Small stones - great agony: Gallstones can cause severe pain
Often people do not even know that stones have formed in their bile, because usually these do not cause any complaints. However, they become dangerous if they lead to colic.
60 to 80 percent do not know that they have gallstones. Gallstones can form directly in the gallbladder or in different bile ducts. In many cases, the gallstones remain unnoticed for years. If symptoms arise, they range from simple nausea after eating high-fat food to biliary colic, which can be very painful. Berndt Birkner from the professional association of German internists in Wiesbaden, explains that about 26 percent of women and 18 percent of men over the age of 40 in Germany have gallstones. Around 60 to 80 percent of those affected do not know about it. In general, the risk group also speaks of the "five F": female, fat, fertile, forty, fair (female, overweight, fertile, forty years old, fair-skinned or blond).
If the stones do not cause any discomfort, treatment is not necessary either. Gallstones result from a disturbed mixture ratio of the bile juice that the liver produces. The Gastro-Liga explains that the bile is made up of about 80 percent water and also contains cholesterol, bile acids, the bile pigment bilirubin as well as lecithin and electrolytes. If too much cholesterol, bilirubin or calcium is mixed in by the liver, these substances can form crystals, which may form into stones over time. Bile cholesterol can also increase due to other factors: if you are overweight, pregnant, losing weight heavily, or in old age. Longer periods of fasting, stress or irregular meals can also influence the mixing ratio and thus promote gallstones.
Blood tests and ultrasound Other factors that can promote development are high-fat nutrition, chronic constipation and also lack of exercise. However, education is also genetically determined in many patients. In the course of life, the gallstones only show up in a quarter of those affected. There is often a feeling of fullness, flatulence or latent nausea, but these symptoms can also have other causes. If such unspecific complaints occur, a doctor's visit is advisable. Anke Richter from the German General Medical Association explains: "I ask every patient with upper abdominal complaints about diseases in the family, about digestion and when the symptoms occur." A blood test with liver and inflammation values provides information and with the help of an ultrasound examination of the gallbladder, the stones can be used immediately Birkner adds: "A medical history also includes gastroscopy to rule out the fact that the stomach is the cause." Clear symptoms that leave no doubt are extreme pain in the right upper abdomen or in the pit of the stomach, which occur without notice. These feel as if the interior is being pulled apart and pressed together at the same time.
Hours of pain from biliary colic Sometimes nausea and vomiting are added to the ailments mentioned. In addition, pain radiating into the back and very typically: pulling pain in the right shoulder. All of these are signs of biliary colic, which can last as little as 15 minutes or as long as five hours. Such colic occurs when gallstones slide out of the gallbladder into the bile duct and get stuck at the mouth in the duodenum. This increases the pressure in the bile duct and prevents the bile from flowing out. Prof. Tilman Sauerbruch from the Gastro-Liga in Gießen explains: "Stones can also get stuck to the neck of the gallbladder when it contracts and releases the bile towards the bile duct and small intestine." However, secretion is still produced by the gallbladder mucosa and so on the pressure in the gallbladder rises, but the trigger can also be gall grit (English sludge) and so general practitioner Richter says: "These gallstone crumbs are tricky because they slip easily into the bile duct and block it just like a gallstone."
Don't put it on the back burner Anyone with the known symptoms would be badly advised to put the problem on the back burner. Sauerbruch advises: "If the colic lasts longer than an hour, a doctor should be consulted or the emergency doctor called." There is a risk of dangerous complications such as acute inflammation of the gallbladder, biliary tract or pancreas. ("") These risks need to be clarified and the doctor can also use pain medication to relieve the pain. Once the acute attack has been overcome, the problem has unfortunately not disappeared. According to the Gastro-Liga, half of the patients with one colic follow the next within a year, and the attacks often return as if out of the blue.
Removal of the gallbladder People are often advised to remove the gallbladder by doctors. In such an operation, the organ is removed via three to four small incisions in the abdomen as part of an abdominal mirroring. Methods such as smashing the stones or dissolving them with medication are considered outdated. New stones would form within a short time, since the actual problem, the disturbed mixing ratio of the bile juice, is not solved. No special nutrition would be necessary after the operation and no medication would be required for fatty foods. The bile juice flows from the liver through the bile duct into the intestine. A new formation of stones in the bile ducts is extremely rare. It is rather the case that the person concerned can lead a completely normal life again, without fear of another colic, but with more enjoyment. (ad)