What is it?
Gallstones is one of the most common pathologies of the hepatobiliary tract.
It is characterized by the formation of stones in the gallbladder, which in general are almost always asymptomatic, but, in some cases the pain is so strong to be similar to giving birth.
Gallstones form when bile stored in the gallbladder, a small bag that collects the bile produced by the liver. When food is eaten, the gallbladder contracts and releases stored bile into the duodenum to help break down the fats.
Bile is a substance made up of water, bile salts, bilirubin, cholesterol and lipids. Thanks to its lipid composition, it acts as an emulsifier of fats in the intestine.
Under particular conditions, the cholesterol and bile pigments present in the bile can aggregate and form massed crystals, called gallbladder stones, or, biliary lithiasis, gallstones or liver stones.
The dimensions of the stones are very variable and heterogeneous. They can be as small as grains of sand or as large as marbles. Smaller stones are much more dangerous than large ones, as they move along the canaliculi or ducts, occluding the bile and pancreatic ducts. This can lead to a more serious pathological condition, known as acute pancreatitis with symptoms such as cramps, digestive difficulties, nausea and vomiting.
A large stone can even occlude the intestine, thus generating a Gallstone ileus, a mechanical intestinal obstruction due to gallstone impaction within the gastrointestinal tract. In this case, symptoms include very high fever, vomiting, diarrhea, abdominal cramps, twinges in the right abdomen, intense sweating and chills.
There are several types of gallstones, which differ in composition and morphology:
- Cholesterol stones are composed of bile pigments, lipids and cholesterol, have a spherical shape and are light in color;
- Pigment stones are cholesterol-free and contain only bilirubin and calcium, which precipitating form calcium bilirubin stones.
- Mixed stones instead are made of cholesterol, calcium, bile pigments, debris, proteins and have a round and wrinkled shape.
Tests to diagnose gallstones include:
- Computed tomography (CT) of the abdomen
- Magnetic resonance;
- Hepatobiliary acid (HIDA).
The most common symptoms of gallstones are the following:
- Sharp pain in the right side of the abdomen;
- Nausea and vomit;
- Fever and chills
- Back pain
- Soft, clear stools or sudden bouts of diarrhea
- Yellow eyes and yellow skin (obstructive jaundice).
Pharmacological treatment involves the use of draining drugs that dissolve stones, while surgery involves the removal of the gallbladder. The operation is very common and is called a cholecystectomy. It consists in removing the gallbladder bag and joining the liver to the intestine, so that the bile can be directly poured from the liver into the intestinal lumen.
This procedure does not cause any alteration of the metabolism.
Surely, both after removal of the gallbladder or in the presence of gallstones, the diet must be low in fat.
Surely it is advisable to follow a “vegetarian-like” diet, ie with a high content of vegetables and a low frequency of foods of animal origin, very rich in cholesterol and triglycerides.
Furthermore, the consumption of carbohydrates must also be limited, as they are transformed into triglycerides in the liver, further accentuating the symptoms of gallstones in the event of their high consumption.
Furthermore, meals must be small and frequent, in order to ease digestion, compared to having two full and abundant meals.
A diet for gallstones don’t have to include foods such as spices, carbonated drinks, alcohol and chocolate.
Hydration is very important, to prevent the formation of stones by diluting urine concentration. It is therefore advisable to drink much water and eat foods, such as soups, broths and vegetables.