MRC uses regular MRI imaging technology plus a dye administered into the bile duct. This test is very useful for diagnosing biliary tract (gallbladder and surrounding ducts) cancer, but may not be able to spot tiny stones or persistent infections.
But there is a risk of complications, so the test is typically only given to people who are thought to be very likely to have stones blocking the bile ducts. A blood test may also be performed to help diagnose gallbladder disease.
Other specific blood tests can also reveal high bilirubin levels (the cause of jaundice, a complication of gallbladder problems) or elevated enzymes suggesting an obstruction in the gallbladder. Urine tests may also be performed to help diagnose problems with the gallbladder by looking for abnormal levels of chemicals like amylase, which is an enzyme that aids in the digestion of carbohydrates, and lipase, another enzyme that helps break down fats.
A much less common type of gallstone is formed by a mixture of pigments, typically calcium and bilirubin salts. The most helpful initial way to image the gallbladder and the liver is by ultrasound, which has the extra advantage of being cheap and not exposing you to any further radiation.
Classically, gallstones can cause symptoms of right upper abdominal pain after meals (especially if they are fatty). Medical professionals who provide responses to health-related questions are intended third party beneficiaries with certain rights under ZocDoc’s Terms of Service.
A check of the blood's amylase or lipase levels to look for inflammation of the pancreas. Amylase and lipase are enzymes (digestive chemicals) produced in the pancreas.
A high white blood cell count may indicate infection. The use of ultrasound testing which uses sound waves to image and make a picture of the intra-abdominal organs including the gallbladder.
The gallbladder and biliary system, shown in green, are directly connected to the liver and also include vessels that pass from the pancreas to the duodenum. The primary purpose of this system is to secrete bile which aids in the breakdown of fatty foods.
We collaborate with our surgeons to provide the correct treatment, and can even perform interventional therapy in our minimally invasive setting. They will join an estimated 25 million Americans, over 10% of the population, who already have gallstones or other gallbladder disorders.
In fact, women between the ages of 20 and 60 are three times more likely to develop gallstones than are men. We are just beginning to learn some answers to fundamental questions, such as what causes gallstones to form and the relative roles of the liver and gallbladder in stone formation.
Bile -- a greenish-brown fluid that is essential to the digestion of fatty foods -- is produced by the liver and secreted into the gallbladder. The chance that a silent gallstone will cause discomfort is about 3% per year in any patient.
Thus, in 20 years, the majority of patients who have asymptomatic gallstones will develop symptoms. As gallstones grow larger, they may block the outlet of the gallbladder and begin to cause serious disorder.
Blockage can progress from gradual or occasional obstruction of the outlet, causing inflammation of the gallbladder (chronic cholecystitis), to total obstruction, causing acute inflammation of the gallbladder (cholecystitis), a condition which requires surgical treatment. Other complications may result when gallstones block the common bile duct which leads to the intestine.
There can be infection of the bile ducts (acute cholangitis) which causes chills and fever. Bile pigments may accumulate in the blood, causing jaundice, a yellow discoloration of the skin and eyes.
When symptoms are evident, a person with gallstones may experience: * severe and steady pain in the upper abdomen, which can spread to the chest, shoulders or back, and is sometimes mistaken for the symptoms of a heart attack * indigestion, nausea or vomiting * severe abdominal pain and tenderness on the right side of the abdomen when the gallbladder is inflamed * jaundice, chills, and fever when gallstones block the passage of bile How are gallstones diagnosed? Patients who complain of abdominal pain or gastrointestinal distress are often given specific tests designed to diagnose gallstones.
A more sensitive technique, called ultrasound, produces an image or photograph of the gallbladder and bile ducts, and allows the physician to determine if any type of gallstone is present. Another test, called cholecystography, requires the patient to swallow pills containing dyes.
The dye passes from the bloodstream into the bile, and outlines the gallbladder, so gallstones can be detected by x -rays. More complicated procedures are required when gallstones in the bile ducts are suspected.
With a technique called PTC (Percutaneous Transhepatic Cholangiographic), a thin needle is passed through the abdomen into the duct network of the liver. If the gallbladder is removed, the bile then flows directly from the liver to the small intestine.
For some patients, however, gallbladder removal may not relieve the symptoms of gas, pain, bloating, or nausea. An oral medication, unsocial, dissolves cholesterol gallstones and represent a safe and effective alternative to gallbladder surgery for many patients.
Many people who have cholesterol gallstones and in whom there is no obstruction of the flow of bile into and out of the gallbladder may be candidates for treatment with unsocial. The drug is extremely well tolerated with only rare instances of mild, transient diarrhea reported, and has been widely used and tested in Europe, Asia, and the U.S. Another alternative to surgery is being explored on a research basis.
Following these new, non-surgical techniques, which leave the gallbladder in place, fully half the patients who were followed up for five years did not have a recurrence of gallstones. Of the patients whose stones recur, a recent study states that only a small percentage will experience symptoms.
Each year more than 25 million Americans are afflicted with liver and gall bladder diseases and more than 27,000 die of cirrhosis. Research has recently opened up exciting new paths for investigation, but much more remains to be done to find cures for more than 100 different liver diseases.
It stores bile, a fluid made by your liver to digest fat. Signs of a gallstone attack may include nausea, vomiting, or pain in the abdomen, back, or just under the right arm. Gallstones are most common among older adults, women, overweight people, Native Americans and Mexican Americans. Gallstones are often found during imaging tests for other health conditions.
Extra estrogen can increase cholesterol levels in bile and decrease gallbladder contractions, which may cause gallstones to form. Women may have extra estrogen due to pregnancy, hormone replacement therapy, or birth control pills.
American Indians have genetic factors that increase the amount of cholesterol in their bile. People who are obese, especially women, have increased risk of developing gallstones.
Obesity increases the amount of cholesterol in bile, which can cause stone formation. As the body breaks down fat during prolonged fasting and rapid weight loss, the liver secretes extra cholesterol into bile.
Research suggests diets high in calories and refined carbohydrates and low in fiber increase the risk of gallstones. Refined carbohydrates are grains processed to remove bran and germ, which contain nutrients and fiber.
1 Gallbladder attacks often follow heavy meals, and they usually occur in the evening or during the night. Gallbladder attacks usually stop when gallstones move and no longer block the bile ducts.
However, if any of the bile ducts remain blocked for more than a few hours, complications can occur. People who think they have had a gallbladder attack should notify their health care provider.
These symptoms may be signs of serious infection or inflammation of the gallbladder, liver, or pancreas. A health care provider will usually order an ultrasound exam to diagnose gallstones.
A CT scan may include the injection of a special dye, called contrast medium. CT scans use a combination of x-rays and computer technology to create three-dimensional (3-D) images.
CT scans can show gallstones or complications, such as infection and blockage of the gallbladder or bile ducts. MRI machines use radio waves and magnets to produce detailed pictures of the body’s internal organs and soft tissues without using x-rays.
A specially trained technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Anesthesia is not needed, though people with a fear of confined spaces may receive light sedation.
With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open-ended or closed at one end; some newer machines allow the person to lie in a more open space. In cholescintigraphy, the person lies on an exam table and a health care provider injects a small amount of unharmful radioactive material into a vein in the person’s arm.
The health care provider may also inject a substance that causes the gallbladder to contract. A special camera takes pictures of the radioactive material as it moves through the biliary system.
A specially trained technician performs the procedure in an outpatient center or hospital, and a radiologist interprets the images. Cholescintigraphy is used to diagnose abnormal contractions of the gallbladder or obstruction of the bile ducts.
ERCP helps the health care provider locate the affected bile duct and the gallstone. The stone is captured in a tiny basket attached to the endoscope and removed.
Health care providers also use blood tests to look for signs of infection or inflammation of the bile ducts, gallbladder, pancreas, or liver. A blood test involves drawing blood at a health care provider’s office or commercial facility and sending the sample to a lab for analysis. Gallstone symptoms may be similar to those of other conditions, such as appendicitis, ulcers, pancreatitis, and gastroesophageal reflux disease. Sometimes, silent gallstones are found when a person does not have any symptoms.
For example, a health care provider may notice gallstones when performing ultrasound for a different reason. However, if a person has a gallbladder attack or other symptoms, a health care provider will usually recommend treatment.
The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of organs and tissues. While watching the monitor, the surgeon uses instruments to carefully separate the gallbladder from the liver, bile ducts, and other structures.
Many laparoscopic cholecystostomies are performed on an outpatient basis, meaning the person is able to go home the same day. An open cholecystectomy is performed when the gallbladder is severely inflamed, infected, or scarred from other operations.
In these cases, the surgeon must switch to open cholecystectomy as a safety measure for the patient. To perform an open cholecystectomy, the surgeon creates an incision about 4 to 6 inches long in the abdomen to remove the gallbladder.
Recovery from open cholecystectomy may require some people to stay in the hospital for up to a week. A few people have softer and more frequent stools after gallbladder removal because bile flows into the duodenum more often.
5 Nonsurgical Treatments for Cholesterol Gallstones Nonsurgical treatments are used only in special situations, such as when a person with cholesterol stones has a serious medical condition that prevents surgery. Unsocial (Actually) and chenodiol (Che nix) are medications that contain bile acids that can dissolve gallstones.
People can decrease their risk of gallstones by maintaining a healthy weight through proper diet and nutrition. Ursodiol can help prevent gallstones in people who rapidly lose weight through low-calorie diets or bariatric surgery. People should talk with their health care provider or dietitian about what diet is right for them.
POINTS TO REMEMBER Gallstones are hard particles that develop in the gallbladder. Women, people over age 40, people with a family history of gallstones, American Indians, and Mexican Americans have a higher risk of developing gallstones.
Gallbladder attacks often follow heavy meals, and they usually occur in the evening or during the night. However, if a person has a gallbladder attack or other symptoms, a health care provider will usually recommend treatment.
If a person cannot undergo surgery, nonsurgical treatments may be used to dissolve cholesterol gallstones. Over time, the gallbladder is less able to concentrate, store, and release bile. The disease occurs more often in women than in men.
This surgery uses smaller surgical cuts, which result in a faster recovery. Open cholecystectomy requires a larger cut in the upper-right part of the abdomen.
If you are too ill to have surgery because of other diseases or conditions, the gallstones may be dissolved with medicine you take by mouth. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions.