shoulder
- Problems with digestion
- Searing pain that is felt in the upper right portion of the abdomen, slightly below the ribs
- Stomach pains
- Vomiting
It is imperative that an individual sees a doctor or rushes to the emergency room when the following symptoms are present:
- Abdominal pain that persists for a long time
- High fever and chills
- Jaundice (e.g. yellowing of skin and/or eyes)
- Stool is light in colour
- Urine is dark in colour
These signs indicate inflammation or a serious infection and the patient should get immediate treatment.
Ways to treat gallstones
Gallstones symptoms are similar to the signs experienced when one has appendicitis, gastroesophageal reflux disease (GERD), pancreatitis, or ulcers. It is important that an individual gets a thorough examination done by a medical expert in this field in order to reach an accurate diagnosis.
To diagnose this condition, a patient will undergo the following:
- A full review of one’s personal and family health history
- A physical exam
- Other tests that may be recommended by the doctor including:
- Blood tests
- Cholescintigraphy (HIDA scan)
- CT scan
- Endoscopuc retrograde cholangiopancreatography (ERCP)
- Endoscopic ultrasound
- Magnetic resonance cholangiopancreatography (MRCP)
- Ultrasound
Asymptomatic gallstones need no treatment. Tiny gallstones are processed and released by the body naturally, so it is safe to say that they are harmless. However, if the gallstones exhibit symptoms, then a treatment must be set in place in order to prevent the condition from getting worse.
There are two ways to treat gallstones:
- Laparoscopic cholecystectomy
- Open cholecystectomy
Cholecystectomy is a surgical procedure that uses medical tools for surgery and a small video camera. These are inserted through tiny cuts strategically made at four points in the abdominal area in order to remove the gallbladder.
Laparoscopic cholecystectomy is done by inserting a surgical device that is equipped with a tiny light and camera at one end. This device checks the gallbladder for gallstones. When present, these gallstones are then removed through one of the incisions. Open cholecytectomy, on the other hand, is carried out by removing the gallbladder if it is damaged, swollen, or shows signs of infection.
Medications can also be prescribed by doctors to dissolve gallstones in case a patient is not suited to undergo surgery. Unlike a surgical treatment, it will take a long time for gallstones to disappear through medicine alone. A lifestyle change will also be needed to back up this treatment. Regular exercise and skipping fatty foods can help, but they are not a guarantee that the gallbladder’s condition won’t worsen.
Final note on gallbladder removal
Removing the gallbladder from the body does not have any major effect other than experiencing stools that are watery or loose. This happens due to the less concentration of the bile that reaches the small intestine from the liver.
For people who no longer have gallstones, it is advisable that they switch to a healthier diet that consists of more fiber and less fats. Specifically, they should avoid foods that are creamy, oily, and high in refined carbohydrates and cholesterol.
Alpine Surgical Practice – Dr Aaron Poh, Consultant Surgeon
3 Mount Elizabeth
#17-16 Medical Centre
Singapore 228510
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