Treatment of gallstone
disease

Gallstone disease (calculous cholecystitis, GSD) is a condition that leads to the formation of stones in the bile ducts and gallbladder due to impaired metabolism of bilirubin and/or cholesterol in the body. Among the common causes of GSD development are lipid metabolism disorders, an improper diet and eating pattern, liver dysfunction, gallbladder inflammation, bile stasis, and a sedentary and unhealthy lifestyle.

The causes leading to the disease can generally be divided into modifiable and non-modifiable factors. Modifiable (changeable) factors include:

• Diet (foods high in cholesterol and refined carbohydrates provoke an increase in cholesterol levels in bile);

• Obesity (triggers increased excretion and synthesis of cholesterol);

• Low-calorie diets (in 25% of cases lead to the production of sludge-like bile and the formation of stones);

• Fasting;

• Intestinal diseases;

• Dependence on geographic location;

• Use of estrogens and fibrates (increases the lithogenic properties of bile);

• Pregnancy.

Non-modifiable causes of calculous cholecystitis include:

• Gender (women suffer from the disease 3–4 times more often than men);

• Age (after the age of 60–70, cholesterol levels in bile increase rapidly, and the probability of stone formation reaches 30–40%);

• Heredity (if relatives had GSD, the risk of development and progression of the disease is 2–4 times higher, indicating the presence of a human lithogenic gene);

• Ethnic characteristics.

In most cases, the disease develops asymptomatically. Probable symptoms, if they do appear, include complaints of discomfort and pain in the right upper abdomen, associated with dietary errors and accompanied by a bitter taste in the mouth in the morning.

In 60–80% of potential patients, gallstones do not cause significant discomfort. When present, clinical symptoms may be absent for many years.

Timely consultation with a gastroenterologist is often delayed by the fact that, after the first biliary colic, the risk of recurrence within the next year is only about 50%.

In the early stages, the disease can be diagnosed by detecting bile heterogeneity during an echographic examination (ultrasound).

To establish an accurate diagnosis, the patient may also be prescribed:

• Blood and urine tests;

• X-ray with contrast of the bile ducts;

• Computed tomography (CT);

• Magnetic resonance cholangiopancreatography (MRCP);

• Endoscopic retrograde cholangiography (ERCP).

Depending on the disease stage, the patient may be prescribed:

• Diet;

• Gradual weight loss;

• Medication therapy.

The goals of treating clinically evident gallstone disease include:

• Relief of biliary colic;

• Prevention of complications in asymptomatic GSD cases;

• Timely surgical intervention and removal of the gallbladder and stones in case of recurrent biliary colic;

• Prevention of biliary colic recurrence after the first attack.

To relieve a biliary colic attack, antispasmodic medications may be used. If the patient's condition does not improve within 5 hours, hospitalization in a surgical department is required.

Diagnosis and treatment of gallstone disease, pancreatitis, biliary dyskinesia, and other gastrointestinal disorders at "Oxford Medical Kyiv" clinic are carried out under the supervision of experienced certified specialists using the latest equipment.

Competent prevention and timely consultation with a specialist will allow you to avoid many unpleasant consequences and, in most cases, eliminate the need for surgery.

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