What are gallstones?

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. The gallbladder is a small organ located just below your liver on the right side of your abdomen. It stores bile, a digestive fluid produced by the liver.

Gallstones can vary in size and composition. They can be as small as a grain of sand or as large as a golf ball. Gallstones may consist of cholesterol, bilirubin (a substance produced from the breakdown of red blood cells), or a combination of both. They form when there is an imbalance in the substances that make up bile, leading to solidification and crystallization within the gallbladder.

Gallstones can cause problems if they block the normal flow of bile out of the gallbladder, leading to pain, inflammation, infection, or other complications. Symptoms of gallstones can include sudden and intensifying pain in the upper right portion of your abdomen, pain in the upper back between the shoulder blades, nausea, vomiting, and jaundice (yellowing of the skin and whites of the eyes).

Treatment for gallstones depends on the size and severity of symptoms. Options can range from watchful waiting (if the stones are small and not causing symptoms) to medications that dissolve gallstones, or in more severe cases, surgical removal of the gallbladder (cholecystectomy).

How can gallstones be diagnosed?

Gallstones can be diagnosed through several methods, depending on the symptoms and clinical suspicion. Common diagnostic approaches include:

●     Medical History and Physical Examination: Your doctor will typically begin by taking a detailed medical history to understand your symptoms and risk factors. They will then conduct a physical examination to assess for signs such as tenderness in the abdomen or jaundice.

●     Ultrasound: This is the most common and usually the first imaging test used to diagnose gallstones. Ultrasound uses sound waves to create images of the gallbladder and can detect the presence of gallstones as well as any inflammation or other abnormalities.

●     Blood Tests: Blood tests may be ordered to check for signs of infection, liver function, or pancreatic problems. Elevated levels of certain enzymes or bilirubin in the blood can indicate blockage or inflammation caused by gallstones.

●     CT Scan: A computed tomography (CT) scan may be performed if ultrasound is inconclusive or if there are complications suspected, such as infection or inflammation spreading beyond the gallbladder.

●     HIDA Scan (cholescintigraphy): This is a nuclear medicine test that can be used to evaluate the function of the gallbladder and bile ducts. It involves injecting a radioactive tracer into the bloodstream, which is then taken up by the liver and excreted into the bile. Images are taken to assess how well the bile flows through the ducts and into the small intestine, which can help diagnose conditions like gallstones.

●     Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure combines endoscopy and X-rays to examine the bile ducts. It is typically used if there is suspicion of gallstones causing blockage in the bile ducts or pancreas.

The specific tests used to diagnose gallstones will depend on the individual's symptoms, medical history, and the results of initial evaluations. Treatment options can then be considered based on the findings from these diagnostic tests.

What are the symptoms associated with gallstones?

The symptoms of gallstones can vary depending on severity and whether they are causing a blockage or other complications. Symptoms include:

●     Sudden and Intense Pain: This is typically felt in the upper right portion of the abdomen, often just below the ribs. The pain can be severe and may radiate to the back or right shoulder blade. It may occur suddenly after a meal, especially a fatty one.

●     Nausea and Vomiting: These symptoms may accompany the pain, particularly if it is severe.

●     Jaundice: Yellowing of the skin and whites of the eyes can occur if a gallstone blocks the bile duct, leading to a buildup of bilirubin in the blood.

●     Fever and Chills: If there is inflammation or infection of the gallbladder (cholecystitis) or bile ducts (cholangitis), these symptoms may develop.

●     Changes in Stool and Urine: Light-colored or clay-colored stools and dark urine can occur due to decreased bile flow caused by gallstones.

●     Indigestion and Bloating: Some people with gallstones may experience indigestion, bloating, or intolerance to fatty foods.

It's important to note that not everyone with gallstones will experience symptoms. Gallstones that do not cause symptoms are called "silent" gallstones and may not require treatment.

What are the treatments for gallstones?

The treatment for gallstones depends on whether they are causing symptoms and the severity of those symptoms. Here are the main treatment options:

●     Observation: If gallstones are discovered incidentally and are not causing symptoms (silent gallstones), your doctor may recommend observation without immediate treatment. Regular check-ups may be advised to monitor for any changes or symptoms.

●     Medications: Medications are available that can dissolve cholesterol gallstones. Ursodeoxycholic acid (ursodiol) is a medication that can be prescribed to help dissolve small cholesterol stones. This treatment is most effective for small stones and can take months to years to be effective. It is not effective for pigment stones.

●     Lifestyle Modifications: Adopting a low-fat diet can help reduce symptoms associated with gallstones, particularly if you experience pain after eating fatty foods.

●     Surgical Removal (Cholecystectomy): This is the most common and definitive treatment for symptomatic gallstones. Cholecystectomy involves removing the gallbladder, which eliminates the possibility of recurrent gallstones. This can be done through traditional open surgery or more commonly nowadays, laparoscopic surgery (minimally invasive). Most people can live normally without their gallbladder.

●     Endoscopic Procedures: In cases where gallstones have migrated into the bile ducts, causing blockage or other complications, endoscopic retrograde cholangiopancreatography (ERCP) may be performed. During ERCP, gallstones can be removed from the bile ducts using specialized tools passed through an endoscope.

The choice of treatment depends on factors such as the presence and severity of symptoms, the size and composition of the gallstones, the presence of complications like infection or blockage, and the individual's overall health and preferences. It's important to discuss all options with a healthcare provider to determine the most appropriate treatment plan for your specific situation.

How does acupuncture help patients with gallstones?

Some ways acupuncture might be thought to help patients with gallstones:

●     Pain Relief: Acupuncture is well-known for its ability to alleviate pain. For patients experiencing gallstone-related pain, acupuncture may help by stimulating the release of endorphins (natural pain-relieving chemicals) and reducing inflammation locally.

●     Reducing Inflammation: In cases where gallstones cause inflammation of the gallbladder (cholecystitis) or bile ducts, acupuncture might help to reduce inflammation through its effects on the nervous and immune systems.

●     Promoting Relaxation: Stress and tension can exacerbate symptoms associated with gallstones. Acupuncture sessions are often relaxing and can help to reduce stress, which may indirectly improve symptoms.

●     Improving Digestive Function: Acupuncture is believed to influence the digestive system by enhancing the flow of qi and blood. This could potentially aid in the management of digestive symptoms associated with gallstones, such as indigestion or bloating.

●     Supporting Overall Well-being: Acupuncture is often used holistically to support overall health and well-being. By addressing imbalances in the body's energy flow, acupuncture treatments may help to optimize the body's natural healing processes, potentially supporting the body as it deals with gallstone-related issues.