The gallbladder is a small, pear-shaped sac located on the right side of the abdomen, below the ribs and beneath the liver. It stores bile, a digestive fluid produced by the liver. When we eat, hormones released by the gastrointestinal system trigger the gallbladder to release bile into the bile ducts, which then enter the intestine and help digest fat.
Gallstones may form if bile in the gallbladder becomes too concentrated or if it fails to empty properly. The stones may be composed of cholesterol, calcium salts or bile pigments. Some people develop gallstones because there is excessive cholesterol or bilirubin in their bile.
Around 2-6 per cent of Indians suffer from gallstones. Many are asymptomatic and the condition is often discovered incidentally during an ultrasound scan. Risk factors include obesity, a sedentary lifestyle, advancing age, a family history of gallstones, diabetes and certain dietary habits, particularly a high-fat, low-fibre diet. Women are more likely to develop gallstones as they have additional risk factors of pregnancy or may be on hormones like oestrogen.
If and when gallstones move into or block the bile ducts, symptoms can occur. The commonest is biliary colic, which is severe pain in the upper abdomen, often on the right side, which may radiate to the back or shoulder. The pain frequently occurs after a fatty meal and may be accompanied by nausea or vomiting.
If a stone obstructs bile flow, it can lead to jaundice. Infection of the gallbladder may develop, producing fever, chills and severe abdominal pain. In some cases, it can also trigger inflammation of the pancreas.
An ultrasound scan is usually sufficient to diagnose gallstones. Blood tests may be required if haemolysis, jaundice or infection is suspected. In some cases, CT scans, MRI scans or specialised imaging of the bile ducts may be recommended.
Approximately 80 per cent of people with gallstones do not require treatment if they remain symptom-free. However, once symptoms occur, the risk of recurrent attacks and complications increases. Persistent pain, bile duct obstruction, infection or pancreatitis are indications for treatment.
The standard treatment for symptomatic gallstones is removal of the gallbladder. This is usually performed laparoscopically and requires only a short hospital stay. One can lead a normal life without a gallbladder as bile then flows directly from the liver into the intestine.
Medications can dissolve gallstones but they work slowly, are effective only in selected cases and the stones often recur. As a result, they are rarely used.
To reduce risk of gallstones:
n Avoid skipping meals
n Maintain healthy body weight
n Avoid rapid weight loss
n Follow a balanced diet rich in fruits, vegetables and fibre
n Limit foods high in saturated fats and refined carbohydrates
n Exercise regularly.
A healthy lifestyle can significantly reduce the risk of gallstones.
The writer has a family practice at Vellore and is the author of Staying Healthy in Modern India. If you have any questions on health issues, please write to yourhealthgm@yahoo.co.in