Biliary colic (gallstones): Symptoms

Of gallstones, the presence of stones in the gallbladder, is one of the most common conditions in the population. Then analyze the process of the formation of stones or gall stones, who are more susceptible, and symptoms before and during biliary colic, diagnoses and treatments with conventional medicine and natural.

Known as the expression Gallstone formation of calculi (stones) within the gallbladder or bile ducts that lead into the first portion of the intestine (duodenum).

The number of stones or rocks is highly variable from person to person. Usually when there are often one is located in the bile ducts, while inside the gallbladder may be many more. Sometimes he has found a single stone or stones in the gallbladder bile of considerable size, however, most of the time it formed are numerous calculations that can count up by hundreds, obviously much smaller size. This size can range from simple biliary sand or mud several inches.
Formation of stones from the gallbladder

These stones or rocks are formed by precipitation of cholesterol or bile pigments (bilirubin in the form of calcium bilirubinate) of bile in which are dissolved. There are also mixed cholesterol stones and calcium bilirubinate at once.

The causes of this formation is due to various pathogenetic factors, including:

* The retention of bile in the gallbladder.
* The increase in cholesterol in the blood, and therefore in the bile.
* The chemical and physical changes experienced by the bile fluid
* Cholecystitis, inflammation of the gallbladder.
* Obesity appears to be an important risk factor for the formation of gallstones, especially in women sobrr. Clinical studies prove it. The most likely reason is that obesity has to reduce the amount of bile salts in bile, resulting in more cholesterol.
* Cholesterol-lowering drugs: Drugs that lower cholesterol levels in the blood increase the amount of cholesterol secreted in bile.
* An increased level of triglycerides.
* Estrogens: Excess estrogen in pregnancy, a hormone replacement therapy or birth control pills seem to increase the amount of cholesterol in bile and decrease gallbladder movement, which can lead to stone formation.
* Genetic factors.

Who are more likely to develop stones or gallstones?
It seems that women, especially after 30 years of age are most prone to this disease.
It also has an influence predisposing to obesity and, above all pregnancies.
These cases would increase the cholesterol content in blood, and during the last months of pregnancy that cause compression of the bile ducts with subsequent retention of bile.

Also there seems to be a hereditary factor that influences the presence of stones or gallstones, not so much by a direct inheritance of the disease, but as a calculous diathesis or constitution, which would facilitate other predisposing causes of gallstone formation , kidney or other organs.

Of course, a diet rich in saturated fats also predisposes to the presence of these calculations.

Symptoms when there is biliary colic
When the patient is not suffering from biliary colic, digestive disorders that are not characteristic, as also seen in other conditions such as gastric or duodenal disease, or to be confused with symptoms of appendicitis. Usually, these symptoms or disorders occur in the form of belching or gas, nausea, vomiting, poor appetite, pain less intense in the liver or stomach area, which usually occur after meals and sometimes also radiating into his right shoulder.

If these symptoms radiating down origin can be interpreted as a state of inflammation of the appendix.

In addition to these symptoms, the doctor can get, by clinical examination other indications that guide you towards a diagnosis of biliary disease. These other symptoms may include:

* Slight liver enlargement on palpation or ultrasound.
* Acute exacerbation more or less intense pain when touching the cholecysto point (corresponding to the depth at the location of the gallbladder).
* Presence in the urine of bile pigments indication light to show the existence of a mild hepatic dysfunction.
* Slight yellowing of the skin and whites of the eyes (or subictericia light icetericia, etc.).

Symptoms of biliary colic
Biliary colic occurs when a stone moves from the gallbladder into the cystic duct and back to the common bile duct. In these cases there may be a blockage of the conduit when the diameter is smaller than the diameter of the calculation. Then there arises a stretching of the walls and occlusion of the lumen of the bile ducts.

A colic can be caused by trauma on the hepatic region, by exertion, by some sudden movement and live like a jump, through mistakes or abuses in the food, from menstruation, for their efforts before delivery and up to an simple emotion (anger, for example).

The start of biliary colic may be sudden and unexpected at times, while in others it is preceded by premonitory symptoms (vomiting, belching, pain in liver region, vague feeling of discomfort, etc.)..

It seems that the night time and early morning is the time period in which this is easier biliary colic.

Symptoms of biliary colic: pain during biliary colic
Once that occurs biliary colic, the pain forced distension that originates in the excretory duct to pass the stone or stones and blocked the canal, is a terrible pain, vivid, haunting. This pain is repeated in the form of violent paroxysms caused to move slightly or with a flick of the sheets.

The source and maximum intensity of the pain is localized to the point cholecysto, which corresponds to the depth at the location of the gallbladder. During biliary colic face reflects the tremendous suffering that is happening. The pulse may be feeble and frequent, shallow breathing, hands and feet are cold, stomach tight and sore to the slightest pressure.

The pain may radiate to the back (toward the bottom of the right scapula). Pain may also radiate to the left, toward the area of the stomach or spleen. However, the most common are up (right shoulder). Generally, it is rare that the pain radiates down, toward the appendix if so it may be confused with appendicitis.

Given this state the person suffering from biliary colic usually acquire a position "Pain Relief", this is forward flexion of the trunk and lower extremities in order to obtain maximum relaxation of the muscles of the abdominal wall above the painful bladder .

Symptoms of biliary colic: The duration of biliary colic
This can be very variable, from hours (five to ten on average) even days, during which painful paroxysms occur.

Colic disappears when the stone or the stone through the biliary tract and enters the duodenum. In this case the colic disappears abruptly.

However, there may be occasions when colic fail to reach its final, ie there is no expulsion of the calculus into the intestine. The stone can be interlocked in a point in the journey to be made to reach the duodenum. In these cases, the colic may cease, but it creates an impediment to more or less completely out of the bile into the intestine. Then comes the table of jaundice in the blood to spill bile, which fails to reach the intestine. The whites of the eyes begins to take on a yellowish color, and skin also accentuate this color more as the amount of bile in blood is higher. Needless to say that in these cases it becomes necessary to consult a healthcare provider right away to avoid this situation.

Diagnosis of gallstone or gallstones
It is one of the principal means of detecting the presence of stones or gallstones because of its high specificity or sensitivity. In these calculations appear as hyperechoic images with posterior shadow, unlike clay or biliary sludge, which are observed low amplitude echoes without shadowing.

Complete blood count
Have lower sensitivity than ultrasound, since the calculations only detect radiopaque.

Oral cholecystography

Try to verify the functionality of the gallbladder is correct.

HIDA scan

May be indicated for the diagnosis of cholecystitis or biliary tract abnormalities associated with the calculations.

Endoscopic retrograde cholangiopancreatography
It may be useful in diagnosing the presence of a stone in the bile duct. In some cases the calculation can be removed by endoscopic papillotomy. Recall that the endoscopic papillotomy has a risk of complications ranging from 5 to 10% with a mortality of 0.5 to 1%. These numbers alone are greater than the actual risk of cholecystectomy - classical coledocostomía elective. For this reason, this procedure should be reserved now for higher risk patients (elderly with associated diseases).

Intraoperative cholangiography

It is used to detect stones in the bile duct during the operation of cholecystectomy. It is indicated when there are multiple small stones, history of cholestasis, bile duct dilation or a history of pancreatitis.

Non-surgical treatment for gallstones
Ursodeoxycholic acid. Dissolves cholesterol stones when the stone is radiolucent, less than 5 mm and that the gallbladder is functional. In these cases the solution is obtained from the calculation in 50-60% of patients. It requires prolonged treatment, and relapse estimates by 50% of cases at 5 years.

Extracorporeal lithotripsy. It consists of the fragmentation of gallstones by shock waves to aid dissolution. You have to always involve treatment with oral ursodeoxycholic acid. This technique has several disadvantages: it can only be used in functional vesicles with few radiolucent stones, therapeutic success is achieved in only 47% of cases (if the calculation is only at 80%). Recurrences occur in 11% every 18 months. It can cause hematuria and kidney damage.

In view of non-surgical treatments outlined here in more complications and other side effects, recommend as much as a preventive measure in case of illness used in the first place, if possible natural treatments. As an example of effectiveness of these I recommend reading the following topics.

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