Gallstones: Causes, Risks, Symptoms and Treatments

Gallstones is the popular term for several chronic conditions of the gallbladder, including biliary colic and cholelithiasis; they are characterized by the presence of gallstones in your bile ducts or gallbladder. Gallstones may obstruct your biliary system and prevent the excretion of bile into your duodenum. If you have gallstones, pressure on your abdomen will cause or increase pain. The pain may be episodic and transitory, however. The condition can worsen and result in prolonged, acute episodes of pain. Cirrhosis, diabetes, hemolysis (the rupture or destruction of red blood cells) and Crohn's disease may elevate your risk of gallstones. A gallbladder typically generates pain and cramping in the upper right quadrant of your abdomen, just below your right rib cage.


"Gallstones" by BruceBlaus (CC BY-SA 4.0)"Gallstones" by BruceBlaus (CC BY-SA 4.0)
The pain may radiate to your right shoulder and scapula (shoulder blade). Gallstones are classically seen in obese women more than 40 years old, but they also occur in a wide range of the general population. In fact, gallstones are found in more than 5 percent of asymptomatic people.

The key symptom of gallstones is pain in the upper right quadrant of the abdomen, radiating to the back, often after a fatty meal. However, such pain can occur at other times, too, often at night. The pain from gallstones is usually unaffected by your position, by whether you have or have not had a bowel movement, or by flatus (abdominal gas). Gallstones may also cause nausea and vomiting. Imaging studies are typically required to confirm a diagnosis of gallstones. A worsening of upper-right-quadrant pain, accompanied by fever and chills, is likely caused by inflammation of the gallbladder, known as cholecystitis; in such a case, prompt medical attention is indicated. If you're far from medical expertise, you may be able to distinguish cholecystitis from simple cholelithiasis, or gallstones, by having someone palpate (apply gentle but firm pressure) to the area just under your right rib cage. If you have cholecystitis, palpation while you're taking a deep breath will often elicit sharp pain, due to the inflammation caused by the infection. Simple cholelithiasis, on the other hand, seldom elicits sharp pain upon palpation.

If you suspect you simply have cholelithiasis while you're boating, you can usually manage the pain with analgesics. You should also avoid fatty foods, as they may make the symptoms recur or worsen. In some cases, however, the pain may be too severe for an affected individual to do much work aboard the boat. Severe pain, nausea and/or vomiting or cramps may necessitate light duties or even bed rest for a period of 2 to 6 hours. On the other hand, if you suspect you may have cholecystitis — if your pain is accompanied by generalized symptoms, including fever and chills — you should seek evacuation and prompt medical care. If it's possible to start an IV, that can help keep the affected individual hydrated and facilitate the administration of antibiotics. Cholecystitis often requires removal of the gallbladder in a surgical procedure known as a cholecystectomy. Some individuals also experience occasional biliary colic, or the temporary blockage of a bile duct. Conservative, nonsurgical treatment of biliary colic is reasonable for most people. But if you have experienced biliary colic and plan to go on an extended voyage, far from adequate medical care for a prolonged period of time, you should discuss the advisability of surgery with your physician, since the chance of complications like cholecystitis increases 2 to 3 percent a year in individuals who suffer from biliary colic.

To prevent gallstones, avoid foods that may exacerbate or cause symptoms; the consumption of coffee, vitamin C, polyunsaturated fat and nuts has been linked to the development of gallstones. Obesity and a sedentary lifestyle, as well as rapid weight loss, may also increase the risk of gallstones.
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