Many people are more or less puzzled by the discovery of gallstones after medical checkups, how can they grow gallstones? I heard that gallstones can be very painful when they attack, so what should I do?
There are many kinds of gallstones, but when we talk about gallstones, we usually refer to gallbladder stones.
The gallbladder is a place where bile is stored. Bile is secreted by the liver and stored in the gallbladder first, and then discharged from the gallbladder when needed, through a thin tube to the intestines, where it participates in the digestion of food.
Why do gallstones grow?
There are many reasons for growing gallstones, and various factors that may affect the composition of bile may increase the risk of gallstones.
Middle-aged and elderly people: As the body’s metabolism degenerates with age, the proportion of various components in the bile changes, and the proportion of cholesterol rises, leading to deposits in the gallbladder and the formation of stones over time.
People who do not eat breakfast all year round: after the liver works all night, the gallbladder is already full of bile, if you do not eat in the morning to stimulate the gallbladder to empty, then the bile will continue to stay in the gallbladder, so that the concentration of bile increases, under such conditions some components of bile may precipitate crystals, and the risk of forming stones is higher over the years.
How come my gallstones don’t hurt?
When you mention gallstones, the first reaction is pain.
In fact, pain is only a typical symptom of gallstones, medically called biliary colic, which often occurs after a meal, with severe pain in the right upper abdomen. The reason for this symptom is that after eating, especially after a high-protein, high-fat diet, the gallbladder makes an effort to discharge bile, but the stones get stuck in the opening of the gallbladder, causing a sudden increase in pressure in the gallbladder and triggering pain.
There are many other symptoms of gallstones, such as bloating, mild abdominal pain in an indefinable location, and a variety of unexplained stomach discomfort that is more pronounced after eating fatty foods. Because these manifestations are not typical, many people think that it is a stomach problem, and even after gallstones are detected, they do not think that it is a gallstone problem without being reminded by the doctor.
There are also some people who have gallstones that really have no symptoms and are discovered during a physical examination.
How to treat gallstones?
If the symptoms are obvious, especially if there are recurrent biliary colic and cholecystitis, the mainstream opinion now is to remove the gallbladder surgically for treatment. With the development of laparoscopic technology, general gallbladder stones can now be done through laparoscopic surgery with little trauma and quick recovery.
Nowadays, some hospitals advocate surgery to remove the gallbladder alone, which caters to the concept that “the body is indispensable to the parents”, but the chance of recurrence is very high.
Why is there a high chance of recurrence? The reason is that after surgery, the gallbladder lining is no longer smooth, making it more likely that stones will form and surgery will be required. The second time the surgery is performed because of the local adhesion scar, it is likely that the opportunity for laparoscopic treatment will be lost and the patient will be forced to undergo open surgery, which is not worth the loss.
For some asymptomatic gallstones, there is actually controversy in the medical community as to whether surgery should be performed.
Conservative view: surgery is not recommended.
Many stones will not attack until death, and there is no need for the patient to receive the knife.
Some atypical symptoms such as vague pain, belching, etc., are not relieved in some patients, even after surgery.
As long as surgery is performed, there is some risk.
The radical view: aggressive surgery.
Although the symptoms are not obvious in this group of patients, many of them will have various symptoms in the future, and even acute cholecystitis and cholangitis will occur. In case of acute attack when the patient is in the field, mountainous areas and other places where timely medical care is not available, it will be a problem; or the attack when the patient is older, poor cardiopulmonary function, and cannot tolerate surgery, the best time for treatment will be missed.
Gallstones with chronic irritation for years will have a certain chance of cancer, and the prognosis of gallbladder cancer is very poor.
The latest guidelines suggest that patients without obvious symptoms should still be operated aggressively when they have the following conditions.
Middle-aged and elderly patients with gallbladder stones ;
Patients with a long history of gallbladder stones of more than 5 years;
Patients with gallbladder stones whose B-ultrasound indicates other lesions in the gallbladder;
Gallbladder stones larger than 1 cm in diameter;
Patients with poorly located stones that may block the bile ducts and cause more serious diseases;
Patients with diabetes mellitus combined with gallbladder stones are recommended to be operated actively when the diabetes mellitus is well controlled;
Gallbladder stones in children;
Patients with family history of gallbladder cancer.
Even if surgery is not necessary for the time being, it is not advisable to ignore it. It is recommended to review B-ultrasound every six months to a year; to eat regularly and avoid overeating.
Gallstones block the duct of bile discharge and cause acute pancreatitis
Can you take Chinese medicine
It is not recommended to take various kinds of herbal medicines for stone removal and elimination.
The so-called lithotripsy herbs often do not really remove the stones.
Some lithotripsy herbs are fine if they do not have lithotripsy effect, but if they do have lithotripsy effect, the risk is higher, especially for some mud-like gallstones. The bile ducts that discharge bile from the gallbladder to the intestines are very thin, so blind stone removal can cause stones to get stuck in the bile ducts after they have been discharged from the gallbladder, or at the most terminal valve, which can lead to septic cholangitis or acute pancreatitis, both of which are serious illnesses that can kill people.