Your gallbladder is a pear-shaped organ under your liver. It stores bile, a fluid made by your liver to digest fat. There is a very useful tool to know more about its location and functions:
The cause of gallstones varies. There are two main types of gallstones:
-Stones made of cholesterol, which are by far the most common type. Cholesterol gallstones have nothing to do with cholesterol levels in the blood.
-Stones made of bilirubin, which can occur when red blood cells are being destroyed (hemolysis). This leads to too much bilirubin in the bile. These stones are called pigment stones.
Symptoms
Many people with gallstones have never had any symptoms. The gallstones are often found during a routine x-ray, abdominal surgery, or other medical procedure.
However, if a large stone blocks either the cystic duct or common bile duct (called choledocholithiasis), you may have a cramping pain in the middle to right upper abdomen. This is known as biliary colic. The pain goes away if the stone passes into the first part of the small intestine (the duodenum).
Symptoms that may occur include:
-Pain in the right upper or middle upper abdomen: may be constant, may be sharp, cramping, or dull and it may spread to the back or below the right shoulder blade.
-Fever
-Yellowing of skin and whites of the eyes (jaundice)
Other symptoms that may occur with this disease include:
-Clay-colored stools
-Nausea and vomiting
Treatment
-Surgery: some people have gallstones and have never had any symptoms. The gallstones may not be found until an ultrasound is done for another reason. Surgery is usually not needed unless symptoms begin. One exception is in patients who have weight-loss surgery.
In general, patients who have symptoms will need surgery either right away, or after a short period of time.
-A technique called laparoscopic cholecystectomy is most commonly used now. This procedure uses smaller surgical cuts, which allow for a faster recovery. Patients are often sent home from the hospital on the same day as surgery, or the next morning.
-In the past, open cholecystectomy (gallbladder removal) was the usual procedure for uncomplicated cases. However, this is done less often now.
Endoscopic retrograde cholangiopancreatography (ERCP) and a procedure called a sphincterotomy may be done to find or treat gallstones in the common bile duct.
-Medication: medicines called chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UDCA, ursodiol) may be given in pill form to dissolve cholesterol gallstones. However, they may take 2 years or longer to work, and the stones may return after treatment ends.
-Lithotripsy: electrohydraulic shock wave lithotripsy (ESWL) of the gallbladder has also been used for certain patients who cannot have surgery. Because gallstones often come back in many patients, this treatment is not used very often anymore
DRUGS AFFECTING INTESTINAL SECRETIONS
1. Drugs affecting biliary composition and flow, used in gallstone disease and primary biliary cirrhosis:
-Ursodeoxycholic acid (Destolit, Urdox, Ursofalk, Ursogal):
2. Bile acid sequestrants: relieves pruritus and diarrhoea, used also in hypercholesterolaemia:
-Colestyramine.
3. Aprotinin: no longer used for treatment of acute pancreatitis.
4. Pancreatin supplements are given by mouth to compensate for reduced or absent exocrine secretion in cystic fibrosis and following pancreatectomy, gastrectomy or chronic pancreatitis.
Source:
-BNF 57 March 2009
-http://www.nlm.nih.gov/medlineplus/
No hay comentarios:
Publicar un comentario