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What is it about ?
The liver is located in the upper right part of the abdomen. The liver produces bile. Bile is a dark green, slightly viscous liquid that is partially stored in a bag under the liver. This pocket is called the gallbladder. The gallbladder is shaped like a (small) pear and is connected to the intestine through the bile duct.
Bile is needed to break down fat. As soon as there is fatty food in the stomach and then in the duodenum (the first part of the small intestine), the gallbladder contracts. This contraction sends bile into the duodenum where fat is broken down. Bile largely determines the color of the stool. If you have no bile, your stools are light beige in color.
Gallstones are stones in the gallbladder that end up in the bile ducts and prevent the flow of bile. Most people don’t have symptoms.
The risk factors for gallstone formation are age (higher frequency in the elderly), being female, hereditary predisposition, obesity, previous childbirth, diabetes, an underactive thyroid (hypothyroidism), intestinal diseases of the small intestine and artificial nutrition.
In whom and how often do they occur?
Gallstones mainly occur after the age of 40. In Belgium, general practitioners see on average 2 new patients out of 1,000 consultations each year for bile problems.
How to recognize them?
Two out of three patients have no symptoms. If there are any complaints, then the most common symptom is pain in the upper right part of the stomach that runs towards the shoulder or back. Sudden, violent pain (biliary colic) is often accompanied by nausea and vomiting. Pain that lasts for more than 12 hours and is associated with fever or jaundice may be a sign of acute inflammation of the gallbladder or bile ducts.
How is the diagnosis made?
Ultrasound is the best exam to make the diagnosis. It most often identifies stones in the gallbladder, but more difficult stones in the bile ducts. In addition to a physical examination, a blood test can help determine the severity of acute inflammation of the gallbladder or bile ducts or inflammation of the pancreas.
Symptoms of acute gallbladder inflammation are stomach ache, upper right, fever, and increased inflammatory proteins in the blood. Symptoms of acute inflammation of the bile ducts are high fever, jaundice (jaundice) and pain, while symptoms of acute inflammation of the pancreas (pancreatitis) are severe abdominal pain, elevated pancreatic tests. and hepatic in the blood.
What can you do ?
Eat healthy and in moderation. Avoid foods that trigger pain. These are often products rich in fat. Watch your weight and be careful not to gain too much. If you are overweight, losing weight can reduce your risk of developing gallstone problems.
What can your doctor do?
Gallstones without symptoms do not need to be treated. If you have biliary colic, your doctor may prescribe pain relievers or cramp medication. He can also give the painkiller by injection. During biliary colic, gallstones can suddenly pass through the bile duct into the intestine. The pain then suddenly disappears and the stones are passed with the stool.
If you regularly suffer from pain in your upper abdomen, your doctor will advise you to avoid pain-causing foods and will refer you quickly (within a few months) for surgery.
He will also direct you to specialized services in the following cases:
- for intervention, in case of acute inflammation of the gallbladder, preferably within 2 to 7 days after the onset of symptoms;
- for immediate hospitalization, in case of inflammation of the pancreas. You will be hydrated there and you will be given intravenous anti-inflammatory drugs; an MRI examination will be performed to better visualize the problem. You will be prescribed an ERCP (endoscopic retrograde cholangiography and pancreatography). This is a visual inspection through the stomach (gastroscopy) that can detect the presence of stones in the bile ducts and possibly remove them. If this procedure has resolved the pancreatitis, the gallbladder is most often surgically removed as a second step to avoid any relapse.
Current surgical methods (laparoscopy and ERCP) are not major interventions. Thus, the elderly and those whose general health is less good can also benefit from this treatment.
After removing the gallbladder, you can sometimes experience stomachaches persistently. This pain is caused by residual or recurring stones in the bile ducts, by spasms or cramps. Other gastrointestinal problems can also cause these abdominal discomfort.
Want to know more?
- Gallstones (image) – Interventional and Pancreatic Bile Center Paris Sud
- Functional anatomy of the digestive tract (image) – microbiologiemedicale.fr
- Ultrasound here Where to find on this page of Cliniques St Luc UCL
- MRI, here, Where to find on this page of Cliniques St Luc UCL
- Endoscopic cholangiopancreatography (CPE) – Erasme Hospital
- Calculate your Body Mass Index (BMI)
- The food pyramid – Eat Move – Health Question
- Nutri-Score – SPF Public health, food chain safety and the environment
Are you looking for more specialized help?
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
Source
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