Hello, I am the gallbladder, a member of the digestive system. Recently, a terrible thing happened in my family, which made me and my family suffer from it, so today let me reveal to you the face of this murderer, so that you can see his nature and be able to take up arms against him in time to avoid more harm.
The “terrorist” I am going to talk about is the stone that exists in the bile duct, which is mainly due to the accumulation of bile and cholesterol metabolism imbalance. It was this small stone that sent my family into a state of panic.
In order to avoid the harm of stones, I am always careful to maintain a harmonious and peaceful state with them to the best of my ability, when the stones are kind and do not invade or hurt me, but when they are angry and rage, their activity increases greatly, and they are likely to be embedded in my jugular abdomen or neck, then, when human beings are full and eat greasy food, I will contract to excrete bile, but due to the blockage of stones, my ability to evacuate will be blocked. However, due to the blockage of stones, my emptying ability will be obstructed and the pressure in my body will be increased, then I will contract strongly so that I can excrete bile, together with the excitation of the vagus nerve, the end result is colic. Colic is usually a persistent and gradually increasing pain in the upper or upper right abdomen, often radiating to the right scapula or shoulder, and sometimes combined with vomiting. If the stone is embedded or obstructs the gallbladder duct for a long time, it can lead to gallbladder effusion.
When a stone attacks my sister, the extrahepatic bile duct, and becomes infected, the typical Charcot’s triad occurs because of its inability to withstand such a blow: 1.
1. abdominal pain: occurs in the subxiphoid or right upper abdomen, mostly colic, with paroxysmal attacks, or persistent pain with paroxysmal intensification, which may radiate to the right shoulder or back, often accompanied by nausea and vomiting.
2. chills and hyperthermia: bile duct obstruction secondary to infection leads to cholangitis, bile duct mucosal inflammation and edema, which aggravates the obstruction and increases the bile duct pressure, and bacteria and toxins retrograde through the capillary bile duct into the hepatic sinusoids to the hepatic vein, and then enter the body circulation to cause systemic infection. Clinically, chills and high fever, generally manifested as chills fever, body temperature can be as high as 39~40℃.
3.? Jaundice: Jaundice can occur secondary to bile duct obstruction, and its severity, occurrence and duration depend on the degree of bile duct obstruction, site and the presence of co-infection. As the jaundice deepens, many patients may develop pruritus of the skin.
When stones attack my brother, the intrahepatic bile ducts, they can be asymptomatic or with only epigastric pain and chest and back swelling discomfort for many years because my brother is still strong enough to withstand the damage of the stones. However, if the damage from stones is too strong, serious symptoms such as acute obstructive purulent cholangitis, systemic septicemia, and infectious shock can occur.
Our common channel for excreting bile into the duodenum is the common hepatic duct, and when a stone obstructs the common hepatic duct, a variety of complex, diverse, and severe symptoms can occur. The most typical clinical manifestations of common bile duct stones are epigastric colic and contralateral back pain, chills, high fever and subsequent jaundice in three major groups of symptoms; if the lower bile duct is completely obstructed, the cystic duct is patent and the wall of the gallbladder is not yet fibrotic and atrophic, there is an enlarged and painful cystic mass in the right upper abdomen; the liver is symmetrically and diffusely enlarged and painful; the patient shows a series of symptoms such as flaccid hyperthermia, hepatocellular damage and biliary stasis. This is acute obstructive septic cholangitis. If the diagnosis is late or the obstruction is not effectively removed in time, the infection is further exacerbated and systemic toxemia and toxic shock lead to severe acute obstructive septic cholangitis (ACST) leading to serious complications and life-threatening conditions.
How are the biliary stones, the culprit of such severe symptoms, formed? Based on observations and summaries, I have found the following factors.
1. Preferring to be quiet and less active. Many women, especially middle-aged women, exercise and physical labor less, for a long time their gallbladder muscle contraction force is bound to decline, bile emptying delayed, easy to cause bile stasis, cholesterol crystals precipitation, creating the conditions for the formation of gallstones. In addition, the high level of estrogen in women’s body affects the formation of bilirubin glucuronide in the liver and increases non-conjugated bilirubin, while estrogen affects the emptying of the gallbladder, causing bile sweat stagnation and promoting stone formation. The incidence of gallstones increases significantly in those who use estrogen after menopause.
2, physical obesity. Many women usually love to eat high-fat, high-sugar, high cholesterol drinks or snacks, eventually leading to obesity, and obesity is an important basis for the development of gallstones.
3, do not eat breakfast. Many modern women do not eat breakfast, and long-term skipping breakfast will increase the concentration of bile, which is conducive to the reproduction of bacteria, easy to promote the formation of gallstones.
4, multiple pregnancies. During pregnancy, the biliary tract function of women is easily disturbed, resulting in weak smooth muscle contraction and retention of bile in the gallbladder, coupled with the relative increase in blood cholesterol during pregnancy, prone to precipitation, the chance of forming gallstones is greatly increased, and the incidence is higher in women with multiple births.
5, snacking after meals. Now the phenomenon of sitting and eating snacks after meals is quite common in China, and this habit may be one of the reasons for the high incidence of gallstones in China. When people curl up, the abdominal cavity pressure increases, the gastrointestinal tract peristalsis is restricted, which is not conducive to the digestion and absorption of food and bile excretion, sitting for a long time after meals to prevent the reabsorption of bile acids, resulting in a disproportionate cholesterol and bile acids in the bile, cholesterol is easy to deposit.
6, cirrhosis of the liver. Patients with cirrhosis have lower estrogen inactivation function and higher estrogen level, coupled with low gallbladder contraction function in cirrhosis, poor gallbladder emptying, bile duct varices, elevated bilirubin in blood and other factors can cause gallstones.
7, genetic factors. Genetic factors obviously play an important role in clarifying the risk of gallstones. Gallstones are more frequently produced in close relatives of patients with cholesterol cholelithiasis. This point seems to contain a genetic factor.
I apologize profusely for any harm caused, and I strongly recommend “cholecystectomy” for people with significant discomfort. Here, I am not expressing my spirit of “sacrificing life for righteousness”, but I recognize that the harm I am doing to the human body is far greater than the contribution I am making to the human body. Many people may wonder, if the gallbladder is cut, what should we do in the future to digest food, especially fatty food? In fact, I play an important role in the human body as a “refrigerator”, the liver produces and secretes bile, and I concentrate and store the excess bile, when the body eats more fat, I will excrete the excess bile to help the digestion of fat. Less my role, and will not hinder the human body’s digestion to a greater extent, the short-term postoperative need for low-fat diet, 2-3 months after surgery, the bile duct will compensatory expansion to play a part of the role of the gallbladder, then you can basically normal diet, no impact on life.
Perhaps, people will ask, what kind of surgery is chosen for the treatment? Compared with traditional open surgery, laparoscopic surgery is characterized by minimal trauma, minimal scarring, low damage to surrounding tissues, less chance of postoperative adhesions, less postoperative wound pain and fewer days of hospitalization, and less cost to the patient. This has brought a blessing to the majority of patients. ERCP biliary stone extraction surgery is also available to preserve the gallbladder with minimal invasion, less bleeding, and advanced technology.
At the same time, for different parts of the stone, the surgery will be different, which requires the doctor to choose different surgical methods according to the different conditions of the patient, which will not be listed here. In a word, recognize and understand bile duct stones, prevent them before they occur, cure them after they occur, and enjoy a healthy life.