Gallstones in women – risks and treatment

By PENDA HONEYGHAN

Monday, November 12, 2018

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GALLSTONES, also referred to as silent stones by virtue of the fact that they are asymptomatic in about 80 per cent of patients, affects thousands of people globally. The condition, which Dr Samantha Nicholson, medical internist at Imani Medical Centre, Papine Plaza, said affects a wide cross section of people, affects women two to three times more than it does men, and occurs as a result of a build-up of solid stone-like material in the gallbladder, usually formed when the bile contains too much cholesterol.

“Gallstones are a very common condition; however, there are a number of factors which increase your chances of developing gallstones such as obesity, age, having a high cholesterol diet and your gender — being a woman puts you at greater risk,” Dr Nicholson said.

She pointed out that women are at increased risk for a number of reasons, many of which are inextricably linked to female hormones.

“The female hormones oestrogen and progesterone, pregnancy, and use of oral contraceptives are among the commonly known contributors to an increase in the production of gallstones in women. What happens is that oestrogen triggers an increase in cholesterol in your bile while progesterone lowers the rate at which the gall bladder is emptying, which encourages the formation of the stones,” Dr Nicholson explained.

These gallstones are asymptomatic in at least 80 per cent of people, which means their threat is minimal even in the case of those with clusters of stones, Dr Nicholson said. The remaining 20 per cent may develop complications which can be life-threatening.

“Gallstones can cause a number of complications such as biliary colic — commonly referred to as gallstone attack which describes a period of pain and discomfort which occurs due to a gallstone temporarily blocking the bile duct. The pain is generally felt in the right upper part of the abdomen, usually under the right side of the rib cage, and in some cases may travel to the shoulders as well,” Dr Nicholson explained. She said patients may also experience nausea and vomiting.

Another common complication that could occur as a result of gallstones is Choledocholithiasis. This is also called bile duct stones and describes the blockage of the bile duct by gallstones resulting in the obstruction of the flow of bile to the intestines which can offset a number of medical complications such as clay-coloured stool, lack of appetite, jaundice, as well as it can lead to cholangitis whereby the duct becomes infected. Dr Nicholson said that cholangitis can lead to sepsis, overwhelming infection and death.

Another complication that may be observed in patients who have gallstones is cholecystitis. This is where the gallbladder becomes inflamed and infected, a direct result of a gallstone becoming lodged in the neck of the gallbladder.

“This condition is associated with severe pain and fever. Gallstones and recurrent cholecystitis are associated with gallbladder cancer, a rare but horrible cancer,” Dr Nicholson advised.

Treating gallstones is often not explored unless the patient presents with pain because gallstones can sometimes pass on their own. If the patient is experiencing pain, Dr Nicholson said the doctor will explore other options.

“In some cases, especially if we are trying to avoid surgery, medication may be given to dissolve gallstones, but this may take months or even years and this may not hinder the formation of gallstones. On the other hand, if gallstones require urgent removal then a procedure referred to as a cholecystectomy, which is the surgical removal of your gallbladder, can be done,” Dr Nicholson said

She said that the procedure is now done laparoscopically, which guarantees minimal scarring and requires a short recovery time.

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