A Simple Guide to Gallstones

A Simple Guide to Gallstones
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What are gallstones?
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Gallstones are stones which are found in the gallbladder which is a sac storing bile from the liver.
They are made from cholesterol and other substances in the bile.


What causes gallstones?
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Gallstones are formed when cholesterol and other substances like calcium found in bile combine to form stones.

They are more common in
1.overweight people

2.Females more than males

What are the symptoms?
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Most people with gallstones do not have symptoms.

Symptomsoccur when a gallstone causes blockage in the bile duct causing obstruction to flow of bile from the liver to the intestine.

The symptoms may be:

1.mild pain in the upper right part of the abdomen and also just below the sternum just like gastritis.

2.Pain in the right upper back or shoulder blade area.

3.Pain is worse when you eat.

4.fever and chills

5.Yellowness of the eyes or skin

6.Dark coloured urine

7.Chest pain occurs when the pain radiates to the chest

How are gallstones diagnosed?
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1.Pain in the right side of the abdomen

2. Murphy's sign positive.
A thumb pressing against the right of the epigastrium causes more pain when the patients breathes in deeply

3.An ultrasound of the right side of the abdomen is the best way to find gallstones.
Most gallstones can be detected from the ultrasound.

4.gallbladder scan. A dye is injected into a vein in your arm.
X-rays are taken as the dye moves through your liver, bile duct, gallbladder.

What are the complications of gallstones?
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A gallsone which is stuck in the bile duct(a tube which leads the bile from the liver to the gallbladder and small intestine) can give rise to:
1.Gallbladder inflmmation or infection(Cholecystitis)

2.Swelling and inflammation of the Pancreas(pancreatitis)

3.Hepatitis due to reflux of the bile back to the liver

4.Peritonitis(inflammation of the inner lining of the abdomen) if the bile duct or gallbladder perfoates or burst.
This is an emergency.

What is the treatment of gallstones?
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1.If there is no symptoms, treatment is not needed.

2.If there is mild pain, some pain and antispasmodic medicines are given.
Patient is kept for observation.
If the pain goes away, the gallsone may have become unstuck in the bile duct and pass out into the intestine.

3.If there is severe pain or recurrence of another attack of pain, it is advisable to have the gallbladder removed.

a.Normal surgery to remove the gallbladder and the gallstones involve 4 holes in the abdomen and the use of a laparoscopic to cut away the gallbladder followed by stitching.
The surgery is usually very safe and the patient may not need to be hospitalised.

b.In an emergency, such as perforated gallbladder, immediate surgery may be required to remove the gallbladder and cleared the inner abdomen of leaked bile.

What is the prognosis of gallstones?
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Most people with gallstones do not have symptoms.

Sometimes gallstones may be detected while having tests for other health problems.

Sometimes an ultrasound done on an woman during pregnancy may show gallstones.

The prognosis for patients after surgery is usually good.

The bile will go straight to the intestine from the liver.
Digestion of oily food may not as good as before and is usually not noticeable.

A Simple Guide to Gastritis

A Simple Guide to Gastritis
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What is Gastritis?
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Gastritis is a disease which is caused by inflammation of the stomach lining.
It may presents as gastritis ,peptic gastric ulcer or if it extends to the duodenum(first part of small intestine) duodenal ulcers.

What are the causes of Gastritis?
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Two main causes are

1.helicobacter pylori infection - this bacteria damages the protective lining of the stomach making the underlying stomach tissue more vulnerable to the acidic gastric juice.

2.excessive production of acidic gastric juice
Excessive production of acidic gastric juice burns into the protective lining of the stomach and cause inflammation of the underlying stomach tissue.
The causes of excessive production of acidic gastric juice are:
1. Most common is stress and anxiety which automatically increase the production of the acid as a result of sympathetic nervous reaction
2.hereditary- some gastric patient has family history of gastric problem. Blood group O tends to have more gastritis while Blood group A has a tendency towards stomach cancer.
3.irregular meals tend to cause more acidic gastric juice to form at regular meal time.
4.alcohol and smoking has been associated with increased acid formation
5.Drugs: prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen,
6. diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.

What are the Symptoms of Gastritis?
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The most common symptoms are
1.upper abdominal upset or pain.
Other symptoms are
2.belching, abdominal bloating,
3.nausea, and vomiting
4.indigestion or of burning in the upper abdomen or in the chest(heart burn).
5.Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention.

How do you diagnose Gastritis?
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Gastritis is diagnosed through one or more medical tests:
Medical history - past and family history of gastritis
Physical examination- epigastric bloating or tenderness
Upper gastrointestinal endoscopy.
The doctor eases an gastroscope, a thin tube containing a tiny camera, through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests(biopsy).
The biopsy will detect how bad is the inflammation or whether there are underlying cancer cells. In additional if any polyps (benign swelling of the lining of the stomach) are detected, they are removed at the same time and sent for biopsy.
Blood test. The doctor may check your blood for any evidence of H.pylori infection and your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
Urea breath test can also determine whether you have H.pylori infection
Stool test. This test checks for the presence of blood in your stool, a sign of bleeding. Stool test may also be used to detect the presence of H. pylori in the digestive tract.

What is the Treatment of Gastritis?
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The main treatment is usually
1.reduce stress
2.reorganisation of work in such a way as to be able to handle the pressure of work better as well as to have regular meals
3.Control of diet - avoid hard foods such as peanuts , tough meat, spicy food, cold food, black coffee, strong tea,citrus fruits and their juices,carbonated beverages, deep fried or oily food.
4. Take more frequent and smaller meals.
5. Avoid alcohol and smoking
6. Avoid drugs such as aspirin, painkillers,steroids which may irritate your stomach and cause increase in acid production
Medical treatment:
Treatment usually involves taking drugs
1.Antacids:to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach.)
2.H2 Antagonist: to reduce to production of acidic gastric juice.(cimetidine, ranididine,omeprazole, Nexium etc)
3. Antispasmodics: anticholinergic drugs like buscopan, librax reduce the spasm in the stomach and duodenum
4. Antiflatulents - to reduce gas in the abdomen
5.If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up H. pylori infection.

Once the underlying problem disappears, the gastritis usually does too.
Talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.
What are the Complications of untreated Gastritis?
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Any untreated gastritis can cause complications such as:
1. peptic ulcers
2. bleeding ulcers
3.perforated stomach and peritonitis

Gastritis or ulcer is not healed overnight. The chances of satisfactory gastric recovery are excellent. However recurrences are always possible so do not stop your medications, good food habits and healthy lifestyle too soon.