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Gallstones- a disease of fat female of forty and Risk of gall stones doubles in women on hormone replacement therapy.
As per published literature and epidemiological data, women are at higher risk of developing gallstones than men with the incidence remains 2-3 times higher than men. The major question arises is that why women are more likely to develop gallstones? The reason may be hormonal imbalance, mainly high levels of estrogen.
The gallstones are pebble like substance found in the gallbladder that form when liquid (bile and digestive enzymes), stored in the gallbladder, hardens into pieces of stone-like material. The gallbladder is a small sac situated below liver in upper abdomen that It stores bile and releases it on requirement, for digestion of fat. The two main causes that lead to the formation of gallstones including
1. Increased level of cholesterol in bile
2. Decreased emptying of gallbladder
Increase level of estrogen in women due to pregnancy or hormone replacement therapy, and birth control pills raises the cholesterol levels in bile. It also decreases the movement of gall bladder. Thus in both condition there will be more cholesterol in bile, and it will stay longer time, this can result in thickening of cholesterol in to the soft lumps that eventually solidify forming gallstones.
Causes and Risk factors for development of Gall stones
With the increased level of estrogen, there are certain other factors that go hand to hand and facilitate the formation of gallstones in female, like
- Age above 40
- Rapid weight loss
- Diets high in fat and cholesterol and low in fibers like junk food.
- Ethnicity- American Indian and Mexican Americans
- Family history
- Cholesterol level reducing drugs
Symptoms and Signs of Gall Stones
There won’t be any symptom or pain for many years if the stone is small and within the gallbladder (silent stone). The size of gallstones can be a small as a grain of sand or as large as a golf ball. The gallbladder can develop just one large stone, hundreds of tiny stones, or a combination of the two.
If there are many or they are large, they may cause pain when the gallbladder contracts in responds to a fatty meal and also the movement of stones out of the gallbladder may block any of the ducts of gallbladder. Blockage of duct causes trap of bile or digestive enzymes in the duct. In respond to this there is inflammation of duct with sever pain in upper abdomen. Blockage of any of the ducts connecting the gallbladder, liver, or pancreas with the intestine can lead to organ damage. If these conditions go untreated, they can even cause death
Characteristic of pain and other symptom
- The typical gallbladder pain comes in episodes, called an “attack”.
- Pain is described as severe, dull and constant, usually occurs within 30 minutes after a fatty food, as gallbladder contracts in respond to food intake.
- The attack can last from one to five hours
Sometimes pain radiates to back, between shoulder blade and under the right shoulder and occurs frequently at night and may awake patient from sleep.
- Nausea and vomiting can be associated with,
- Low grade fever for long time
- Yellowness of skin or whites of eyes and clay color stool. If not treated in time, the infection progresses to complications.
There is no known way to prevent gallstones. But some doctors believe that if you take certain precautions, you may avoid gallstones and its symptoms, such as
Stay trim. Try to stay as close to your ideal weight as possible.
Slendrize gradually –the risk of developing gallstones increases in cases of sudden weight loss. So try to lose only one or two pounds a week, and if one needs to reduce weight faster then do it under doctor’s supervision.
Avoid fats. It is not prove that fatty foods leads to gallstone formation but certain doctors believe that fat can contribute to it. For that one should avoid foods like butter, burgers and fried food, else opt for lean cuts of meat and fishes.
More grains and vegetables- some studies have shown that vegetarian have a lower risk of developing gallstones, possibly because of high fiber diet. So go for more colourful vegetables, salad and include whole grain in diet.
If one suffers from the attack of gallstones she should immediately contact to physician who may advice to undergo certain test to confirm the diagnosis, as Abdominal ultrasound,CTscan, Xray, Endoscopic retrograde cholangiopancreatography(ERCP), Gallbladder radionuclide scan, Oral cholecystogram. The blood test may be performed to look for signs of infection, obstruction, pancreatitis, or jaundice.
Surgical removal of gallbladder is thought to be a better option nowadays with advancement in surgical technique for treatment in patient with multiple gallstones. The laparoscopic cholesystectomy is most commonly performed as it involves minimum invasion and smaller surgical cuts allows faster recovery. A patient may have been operated in morning and can be discharged from hospital on the same day or next morning. In the past, open cholecystectomy (gallbladder removal) was the usual procedure for uncomplicated cases.
Lithotripsy is elctrohydraulic shock wave is other method used in treatment of gallstones. They break the stones with high energy shock waves. However ,its application is limited if there are a large number of stones present, if stones are very large, or if person is having acute cholecystitis or cholangitis. To inhance its efficiency it should be in combination with UDCA.
Medicines are given in form of bile salts, if the gallbladder is working properly and that has to be taken for longer periods. It aims of dissolving the stones. But there are chances of recurrence. Other medicines are given specially to dissolve the cholesterol stones.
Gallstones develop in many people without causing symptoms. The chance of symptoms or complications from gallstones is about 20%. Nearly all patients (99%) who have gallbladder surgery do not have their symptoms return
Homoeopathy gives promising results!
When the stones are of a smaller size, homeopathic medicines will help in possibly dissolving the stones. Homeopathy medicines are effective in alleviating pain as well as chronic inflammation of gallbladder (cholecystitis) associated with the condition. Homeopathy also helps to control further stone production activity. It the stones are bigger, multiple and impacted, it may require surgical intervention. In cases of Large and multiple stones, homeopathy has no curative role to play.
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