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

The gallbladder can be found under the liver and is a pear shaped organ. This four inch organ is responsible for storing bile, which is a combination of the various fluids as well as fat and cholesterol. These are essential for the body and its metabolism, as the bile helps in breaking down the food that enters the digestive system. With the help of the gallbladder, this bile divides the food into smaller parts within the intestine. This ensures that the energy released by the food is more easily absorbed into the bloodstream. There are a host of problems that can attack the gall bladder including stones, infection and more.

Let us find out the symptoms of a gallbladder attack and the various ways in which it may be successfully treated.

    Pain: One of the most common symptoms of a gallbladder attack includes pain. This can be felt in the section that lies in the middle and the upper right portion of the abdomen. The patient may initially experience mild pain that comes and goes intermittently. Eventually, if the pain is not treated, it can start to radiate on a constant basis and hold the patient in its grip.
    Nausea: Nausea and vomiting are also common symptoms of any gallbladder related problem. Chronic cases usually end up experiencing these symptoms. Nausea and vomiting in such conditions are a result of digestive problems like acid reflux which can be caused due to the gall bladder condition.
    Fever: If there is an infection in the gall bladder, then the patient may also experience fever and chills. This will require immediate treatment and the prescription of antibiotics. If it is not treated on time, the problem can become serious and dangerous.
    Loose Motions: Diarrhoea is a problem faced by many patients suffering from this condition along with jaundice and lighter coloured stools.

Treatment: Mostly, doctors will recommend surgical methods to deal with gall bladder attacks and conditions. A laparoscopic surgery may be conducted to remove the gallbladder. Also, medication will be prescribed to dissolve the gallstones that may have been caused by cholesterol. The patient will also have to undertake many lifestyle changes in order to successfully treat this condition over a period of time.

One will have to avoid greasy and oily food. Also, the fat intake of the patient will have to be reduced so that the cholesterol build up does not affect the gallbladder again. The patient will also have to add fibre to his or her daily diet, in the form of fruit and oats. This will help in improving the bowel movements as well.

The Symptoms and Treatment of Gallbladder Attack

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!

The gall bladder, which sits just below the rib cage to the right of the stomach, is very tender to touch. It is a little sac or storage compartment for bile, which is produced by the liver. The gallbladder emits bile into the small intestines via a duct referred to as the cystic duct. The entire process is meant to break down foods (namely fatty foods). 
Gallbladder attack symptoms may include one or more of the following:
1.Pain in the back right shoulder blade:
Sometimes, pain radiates through to the back shoulder blade on the right side or in the middle between the shoulder blades. This is pain from the gallbladder affecting the back of the shoulder. This back shoulder blade chest pain is one of the most common yet unknown symptoms of a gallbladder disorder. This can come and go or be constant. It may be sharp, excruciating or dull. It may also occur especially at night. A gallbladder attack will typically last for one to four hours.
2. Pain in the stomach: 
The most common symptom of a gallbladder problem is pain. This pain usually occurs in the mid to upper-right section of your abdomen. It can be mild and intermittent, or it can be quite severe and frequent. In some cases, the pain will begin to radiate to other areas of the body, including the back and chest.
3. Nausea or Vomiting: 
Nausea and vomiting are common symptoms among all types of gallbladder problems. But only a chronic gallbladder disease may cause digestive problems, such as acid reflux, gas, nausea, and vomiting.
4. Diarrhea:
Having more than four bowel movements a day for at least three months may be a sign of chronic gallbladder disease.
5. Fever or Chills:
An unexplained fever may signal that you have a bile duct infection. If you have an infection, you need treatment before it worsens and becomes dangerous. The infection can become life-threatening if it's allowed to spread to other parts of the body.
6. Unusual Stools or Urine: 
Lighter-colored stools and dark urine are possible signs of a common bile duct block.

Recognizing The Symptoms Of A Gall Bladder Attack

Gall bladder stones can be painful. Until and unless it is surgically removed and cured from within, the pain continues to hinder daily life. The good news is that there are ways by which pain from gall bladder stones could be managed. 

Here is a list of quick, easy-to-follow remedies to counter the pain.

Heat Pack: Applying a heat pack or hot water bottle on to the stomach making sure that the heat is directly passed on to the gall bladder can give instant relief from the pain. The heat should be applied at an interval of half an hour and a layer of cloth should be placed in between the skin and the heat pack.
Over the counter medicine: In most cases, over the counter pain relief meds can make the pain go away. NSAIDs should be avoided until and unless suggested by the doctor. A pain relief medicine with anti-inflammatory properties will perfectly suit the gall bladder condition.
Try vegetable juice: While gulping vegetable juice might sound a little indifferent, it has instant benefits with no side effect. All it needs is to mix beetroot, cucumber, and carrot in equal proportions and extract the juice from it. The juice extracted from this mixture should be consumed twice in a week to flush out the toxins from the system and ease the gall bladder pain.
Citrus fruits: Citrus fruits such as lemon, orange etc. contains pectin that is believed to be a remover of stones and blockages. This is also believed to be a great agent for countering pain originating from the gall bladder. Consumption of 10-12 tablespoon of lemon juice extracted from fresh lemons followed by a glass of water will wither the pain away in few weeks.
A mixture of honey and turmeric: Honey s antiseptic nature prevents infection and the curcumin found in turmeric makes the bile more soluble in the gall bladder. These two herbs in tandem can ease the gall bladder pain and get relief from the stones too. A tablespoon of honey and 1 tablespoon of turmeric should be consumed daily to get the benefits.
Take the herbal route: There are several herbals that are believed to be extremely effective in treating pain origination from the gall bladder. Some of them include goldenseal, quebrapedra, catnip, fennel seed, yellow dock, rosemary, nettle, peppermint herbal tea etc.
Apple Cider Vinegar: Apple cider vinegar is acidic in nature and consumption of a quarter of a glass followed by a quarter of a glass of apple juice can show instant results. It should be consumed daily after breakfast. There are instances where the pain eases out within a matter of 15 minutes.

Gall Bladder Stone Pain - Tips To Help You Manage It!

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

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