Gallstones Disease

Types, symptoms, and treatment for Gallstones

Hi, I’m Dr. Nimesh Shah. I’m a consultant endoscopic, laparoscopic and G.I surgeon. I’m attached to Global Hospital Parel and SL Raheja Fortis Hospital at Mahim, and I’m also a director and partner at Sanjeevani Hospital, which is our hospital at Dadar. We have talked about gallstone disease as of now. Gallstone disease is a very common phenomenon observed in the Indian population. There are various types of gallstones that are available, that is either a pigment stone or a cholesterol stone. Pigment stone occurs because of hereditary spherocytosis or something wrong with your blood cells, which get destroyed more, and that causes gallstones.

The other cause of gallstones is a cholesterol inborn error. The other type of gallstones are cholesterol stones, which are due to inborn errors of metabolism of a cholesterol as either the cholesterol that is secreted by the liver is much more, or the water that is secreted by the liver is less. So the gall bladder which…whose function it is to super-concentrate the bile concentrates much more than what is necessary, and you get crystallites of cholesterol stones formed. These are most common stones seen in the Indian population.

The symptomatology of this is usually bloating, a fullness of abdomen, a lot of flatulence, also some patients have a lot of refluxes, we call it a…which is associated with gallstones hydro semi a. And also some patients develop severe pain which is called as a biliary colic, which may need medical intervention. The diagnostic modality that is used for gallstone disease is doing an ultrasound. An ultrasound will tell us on the thickness of the gallbladder, the type of stones, the multiple stones, or multiple small stones, or a single large stone. So the number of stones, if you have multiple stones, you may develop a biliary colic. If it’s a large stone you may develop acute inflammation of the gallbladder, which will need hospitalization.

The gold standard of treatment is surgery. Surgery is usually done laparoscopically, wherein small holes are made in the tummy and the gallbladder is removed completely. If y=remove your gallbladder, there is no problem in your digestion or anything like that, because effectively, the bile that is secreted by the liver is a waste product of our body, it has no role to play in digestion. It only activates the enzymes of the pancreas when it mixes with the pancreatic juice in the pancreas…in the intestine. The liver secretes about two and a half to three liters of bile every day, out of which 150 to 200 ml goes in the gall bladder. Out of the 200 ml, it is emptied every time you eat. So roughly about 800ml is concentrated by the gall bladder and is emptied into the intestinal...intestinal tract. Now vis-à-vis, 2.5 liters is flowing straight into your intestinal tract. So it does not really hamper your digestion in any way.

Again going back to treatment as laparoscopic surgery is the preferred and gold standard of treatment worldwide, wherein three four small holes are made and the gall bladder is completely extracted. Some patients at some centers are doing the single port, that is a single hole through the umbilicus, which is technically much more difficult. There is always a percentage chance of having to cut open a patient during surgery that may be because of bleeding or abnormal abnormality, which is quite common in the gall bladder region.

The above information is a limited information. If you need to further know about the disease then you can contact me directly through Lybrate.