Symptoms
Gallstones manifest as pain and cramping below the breastbone and in the right upper abdomen. The pain may also radiate to the back and shoulders. Biliary colic with stones in the bile ducts causes unbearable discomfort. Possible complications include inflammation of the gallbladder, bacterial infection, fever, blockage of the bile ducts with jaundice, inflammation of the bile ducts, and inflammation of the pancreas. However, many gallstone carriers are asymptomatic and have no health disorders.
Causes
The cause of symptoms is precipitation and resulting solid deposits in the area of the gallbladder or bile ducts. Gallstones look like pebbles and are often composed of cholesterol and, less commonly, bilirubin (pigment stones) and calcium. A number of risk factors are known. These include:
- Age
- Overweight, little physical activity
- Female sex, estrogens
- Heredity
- Pregnancy
- Rapid weight loss
- Certain diseases
Diagnosis
The diagnosis is made in medical treatment, among other things, on the basis of the patient’s history and with imaging techniques (eg, ultrasound). Other conditions that may cause chest pain must be ruled out. These include, for example, dyspepsia, gastric or intestinal ulcer, liver abscess, and cardiovascular disease such as myocardial infarction.
Nonpharmacologic treatment
Stones are removed by surgical methods. The most common method is surgical removal of the gallbladder using an endoscope (laparoscopic cholecystectomy). If gallstones are discovered by chance and do not cause symptoms, they often do not need to be removed. Watchful waiting is then considered the method of choice.
Drug treatment
Pain medications such as NSAIDs, opioids, and spasmolytics are used for drug treatment of pain. For drug dissolution and prevention of cholesterol-containing gallstones, ursodeoxycholic acid is used in very rare cases. However, drug therapy is less successful than surgical removal and recurrences are to be expected. Therefore, it is not considered the method of choice. So-called “liver flushes” with Epsom salts, olive oil and grapefruit juice are not suitable for the treatment of gallstones! Although they lead to greenish stones in the stool, these are not the gallstones, but a mixture of stool and oil. In addition, the intake of oil may aggravate the symptoms.
