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Gastroenterology

Gallstones

Gallstones are solid deposits of digestive fluid that can form in the gallbladder.

Gallstones
Gallstones are substantial deposits made of digestive fluid that may form in the gallbladder. Gallstones may vary in size and shape. They can be as small as a grain of sand or as big as a golf ball. Some people develop one gallstone, whereas other patients may develop several at the same time. 
Patients that present symptoms caused by gallstones usually require surgery to extract them (Cholecystectomy). In those cases where symptoms are not shown, treatment is not required. 

Causes of Gallstones:
The causes for gallstone formation are not clear, but the General Surgeon suggests that may be a result of one of the following:
  • When the bile contains high levels of cholesterol
  • When the bile contains too much bilirubin
  • When the gallbladder does not empty completely

Symptoms of Gallstones:
Gallstones can be asymptomatic. If one of the gallstones block a duct, some of the symptoms may be:
  • Intense pain in the upper or central portion in the abdomen
  • Back pain, just below the shoulder blades
  • Pain in the right shoulder
  • Vomit or nausea

Risk factors
  • Being a woman
  • Being over 40 years old
  • Being overweight
  • Have a sedentary lifestyle
  • Being pregnant
  • Having a diet high in fat and cholesterol
  • Not ingesting enough fiber
  • Having close relatives with gallstones
  • Being diabetic
  • Having anemia or leukemia
  • Losing weight rapidly
  • Ingestion of medication with estrogens, such as contraceptive pills or hormone therapy
  • Having an illness that affects the liver

Diagnosis
To accurately diagnose gallstones, your Gastroenterologist will perform one of the following procedures:

Treatment:
In many cases, gallstones do not cause symptoms, and therefore treatment is not required. When patients present symptoms, the Surgeon will recommend Gallbladder removal surgery (Cholecystectomy).

What is a Cholecystectomy?
Cholecystectomy is a surgical procedure to remove the gallbladder, a pear-shaped organ located just below the liver, in the upper right part of the abdomen. The gallbladder collects and stores bile, a digestive juice produced in the liver. 

Cholecystectomy may be necessary if you experience pain due to gallstones that block the passage of bile. Cholecystectomy is a routine surgery that carries a very low risk of complications. In most cases, you will be able to go home the same day. 
The specialist in General Surgery may recommend a Cholecystectomy if you suffer from the following: 
  • Gallstones in the gallbladder (Cholelithiasis) 
  • Gallstones in the bile ducts (Choledocholithiasis) 
  • Inflammation of the gallbladder (Cholecystitis) 
  • Inflammation of the pancreas (Pancreatitis) due to gallstones

Before Cholecystectomy

The Surgeon will review the medical history, do a physical exam, imaging tests, and questions related to your symptoms, lifestyle, and medical history.
Some of the restrictions that the patient has are not to drink or eat any food eight hours before surgery.

During Cholecystectomy

Depending on your situation, the complexity of Cholecystectomy surgery will be.
  • Laparoscopic Cholecystectomy; its duration is variable depending on the complexity of each case. The General Surgeon or Gastroenterologist makes tiny cuts in the abdomen; through these, he introduces a small video camera and removes the gallbladder using surgical tools. Once the Doctor is sure there is no problem, the cuts are sutured, and the patient is taken to the recovery area

After Cholecystectomy

The steps to take for recovery change depending on the procedure:
Laparoscopic Cholecystectomy; usually the patient is discharged the same day unless the Doctor recommends that he stay overnight in the hospital. Following the treatment and recommendations provided by your Surgeon, can help you have good progress in your recovery, the recovery period is approximately one week.




Am I a candidate for this procedure?
The Cholecystectomy surgery procedure will depend on the diagnosis and evaluation made by the specialist in
General Surgery or Gastroenterology.

When consulting your Doctor, we recommend keeping a record of your pain with a detailed description of the symptoms, duration, and what you think triggered them. Also, mention any medications you are taking.

Living with gallstones
In many cases, gallstones do not require treatment and can even dissolve on their own. In case of complications, it is vital to get in touch with a Gastroenterologist or General Surgeon to evaluate the possibility of performing a Cholecystectomy to remove the stones. You can reduce the risk of developing gallstones by following the following recommendations: 
  • Don't skip meals 
  • Losing weight gradually 
  • Eating more fiber-rich foods 
  • Keep a healthy weight.

When should I visit the Doctor?
It is essential to schedule a visit with a Gastroenterology or General Surgeon specialist to diagnose gallstones accurately.

When visiting the Gastroenterologist, it is recommended to have complete control and description of the symptoms. It is also important to mention if you are taking any medication. Learning more about this condition and its symptoms is the first step in getting it under control.


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