How to deal with troublesome gallstones

Although most people have never heard of them, they are relatively common in Kenya. As the name implies, these are stones found inside the gallbladder. They occur in close to one in every four women and one in every six men.

Where is your gallbladder?

The gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver.

The gallbladder acts as a storage container for a digestive fluid called bile. Bile is produced in the liver. After you eat, bile is released from the gallbladder into your small intestine where it helps to digest food (particularly fatty foods).

How do you get gallstones?

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Gallstones occur if your bile contains too much cholesterol or if it contains too much bilirubin (a waste product found after the destruction of blood cells).

They can also occur if your gallbladder doesn’t empty correctly.

What does it feel like to have gallstones?

Sometimes, gallstones are silent (produce no symptoms) and may remain so for many years. However, they may become troublesome. The most common complaint is abdominal pain (usually on the right upper side).

This pain usually comes and goes and can sometimes is felt in the back. In certain cases, one may develop yellowness of the eyes, nausea, vomiting and even fever.

Risk factors

For the longest time, gallstones were popularly referred to in the medical world as the disease of 4 Fs; fat, fertile, female aged over forty.

Other risk factors include; family history of gallstones, having diabetes, being pregnant, eating a high-fat or high–cholesterol diet, eating a low-fibre diet, losing weight very quickly, use of some cholesterol-lowering medications and hormonal therapy (especially use of oestrogen).

Liver disease and sickle cell disease may also increase your risk of getting gallstones.

How can my doctor confirm that I have gallstones?

Usually, an ultrasound is a good way of confirming whether or not you have gallstones. The advantage of ultrasound is that it does not expose you to any radiation.

Blood tests may be required if your doctor is concerned about gallstone complications.
Occasionally, the doctor may request for other tests such as CT scan or MRI scan or a special scan for the gallbladder/liver known as an ERCP.

Are there drugs to treat gallstones?
Yes, there are. Sometimes, medication may be given to try and dissolve small gallstones, but they do not always work. In addition, you need to take them for many months before any effect is seen.

How about surgery?

If your gallstones are causing constant pain or keep causing your gallbladder to get inflamed, you will probably need to have it removed.

This can be done through a traditional cut of the abdomen or through laparascopic methods (keyhole surgery) in which the surgeon cuts three or four small holes on the belly and uses a camera to help guide him to operate.

This method is associated with shorter hospital stays and quicker recovery after discharge. Keyhole surgery is currently available in Kenya.

Do all gallstones need treatment?

No. If your gallstones are not giving you any symptoms you usually do not need to get any treatment.

Are there any complications in having gallstones?

Gallbladders containing stones are more likely to get inflamed (painful and swollen) and infected than normal gallbladders.
Stones may also get into the digestive system and cause the intestines not to function properly. They may also block the various tubes that allow digestive juices to reach the intestines.

Although gallbladder tumour is rare, having gallstones puts you at a slightly higher risk than normal for developing gallbladder cancer (there is still research being done into the relationship between cancer and gallstones).

How does one live without a gallbladder?

Usually, one does not develop any problems after removal of the gallbladder. You do not need to take any vitamin supplements or any special medication.

Some people do, however, notice that they get bloated or go to the bathroom multiple times (to empty bowels) after they get their gallbladders removed.

In some cases, this may be improved by reducing the fat content in your meals (total fat elimination is not necessary).

This article was first published in the Business Daily .