MEDICAL NOTES

Gallstones may be painful, but are easily fixed

One in six women and one in ten men will develop gallstones during their lives, although many of them will never know it.

Gallstones occur in the gallbladder - a hollow, sausage-like structure found below the liver under the ribs on the right side of the abdomen. The gallbladder’s job is to store bile, a yellowish-green digestive fluid made by the liver. After a meal the gallbladder contracts, sending the bile down a tube - the common bile duct - into the intestine.

If the bile in the gallbladder is over-concentrated, little crystals may form. These can go on to form stones. There may be just one or two, or several hundred, stones in an affected gallbladder.

For some people, these stones cause no problem. But for others they can cause considerable pain, known as biliary colic.

This happens when the contracting gallbladder squeezes on a stone, or (more seriously) when a stone gets jammed in the bile duct.

This pain is typically felt after food, particularly fatty or greasy meals. Sometimes it will disturb sleep. The pain is usually felt under the ribs on the right, or in the back, or both.

Gallstones are usually diagnosed by ultrasound - a machine that makes a picture by bouncing sound waves through the body.

Treatment usually involves removing the gallbladder. There has been some success with drugs that dissolve gallstones but these often fail and are not pleasant to take.

Most cases are now dealt with by an operation known as laparoscopic cholecystectomy. In this, the gallbladder is removed via the laparoscope - a small tube inserted through the abdominal wall.

Other tubes are also inserted to allow a tiny television camera and other instruments to be used. The patient can often leave hospital within a day of the operation and be back at work in a week.

Not all cases can be done this way and the traditional operation is still necessary quite often. This also produces very good results but means a longer stay in hospital and a bigger scar on the abdomen.

It is used to be said that gallstones affected a group of people known as the “five Fs” - fat, fair, fertile, female and forty. But we now know that all types can be affected.

 
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