Operation

February 7, 2010

This morning, I received a very casual text from a friend asking what I was doing. I responded that I was busy sorting out some house things, what about her. She explained that she was in the hospital with gallstones. I scratched my head, how could a casual conversation of 'what are you doing?' could turn into 'I'm in the hospital getting ready to have surgery'. Apparently she was all hopped up on pain medication and couldn't explain to me what gallstones were or how one gets them. So, I decided that I needed to research. Today's question is: what are gallstones?

A: Gallstones are hardened deposits of bile that form in the gallbladder. The gallbladder is an organ that sits the right side of the abdomen below the liver. The gallbladder stores bile produced by the liver for secretion into the small intestine to aid digestion. The bile is made of cholesterol, fats, salts and a pigment called bilirubin - if one of these 'ingredients' is more prominent, gallstones will form.

Risk factors that may lead to the formation of gallstones include:

• Gender: females are more susceptible to the formation of gallstones
• Age: those who are 60 or over
• Ethnicity
• Being overweight or obese
• Pregnancy
• Eating a high-fat or a high-cholesterol diet
• Eating a low-fibre diet
• Heredity
• Having diabetes
• Disruption of the gallbladder's normal emptying cycle
• Losing weight very quickly
• Taking cholesterol-lowering medications
• Taking medications that contain estrogen, such as hormone therapy drugs

Most people experiencing gallstones have 'silent gallstones', which do not cause any symptoms and generally do not need treatment. However, those who have more severe gallstones may experience pain in the abdomen, between the shoulder blades or under the right shoulder, and/or nausea and vomiting.

Complications may arise, including:

• Inflammation of the gallbladder, manifesting with severe pain and fever.
• Blockage of the common bile ducts, the tube that moves the bile to the small intestine, which may later lead to jaundice.
• Gallbladder cancer, which is relatively rare.

For treatment of more severe gallstones, doctors may prescribe medications to dissolve the gallstones. The medication is taken orally and usually takes many months of treatment to see results. Doctors are experimenting with injections directly into the gallbladder, however the effectiveness and safety of this procedure has not been confirmed. The second treatment option is removal of the gallbladder. Doctors reroute the bile ducts so that bile will flow directly from the liver to the small intestines.

The last I heard, my friend had not received gallbladder removal surgery. She is quite a healthy indivdual, both with diet and exercise, however has just had a baby. She explained that her doctor advised that she had 'silent gallstones' for a year, which I suspect made her fall into the pregnant risk factor category. But, she has returned home and I wish her a speedy recovery!