Definition
Cholelithiasis is the presence of one or more calculi (gallstones) in the gallbladder.
A gallstone is a stone formed within the gallbladder out of bile components. The term cholelithiasis may refer to the presence of gallstones or to the diseases caused by gallstones. Most people with gallstones (about 80%) never have symptoms. When a gallstone blocks the bile duct, a crampy pain in the right upper part of the abdomen, known as biliary colic (gallbladder attack) can result.
This happens in 1–4% of those with gallstones each year. Complications of gallstones may include inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), jaundice, and infection of a bile duct (cholangitis).
Symptoms of these complications may include pain of more than five hours duration, fever, yellowish skin, vomiting, dark urine, and pale stools.
Diagnosis
Tests and procedures used to diagnose gallstones include:
- Tests to create pictures of your gallbladder. Your doctor may recommend an abdominal ultrasound and a computerized tomography (CT) scan to create pictures of your gallbladder. These images can be analyzed to look for signs of gallstones.
- Tests to check your bile ducts for gallstones. A test that uses a special dye to highlight your bile ducts on images may help your doctor determine whether a gallstone is causing a blockage.
- Tests may include a hepatobiliary iminodiacetic acid (HIDA) scan, magnetic resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure.
- Blood tests to look for complications.Blood tests may reveal an infection, jaundice, pancreatitis or other complications caused by gallstones.
Treatment
Most people with gallstones that don't cause symptoms will never need treatment. Your doctor will determine if treatment for gallstones is indicated based on your symptoms and the results of diagnostic testing.Your doctor may recommend you be alert for symptoms of gallstone complications, such as intensifying pain in your upper right abdomen. If gallstone signs and symptoms occur in the future, you can have treatment.Treatment options for gallstones include:- Surgery to remove the gallbladder (cholecystectomy). Your doctor may recommend surgery to remove your gallbladder, since gallstones frequently recur. Once your gallbladder is removed, bile flows directly from your liver into your small intestine, rather than being stored in your gallbladder.You don't need your gallbladder to live, and gallbladder removal doesn't affect your ability to digest food, but it can cause diarrhea, which is usually temporary.
- Medications to dissolve gallstones.Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way and gallstones will likely form again if treatment is stopped.Sometimes medications don't work. Medications for gallstones aren't commonly used and are reserved for people who can't undergo surgery.
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