Gallstones form in the gallbladder and common bile duct, structures used by the body to transport digestive enzymes. In case of abnormalities, they can form in and around the gallbladder. Their diameter varies from a few millimeters to several centimeters and, generally, they do not cause symptoms. Many factors can contribute to the formation of gallstones, including metabolic mechanisms, heredity, immune system disorders, and environmental problems. The diagnosis is made by paying attention to the almost imperceptible symptoms that accompany them and to the pathologies that are at their origin. However, you should consult your doctor to get an accurate diagnosis and adequate therapy.
Steps
Part 1 of 4: Recognizing the Symptoms of Gallstones
Step 1. Keep in mind that gallstones are mostly asymptomatic
They can last for decades without causing any negative effects. In most cases, there is no incontrovertible symptomatology when suffering from this pathology. In fact, only 5-10% of patients develop certain symptoms. This aspect can complicate the investigation if there is some suspicion, so it is necessary to consult your doctor to obtain an accurate diagnosis.
Less than half of people with gallstones have symptoms
Step 2. Notice if you have biliary colic
Patients may experience recurrent pain in the upper right abdomen (located in the right upper quadrant) or in the lower frontal area of the sternum (epigastric pain). The malaise can be persistent and accompanied by nausea and vomiting. Known as "biliary colic", it usually lasts just over 15 minutes and can sometimes radiate to the back.
- Often, after the first biliary colic, other episodes occur which usually disappear on their own. Therefore, you may only get sick a few times a year.
- This symptom can easily be confused with other gastrointestinal or abdominal pain.
- If you think you are suffering from biliary colic, consult your doctor.
Step 3. Pay attention to how you feel after a large or high-fat meal
Find out if you have abdominal pain and / or biliary colic after eating something heavy, such as a plate of bacon and sausage or a Christmas dinner. It is on these occasions that symptoms tend to manifest.
Some patients are able to tolerate minor biliary colic unaccompanied by signs of infection without medical intervention
Step 4. Notice if severe abdominal pain spreads to your back or shoulders
It is the main symptom that indicates inflammation of the gallbladder, often caused by gallstones. Usually, it gets worse when you inhale.
You may feel this pain especially between the shoulder blades and the right shoulder
Step 5. Check if you have a fever
Inflammation of the gallbladder is a much more serious condition than biliary colic and fever is the best way to distinguish them based on their severity. You should see your doctor right away if you suspect gallbladder inflammation.
- Generally, it develops in 20% of patients, with a higher incidence in diabetic subjects.
- It can involve gangrene and perforation of the gallbladder.
- Fever may also be accompanied by jaundice, which presents with yellowing of the whites of the eyes (the sclera) and skin.
Part 2 of 4: Learn About Risk Factors
Step 1. Pay attention to age
The risk of developing gallstones increases as you age. In fact, the incidence of stones increases between the ages of 60 and 70.
Step 2. Consider the sex
In women, the likelihood of a diagnosis of gallstones is higher than in men (two to three times more). 25% of women suffer from this pathology around the age of 60. This imbalance between the sexes is attributable to the effect of estrogen, present in greater quantities in female subjects. In other words, they stimulate the liver to eliminate cholesterol which agglomerates in the form of stones.
Women on HRT are at a higher risk of developing gallstones due to the estrogen they take. Hormone therapy can even double or triple this probability. Likewise, the birth control pill can also promote the formation of gallstones due to the effect it produces on female hormones
Step 3. Be aware that pregnancy can also have an impact
The risk of suffering from gallstones increases if you are pregnant. Also, pregnant women are more likely to experience symptoms, such as those listed above, than those who are not pregnant.
- See your doctor right away if you suspect you have biliary colic or gallbladder inflammation.
- Gallstones can disappear after pregnancy without surgery or drug therapies.
Step 4. Pay attention to inheritance
Northern Europeans and Hispanics are high-risk groups. In some Native American peoples, particularly in the indigenous peoples of Peru and Chile, there are cases of individuals suffering from gallstones.
Consider your origins. If there is or has been a relative in the family with gallstones, the likelihood of developing this disease is higher. However, studies regarding this risk factor are not yet definitive
Step 5. Consider your health or medical conditions
Consult your doctor if you have Crohn's disease, cirrhosis of the liver or hematological diseases, as these are all factors that put you at risk of gallstones. Organ transplantation and prolonged parenteral nutrition can also promote gallstone formation.
In addition, the risk of developing both gallstones and cholecystitis, even in the absence of stones, increases in people with diabetes, possibly due to weight and obesity
Step 6. Be aware that a certain lifestyle is also a risk factor
Obesity and crash diets have been found to increase the risk of gallstones by 12-30%. In fact, in obese subjects, the liver produces a greater amount of cholesterol which makes up about 20% of the stones. In general, the fact of gaining weight and losing weight frequently can promote their formation. The risk is greater in people who lose more than 24% of their body weight or more than 1.3 pounds per week.
- In addition, even a diet high in fat and cholesterol can cause the formation of cholesterol-based gallstones (they are the most common and have a yellow appearance).
- If you don't play sports and lead a sedentary lifestyle, you are at a higher risk of gallstones.
Step 7. Note that some medications can affect the development of gallstones
The use of birth control pills from an early age, hormone replacement therapy with high doses of estrogen, recurrent use of corticosteroids or cytostatic drugs, and medicines that serve to lower cholesterol can increase the risk of developing this condition.
Part 3 of 4: Diagnosing Gallstones
Step 1. Get an abdominal ultrasound
It is the best test for detecting and distinguishing gallstones. It is a painless diagnostic imaging test in which ultrasound produces an image of the soft tissue in the abdomen. An experienced technician can locate gallstones in the gallbladder or common bile duct.
- This test can detect gallstones in approximately 97-98% of people.
- The procedure involves the use of a machine that reconstructs the image of the gallbladder by refracting sound waves against the organs of the body. The sonographer will apply some gel on the abdomen to allow the ultrasound to pass through the body and more accurately detect any abnormalities. It is painless and typically lasts 15-30 minutes.
- You should fast for at least 6 hours before the exam.
Step 2. Make an appointment for a computed tomography (CT) scan
If the doctor needs images in sections of the area or if the ultrasound did not produce clear frames, a CT scan may be needed. This diagnostic exam generates a cross-sectional image of the gallbladder using special (ionizing) radiation that is processed by a computer.
- You will be asked to lie down inside a cylindrical machine that will scan the body for about 30 minutes. The procedure is painless and almost quick.
- In some cases, the doctor may order an MRI instead of a CT scan. This is an imaging test similar to computed tomography, but which captures temporary changes in the position of atomic nuclei to recreate a three-dimensional map of internal organs. It can last up to an hour, during which you will have to lie inside a special cylindrical machine.
- A CT scan doesn't guarantee anything more than an ultrasound, other than the fact that it can distinguish a stone in the common bile duct, the channel that carries bile from the gallbladder to the intestine.
Step 3. Get a blood test
If you suspect an infection in the abdomen, you can have a blood test called a complete blood count. It helps you determine if there is a widespread infection in the gallbladder that may require surgery. In addition to infections, it can also detect further complications caused by gallstones, including jaundice and pancreatitis.
- This is a normal blood sample. A nurse will use a small needle to acquire a blood sample which will be analyzed in the laboratory in order to provide the information requested by the doctor.
- Typically, an increase in white blood cells and a high C-reactive protein value indicate acute cholecystitis, which is inflammation of the gallbladder that could be caused by gallstones. Your doctor may prescribe these tests together with the electrolyte panel to complete the blood count.
Step 4. Undergo endoscopic retrograde cholangiopancreatography (ERCP)
Your doctor may recommend an ERCP, an invasive technique whereby a flexible, finger-thick tube is introduced into the mouth and along the digestive tract to examine portions of the stomach and intestines. If any gallstones are found during this examination, they can be removed.
- Tell your doctor about all medications you are taking, especially if you are taking insulin, aspirin, blood pressure pills, Coumadin (warfarin), heparin. They can interact with blood clotting during some procedures, so you are likely to be instructed to change your intake.
- Due to the invasiveness of this technique, you will be sedated and will need to be accompanied by someone who can take you home once the exam is over.
Step 5. Eliminate gallstones with liver function tests
If your doctor has already prescribed tests for you for cirrhosis or other liver diseases, at the same time he could check if there is any imbalance due to problems with the gallbladder.
- You can undergo liver function tests with a blood sample to get more guidance on the diagnostic hypothesis of gallstones.
- Your doctor will check your bilirubin, gamma glutamyl transpeptidase (GGT or gamma-GT) and alkaline phosphatase levels. If these values are high, you may be suffering from gallstones or another gallbladder problem.
Part 4 of 4: Preventing Gallstones
Step 1. Lose weight slowly
If you are trying to lose weight, do not follow any crash diets. Try to eat healthy and balanced, including plenty of fresh fruits and vegetables, complex carbohydrates (such as wholemeal bread, pasta, and rice), and protein. Your goal should be to drop 450-900g per week, no more.
By losing weight slowly but steadily, you can reduce the risk of developing gallstones
Step 2. Decrease your consumption of animal fats
Butter, meat and cheese are foods that can raise cholesterol and promote the onset of gallstones. If the lipid and cholesterol index is high, there is a risk of the formation of yellow cholesterol stones, which are the most common.
- Instead, opt for monounsaturated fats. They raise the level of "good cholesterol", which in turn helps reduce the risk of gallstones. Choose olive and canola oil over saturated animal fats, such as butter and lard. Omega-3 fatty acids, found in canola, flaxseed, and fish oil, can also help reduce the risk of this condition.
- Nuts also contain healthy fats. According to some research, it is possible to inhibit the formation of gallstones by consuming peanuts and nuts, including walnuts and almonds.
Step 3. Eat 20-35g of fiber per day
Consuming fiber helps reduce the risk of this pathology. Among the foods that are rich in it, consider legumes, nuts and seeds, fresh fruit, vegetables and whole grains. You shouldn't have a hard time getting enough of these nutrients through diet alone.
However, you can also consider taking fiber-based supplements, such as flaxseed meal. To dissolve it quickly, pour a heaping teaspoon into 240 ml of apple juice
Step 4. Choose your carbohydrates carefully
Sugar, pasta and bread can contribute to the formation of gallstones. Opt for whole grains, fruits, and vegetables to lower the risk of gallstones and cholecystectomy (ie, the removal of the gallbladder).
According to some research, there is a relationship between high carbohydrate intake and increased incidence of gallstones, because carbohydrates are converted into sugars in the body
Step 5. Drink coffee and alcohol in moderation
Some research suggests that moderate consumption of coffee and alcohol (a couple of drinks per day) can decrease the risk of gallstones.
- Caffeine stimulates the contractions of the gallbladder and lowers cholesterol in the bile. However, according to research, other caffeinated and theine-containing drinks, such as tea and sodas, don't seem to have the same effect.
- Studies have found that, in some people, at least 30ml of alcohol per day can reduce the risk of gallstones by 20%.
