Gallstones can cause severe pain

Small Stones - Great Torments: Gallstones can cause severe pain

20/06/2013

Often, people do not know that stones have formed in their bile, because most of them do not cause any discomfort. However, they become dangerous when they lead to colic.

60 to 80 percent do not know that they have gallstones
Gallstones can form directly in the gallbladder or in the different bile ducts. In many cases, the gallstones go unnoticed for years, it comes to complaints, ranging from simple nausea to high-fat food to biliary colic, which can be very painful. Berndt Birkner from the Professional Association of German Internists in Wiesbaden, explains that about 26 percent of women and 18 percent of men over 40 have gallstones in Germany. But about 60 to 80 percent of those affected know nothing about it. One generally speaks of the risk group also of the „five F“: female, fat, fertile, forty, fair (female, overweight, fertile, forty years old, fair skinned or blonde).

If the stones do not cause discomfort, treatment is not necessary. Gallstones are caused by a disturbed mixing ratio of the bile juice that the liver produces. Gastro-Liga explains that about 80 percent of bile is water and also contains cholesterol, bile acids, bile pigment bilirubin, and lecithin and electrolytes. If too much cholesterol, bilirubin or calcium are added through the liver, these substances can form crystals that eventually form into stones over time. Bile cholesterol can also be increased by other factors: obesity, pregnancy, severe weight loss or even old age. Also influence on the mixing ratio may have longer periods of fasting, stress or irregular meals and thus promote gallstones.

Blood test and ultrasound
Other factors that can promote the development are high-fat diet, chronic constipation and lack of exercise. However, in many patients, the formation is also genetic. In the course of life, the gallstones are noticeable only in a quarter of those affected. Often, bloating, flatulence, or latent nausea may occur, but these symptoms may have other causes. If such nonspecific complaints occur, a doctor's visit is recommended. Anke Richter from the German Association of General Practitioners explains: „I ask every patient with upper abdominal complaints about illnesses in the family, about digestion and when the symptoms occur. "A blood test with liver and inflammation gives information and with the help of an ultrasound examination of the gallbladder, the stones can be seen immediately. „An anamnesis also includes a gastroscopy to rule out that the stomach is the cause. "Unambiguous symptoms that are beyond doubt, extreme pain in the right upper abdomen or in the pit of the stomach, which occur without notice, these feel as if the interior is simultaneously pulled apart and compressed.

Hours of pain caused by biliary colic
Nausea and vomiting sometimes accompany these conditions. Also in the back radiating pain and quite typical: pulling pain in the right shoulder. These are all signs of a biliary colic, which can last only 15 minutes, but also up to five hours. Such colic occurs when gallstones from the gallbladder slip into the bile duct and get stuck at the mouth into the duodenum. The pressure in the bile duct is thereby increased and the bile can not drain. Prof. Tilman Sauerbruch of the Gastro-Liga in Gießen explains: „Likewise, stones may also stick to the neck of the gallbladder as it contracts and delivers the bile to the bile duct and small intestine. "However, secretion from the gallbladder mucous membrane continues to build up, increasing the pressure in the gallbladder. English sludge) and so says family doctor Richter: „These gallstone crumbs are treacherous, because they slip easily into the bile duct and clog it just like a gallstone. "

Do not delay
Anyone who experiences the familiar symptoms would be ill advised if he postpones the problem. Sauerbruch advises: „If the colic lasts longer than an hour, a doctor should be consulted or the emergency doctor should be called.“ There is a risk of dangerous complications such as acute inflammation of the gallbladder, biliary tract or pancreas. („“) These risks must be clarified and in addition the doctor can relieve pain with medication. If the acute attack is over, the problem has not disappeared. According to the gastro-league, half of the patients in one colic are followed by another within a year, and the attacks often return as if out of the blue.

Removal of the gallbladder
Patients are often advised by doctors to remove the gallbladder. In such an operation, the organ is removed as part of a laparoscopy over three to four small cuts in the abdomen. Methods such as smashing the stones or dissolving them with medications are considered obsolete. It would form new stones within a short time, because the real problem, the disturbed mixing ratio of the bile juice, is not resolved. After the surgery, no special diet would be necessary and also no drugs are required for fatty foods. From the liver, the bile fluid flows through the bile duct into the intestine. Re-forming stones in the bile ducts is extremely rare. Rather, it is the case that the person affected can live a normal life again, without fear of another colic, but with more enjoyment. (Ad)