Gallstones And Complications
The cause of the lower back pain that requires the patient to go to emergency is often caused by gallstones. In the body, stones can be found in many organs, but most often in the bile ducts. It is difficult to say exactly the proportion of people with gallstones because the majority of patients with gallstones have no symptoms.
Gallstones can be found only in the gallbladder (common in European countries), biliary tract or simultaneously in both places. In Vietnam, it is common to see gallstones
Where does gallstones come from?
Gallstones are made up of bile components such as bile pigments, cholesterol, and fatty acids. According to the external shape and the composition of gravel, divided into 2 main types: cholesterol and pigment stones.
Cholesterol stones: Cholesterol dissolves in bile thanks to bile salts and lecithidine
Pigment stones: Usually occur when the bile ducts inside and outside the liver become infected, the bile becomes stagnant, making the bile pigments and calcium adhere to the bile ducts, which are damaged, precipitate to form bile mud, gallstones.
Worms and worm eggs can also be conditions for bile pigments and calcium to form in stones. Pigment stones are usually black or brown.
Depending on gallstones or gallstones, clinical manifestations are different.
Gallstones: 80% of gallstones are asymptomatic or very mild. 20% of symptomatic gallstones are characterized by severe pain in the lower right flank (cramping pain)
The pain is caused by stones moving to the gallbladder neck, causing a temporary blockage and stretching leading to anemia causing pain. The pain usually occurs after a fatty meal, alcohol or during the period before menstruation or when too nervous.
The pain often appears in the evening or at night, the pain is continuous, increasing and sometimes accompanied by symptoms such as arrhythmia, systolic, bradycardia. The pain may last from a few minutes to several hours.
If the pain lasts longer than 6 hours, there may be complications of cholecystitis. Diagnosis of gallstones with a simple ultrasound can detect stones. Acute cholecystitis - a common complication of gallbladder stones (90%).
The symptoms of acute cholecystitis in the beginning are like a liver ache but they last longer, are more severe, and the pain relievers do not help, the patient does not dare to breathe deeply, the pain may spread to the right shoulder.
In addition, patients also have other symptoms such as abdominal cramps, nausea, flatulence. 20% of patients with acute cholecystitis may have gallbladder necrosis and peritonitis requiring emergency surgical intervention.
Treatment of gallbladder stones without major medical complications. Treating liver cramps with antispasmodics and analgesics. Treatment of removing stones with medications that dissolve stones is only effective for cholesterol stones smaller than 1cm.
Medicines used to dissolve stones are drugs that work to reduce the saturation of cholesterol, making cholesterol not precipitate. Gallbladder removal is the most ideal method to treat gallbladder stones that have complicated or painful, recurrent episodes.
Gallstones: The stones are located in the common bile ducts and the bile ducts in the liver. When stones are small and do not cause biliary obstruction, the patient may have no symptoms at all, but when large stones cause obstruction of the bile ducts, they can cause symptoms to appear in sequence: pain - fever - jaundice.
In addition to acute complications such as cholangitis, biliary tract infection, biliary abscess, permanent cholestasis will lead to secondary cholestatic cirrhosis.
Over 50% of acute pancreatitis cases are associated with a common bile duct stone and the prognosis of pancreatitis in these cases is often very severe.
Diet and how to prevent gallstones
Reduce fat and fat. Limiting eating cholesterol-rich foods such as animal viscera, but patients can still eat eggs (eat less) because eggs do not cause biliary colic create necessary stimulation for the gallbladder to promptly excrete bile secretions prevent fluid retention, avoid stone formation.
Increasing protein to fight steatosis of the liver cells because cholin and methionine in protein are also known as fat targets that convert fat from the liver to the subcutaneous fat storage.
Eating foods rich in carbohydrates, easily digestible glucid does not affect bile, and is high in fiber, which helps digestion.
Eat plenty of fresh vegetables rich in vitamins B and C to increase fat and flour metabolism.
Prevention of gallstones: Follow a diet that lowers cholesterol and prevents intestinal infections especially from parasites by eating hygiene and regular worming..
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