Medical Terminology Made Simple: Gallstones

Barry Lenson

Medical Terminology Made Simple: Gallstones

Medical Terminology CourseAs a service to students who are thinking of entering the medical and medical support professions, StraighterLine is running short posts on medical terminology. Each post will define one medical problem or condition.

Today’s medical term is . . . Gallstones

If you ever experience pain on the right side of your abdomen, centered two or three inches below your sternum, you could be suffering from gallstones.

Gallstones are just what they sound like. They are hard, stone-like pebbles that form in the gallbladder. But before we go any further, here’s a quick explanation of what a gallbladder is and what it does.

Your gallbladder is one of those vestigial organs that developed when prehistoric humans ate in a way that was a lot different from the way we eat today. Back in those ancient days, humans typically didn’t each too much for long periods of time. Then suddenly we would kill some kind of large, fatty animal and feast on it. (Think mastodons or elks.) When we did that, our gallbladders contracted and squeezed a quantity of a substance called bile into our digestive tracts though a little hole called the bile duct. Bile is a substance that helps dissolve and digest fat.

If you don’t have gallstones in your gallbladder, it will function pretty much the same way today. You eat a meal that contains some fat, and your gallbladder contracts and squirts bile into your intestines. But problems occur when you have stones in your gallbladder. When your gallbladder contracts, it squeezes down on those stones, causing pain that can range in intensity from a dull ache to severe discomfort.

This explains why most people first learn they have gallstones after enjoying a larger-than-usual meal. Once that pain is felt, it is relatively easy today to diagnose whether or not you have gallstones. An ultrasound of your abdomen can detect whether stones are in your gallbladder, waiting to cause you more misery the next time you gorge yourself on an elk.

People who suffer from gallstones suffer from the problem in different ways. Sometimes the pain is constant, sometimes it comes and goes, or becomes intense after eating. The problem can become severe if gallstones get lodged in the bile duct. The gallbladder contracts, but it can’t secrete any bile. That causes intense pain and requires emergency treatment. People who have blocked bile ducts can appear jaundiced, meaning that the whites of their eyes, and even their skin, can take on a yellowish hue.

There are a number of treatments for gallstones. In one procedure, a scope is inserted down the sufferer’s mouth. This scope is equipped with a small wire snare-like device that literally reaches into the bile duct to snare a stone that is lodged there. In some cases, oral medications can dissolve the stones. Some sufferers report that they are able to reduce their symptoms by avoiding fatty foods.

But by far, the most common treatment option today is an operation in which the gallbladder is removed laparoscopically.  In that procedure, the patient is put under general anesthesia.  Several small incisions are made in the abdominal wall and three or four surgical instruments are inserted. One of these instruments cuts away the gallbladder, places clips on the bile duct so that no leakage occurs, and literally pulls the gallbladder out of the patient’s body through one of the abdominal incisions. Recovery from this operation is usually quick and uneventful. Many patients are able to return home on the same day and never experience gallstone pain again.

It’s interesting to note that ultrasound is not used to pulverize gallstones (ultrasound is the most common approach today to eliminate kidney stones) because the gallbladder is located behind the liver, which would be injured by ultrasound.

The good news is that laparoscopic techniques have almost eliminated the need for old-fashioned operations to remove the gallbladder. Those procedures required a large incision and a long and painful recovery time.

So there it is – more than you probably wanted to know about gallstones. And hopefully, more than you will ever need to know.

 

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