Sometimes, when it comes to problems in the abdominal area, an ultrasound is not clear enough for a diagnosis. In such cases, an Endoscopic Retrograde Cholangiopancreatography (ERCP) may be performed. This procedure gives the doctor a clear view of the duodenum, bile duct, pancreatic ducts, gallbladder and papilla of Vater.

This procedure is usually performed under intravenous sedation without general anesthesia. This procedure involves the use of a duodenoscope, which can be described as a thin, long, flexible tube with a camera at one end. It also has a fiber optic bundle that transmits lights to the camera and a chip to transmit video images to a TV screen.

This is inserted through the patient s mouth and sent down the throat through the food pipe to the stomach and duodenum while the patient is lying on his or her back. The air pipe is left undisturbed so as to not interfere with the patient s breathing. Since the patient is not under general anesthesia, he or she can move and turn according to the doctor s needs. The papilla of Vater is a small nipple like structure with an opening to the bile duct and pancreatic duct. Once this has been identified, a small plastic catheter is passed through the duodenoscope into the bile duct or pancreatic duct through the papilla. Dye is then injected into the area and X-rays are taken of the bile ducts and pancreatic duct. In cases where a biopsy is needed, other instruments can also be passed through the endoscope. Plastic or metal stents can also be passed through this to relieve obstructions in the bile ducts and pancreatic ducts.

ERCP can be used to diagnose and treat a number of conditions in the liver, bile ducts, gall bladder, pancreas and papilla of Vater. These include:

  Blockage of the bile duct by gallstones, cancer, scars, tumors or compression from adjacent organs.

  Jaundice due to an obstructed bile duct. This can also cause light stools and dark urine.

  Persistent upper abdominal pain

  Unexplained weight loss and loss of appetite

  Diagnosing a Dysfunctioning Sphincter of Oddi within the Papilla of Vater

ERCP can also be used to confirm pancreatic cancer and cancer of the bile duct. Once the diagnosis is confirmed, the doctors can customize treatment according to the patient s needs.

Endoscopic Retrograde Cholangiopancreatography - Procedure and Results

Gallstone Pancreatitis is the result of a blockage in the pancreatic duct by a gallstone. Due to the blockage in the pancreatic duct, inflammation occurs and causes the problem to begin.

This can be a life-threatening situation and should be immediately checked. If the stones from the gallbladder travel down the common bile duct and get stuck at the sphincter, it can stop the outflow of all materials from the pancreas as well as the liver and become quite severe. There are a lot of risks involved when a person suffers from this issue. Rapid weight loss, high cholesterol levels, diabetes are a few of the risks of the disease.

Symptoms of Gallstone Pancreatitis
There are a number of symptoms like pangs of pain in the upper left abdomen and the back, swollen and tender abdomen, vomiting and nausea, increase in the heart rate, fever and more can be seen in a patient suffering from gallstone pancreatitis. Any individual who notices any of the following symptoms should get themselves checked immediately. Any pain in the upper abdominal area can be aggravated by eating foods which are high in fat as well.

Diagnosis of Gallstone Pancreatitis
In order to be completely sure about having gallstone pancreatitis, a number of tests are performed. Blood tests are followed by abdominal CAT scan to check for the inflammation of the pancreas. This also shows how severe the inflammation of the pancreas is. Sometimes abdominal ultrasound is also suggested as CAT scans are sometimes not as sensitive in identifying the problem. Once the problem has been detected, immediate treatment is recommended by doctors.

The Treatment of Gallstone Pancreatitis
The best treatment for pancreatitis is done in the initial stage of the problem. By avoiding taking in liquids and solid food up until the inflammation subsides is one of the best treatments. If the inflammation is relatively modest, the swelling can reduce in a few days by intravenous delivery of fluids for a couple of days.

1. If a CAT scan or MRI of abdomen suggest that a stone in present in the Common bile Duct (CBD), the an Endoscopic treatment referred as ERCP (endoscopic retrograde cholangio-pancreatography) is done. 

2. After the acute pancreatitis episode settles down, patient must undergo a Gall Bladder removal surgery. This is done as gall bladder is the factory of gall stones and patient is at-risk to another episode of Acute Pancreatitis.

In case of severe inflammation, fever and persisting pain, intravenous delivery of food should continue if oral intake of food does not start within 5 to 7 days. Anti-nausea medications are used to treat severe nausea and vomiting along with nasogastric tube. In certain cases, it is important to remove the gallstones from the bladder immediately while in some cases doctors suggest waiting for a period of 24-48 hours before starting the removal procedure. Sometimes a surgical removal of the gallstones is also required but only if the stones do not pass out of the system on their own.

All You Need to Know About Gallstone Pancreatitis

Gallstones are solid deposits/stones of digestive fluids that form in the gall bladder. The size of these stones varies from person to person. While some people may develop only one stone in the bladder, others may develop multiple gallstones simultaneously.

Signs you must watch out for-

Abdominal pain
Pain in the back or between the shoulder blades
Vomiting and nausea
Heartburn
Bloating and indigestion
Change in bowel movement
Dark urine
Fever and chills
Rapid heartbeat
Yellowish skin and pale eyes (Jaundice)
These are the most common symptoms that a person with gallstones encounters. One should consult the doctor right away upon experiencing these symptoms. If ignored for long, these signs can aggravate and lead to further complications.

Complications that may arise from gallstones-
There are quite a few complications of gallstones, including the following-

Cholecystitis- when gallstones become stuck at the neck of the gallbladder, it causes inflammation.
Obstruction in the pancreatic duct- a gallstone blocking the pancreatic duct can cause pancreatitis followed by intense abdominal pain.
Blockage in the bile duct- if the gallstones create a blockage in your bile duct, the outcome may be an infection or jaundice.
Gallbladder cancer- people, who have a history of gallstones, are more likely to develop gallbladder cancer.
Treatment of Gallstones-
Gallstones can certainly be treated, if diagnosed early in time. To confirm the diagnosis, your doctor may perform a CT scan, X-ray, Ultrasound or an ERCP. Once the condition is diagnosed, your doctor will recommend a surgery to remove the stones in the gallbladder (known as Cholecystectomy). The preferred choice of surgery includes the following-

Laparoscopic removal- In most of the cases, the doctor adopts this minimally invasive approach to remove gallstones. First, he makes a small incision in the abdomen. He will then insert a tube-like instrument with an attached camera into the gallbladder to have a clear sight of the gallstones, and surgically remove them from the gallbladder.
Open surgery- This is performed under general anesthesia. During this procedure, a single, long incision of roughly 3-6 inches is made on the upper side of your right abdomen. The tissues and muscles are pulled back to divulge the gallbladder. The gallstones are then removed, and the incision stitched up. Open surgery is performed when laparoscopic surgery is not suitable for the patient.
Gallstones cannot be managed with just diet and medications. A surgery is usually needed to remove the stones and cure the patient. For Laparoscopic surgery, the rate of success is nearly over 95%. Identify the symptoms before it aggravates, and consult a doctor for treatment.

Gall Stones - Is Surgery The Only Treatment?

Diet and other lifestyle factors such as lack of exercise and high waist-hip ratio are seen to be the significant contributing factors of certain medical conditions, gallstones one among them. Gallstones have become a highly prevalent issue in India, with an increasing number of patients reporting abdominal pain and discomfort. And it is also seen to be more common in females than in males. If your doctor suspects this problem, then he would proceed with the diagnosis and treatment as applicable.

How are gallstones treated?
If gallstones are not leading to any signs or symptom, then in such cases the treatment is not required. However, if an individual suffers from any symptoms or a gallbladder attack, then the health care provider normally recommends undergoing surgery. This surgery is used for removing the gallbladder. Sometimes, the individual may not be in a condition to undergo surgery and, in such cases, conventional treatment may be used for curing the disorder.

The surgery for the removal of the gallbladder is known as the cholecystectomy and is one of the most common surgical interventions performed for people with gallstones. The gallbladder is not considered to be a significant organ in the human body. This means that an individual can easily survive without the gallbladder. As the gallbladder is removed, bile starts flowing out of the liver through common and hepatic bile ducts without creating any issues.

What are the surgical options required for removal of gallstones?
There are two types of surgeries used for removal of stones in the gallbladder. These are explained below.

Laparoscopic cholecystectomy: In this surgery, the surgeon makes small incisions in the abdomen for the insertion of a laparoscope, which has a tiny camera attached to it. This camera enables a magnified image to be sent to the video monitor so that the surgeon can see the tissues and organs clearly. At the same time, the surgeon uses certain instruments for carefully separating the gallbladder from the liver, bile ducts and other organs. Then the gallbladder is carefully removed through one of the small incisions. This is the most suitable options for the removal of the gallbladder since it is performed on an outpatient basis, which means that the patient can go home the same day.
Open cholecystectomy: This is done when the gallbladder has severe inflammation or infection or scars from different operations. This may also be performed at the time of the laparoscopic cholecystectomy. In such cases, the surgeon switches to open cholecystectomy as a safety means for the patient.
What to expect after the procedure?
A small percentage of the patients have softer and more frequent stools after the removal of the gallbladder. These changes in bowel habits are normally temporary, and they are required to be consulted with the expert.
Since the incidence of gallstones is found to be related to gallbladder cancer, it is essential to work with your doctor to avail proper treatment and avoid such dire complications.

Surgical Option To Remove Gallstones - Know Which One Will Be Better For You!

Surgery using a laparoscope is the most common way to remove the gallbladder. A laparoscope is a thin, lighted tube that lets the doctor see inside our belly. It is a minimally invasive surgery in which small incisions and specialized tools are used to remove a diseased or infected gallbladder.

The gallbladder is a small organ that sits right under the liver and is credited with bile storage, which can help the body in breaking down various kinds of fats that enter it. So, what all do you need to know about this operation? read this list.

Reasons for gallbladder operation
The gallbladder is not a very efficient organ. It can lead to blockages and choking as the bile it stores can become very thick and difficult to handle. Also, this bile can harbour deposits that are hard ball like substances, usually known as gallbladder stones. The size of these stones can vary from the size of a grain to the size of a golf ball. 

Further, these gallbladder stones can cause infections, which can lead to symptoms like nausea, vomiting, bloating and more. Another reason can also be the gallbladder disease known as chloelithiasis, which can cause abdominal pain. Inflammation in the pancreas, also known as pancreatitis, can lead to gallbladder open removal surgery.

Risk
While the gallbladder removal surgery is usually considered a safe one, with little or no complications, there are risks attached to this surgery too. These include sudden and excessive bleeding and the creation of blood clots, allergic reactions to the drugs used as well as anaesthesia, blood vessel damage, accelerated heart rate which leads to an increased risk of contracting a heart attack or heart disease, infections, inflammation or swelling in the pancreas, and injuries caused to the bile duct during surgery.

You might also need this type of surgery if you have the following:
1. Biliary dyskinesia, which occurs when the gallbladder doesn't fill or empty correctly due to a defect
2. Choledocholithiasis, which occurs when gallstones move to the bile duct and potentially cause a blockage that prevents the gallbladder from draining
3. Cholecystitis, which is an inflammation of the gallbladder
4. Pancreatitis, which is an inflammation of the pancreas

Laparoscopic surgery is preferred over open cholecystectomy surgery because the smaller incisions that are made reduce your risk of infection, bleeding, and recovery time.

Preparation
To prepare for your gallbladder removal surgery, the doctor may ask you to have a prescription fluid so that your bowels are flushed clean. You may also be asked to fast for at least six hours before the surgery so that there is no hindrance to the same. Also, the use of an antibacterial soap to bathe is usually prescribed so that the risk of contracting infections decreases.

While this surgery can be a simple one, you will have to take due care after the surgery to ensure that the recovery is fast and virtually pain free.

All About Gallbladder Surgery

Gallstones can be the cause behind quite some pain and discomfort if not treated by an Ayurvedic medical expert. This helps you get over the ailment before it can inflict any more pain. Before learning about the treatments for the condition, it is important to learn what exactly is a gallstone? A gallstone as the name suggests is a peculiar stone-like formation found in the gall bladder. The stones vary in size and number from person to person and are mainly constituted from bile components that settle inside gallbladder. Gallstones as mentioned above are only stone-like formations and not really stones. They are formed from the cholesterol, bilirubin and salt contained in the bile.

How are gallstones diagnosed?
In the majority of cases, it becomes impossible to detect whether a person has gallstones or not. It is only when the stones close or block a specific duct and become the cause for inflicting some pain, does the chance of the presence of a gallstone crosses the mind. In case one is undergoing similar pain in the stomach, it is advised that you make your way immediately to an Ayurvedic medical expert, who will help you to recover from the condition with 100% natural medicines and treatments, with no side effects whatsoever.

Different types of Gallstones:
Another thing to be noted, before you start treatment for gallstones, is their type. There are distinctly two different types of gall stones. These are-

Pigment Stones: Pigments stones are smaller in size compared to the cholesterol stones and are usually larger in number and darker in colour. The main building component of these pigment stones is bilirubin. The bilirubin, in turn, comes from the bile, which is an enzyme secreted by the liver and carried into the gallbladder to be stored there.
Cholesterol Stones: The Cholesterol stones, on the other hand, are the most common kind of gallstone there is. 80% of the times, patients are detected to have cholesterol stones. These stones are characterised with a yellowish green colour.
Causes leading to Gallstone:
Only when gallstones reach a particular size or an overwhelming number that they start blocking ducts, which in turn cause the pain. But what results in the formation of these gallstones? There are a number of things that can lead to the formation of these stone like formations in your gallbladder. Some of these reasons include-

Increase in weight
A non-efficiently functioning gallbladder
Following a wrong diet
Over consumption of cholesterol rich food
Genes, and most commonly
Bile
While these are the common causes for bile stones, the most common causes of pigment stones are certain kinds of medical conditions, such as- sickle cell anaemia or other blood diseases and cirrhosis of the liver.

Ayurvedic cures for Gallstones:
According to Ayurveda, there are three doshas, namely the Kapha, pitta, and Vata, which lead to the formation of gallstones. Opting for Ayurvedic treatment helps you eliminate the requirement of harsh allopathic medication or for that matter surgery. The three major point covered by Ayurvedic treatment for gallstones include- modification in diet, herbal and all natural Ayurvedic medication and detoxification.

Ayurvedic gallstone treatment includes detoxification, herbal medications and diet modifications. A common therapy is a liver flush, which can include olive oil, lemon juice and spices. Citrus fruits, vitamin C, tumeric and ginger may assist with reducing cholesterol in the gallbladder to prevent its buildup. You can also place a castor oil pack over the gallbladder area to purportedly alleviate pain and inflammation, improve circulation and promote healing of damaged tissues.

Naturopathic Treatment for Gallstones:
Gallstone treatment requires altering carbohyderate and lipid metabolism of the entire body, especially of the liver. This will mostly involve changing the foods you eat, as well as adding specific supplements to encourage particular biochemical paths in the body. The details of this process consist of three major categories of actions.

Normalize bile composition leaving the liver
Dissolve existing gallstones in the gallbladder
Prevent the reabsorption of bile and cholesterol in the small intestine
Naturopathic treatment will start with a high-quality nutrition program made to reduce your body's tendency to produce excess cholesterol. It will also use a variety of nutritional supplements to break up fat deposits in the liver. Still other agents, both herbs and supplements, can dissolve existing gallstones. The exact details will vary from one individual to another depending on your medical history. As always in Naturopathic Medicine, the treatment program is customized to you and your individual situation. 

Gallstones - Know The Different Types!

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