When gallstones cause problems

Sudden severe pain, nausea, vomiting: In addition to genetic predisposition, unhealthy Nutrition to the formation of gallstones. If left untreated, further dangers lurk.

gallstones occur more frequently than is generally believed. Around 15-20% of all Germans have them and often do not know about them. Until the stones cause problems: Sudden severe pain in the upper abdomen, which can radiate to the shoulder, feeling of fullness, heartburn and flatulence, nausea and vomiting are typical symptoms of biliary colic caused by one or more gallstones.

“When gallstones get into the gallbladder duct and block the flow of bile, severe pain attacks occur,” explains Dr. Reinhold Lunow the process. Although around 10% of all Europeans have a genetic predisposition to gallstones, the cause is usually environmental influences, especially an unhealthy diet with a lot of fat, fried and roasted foods. The main foods are hard-boiled eggs, Coffee, legumes and alcohol as trigger famous.

risk factors for gallstones

In addition to diet and predisposition, the following factors promote the formation of gallstones: obesity and lack of exercise, pregnancy, the use of ovulation inhibitors, diabetes (Diabetes mellitus), condition after small intestine surgery (bile acid loss syndrome), inflammatory bowel disease (Crohn's disease) and chronic constipation (obstipation).

Gallstones mainly occur when the composition of the bile becomes unbalanced. If the proportion of cholesterol If the amount of bile in the bile fluid is too low or the amount of bile acid falls, cholesterol crystallizes. Cholesterol crystals form, which in turn accumulate to form gallstones. If the gallbladder cannot contract and empty properly, the risk of gallstones increases.

Such crystals can also form from bilirubin pigment material if the body produces increased amounts of bilirubin, a breakdown product of the red blood pigment hemoglobin. However, if the conversion into its soluble breakdown products or their drainage is disrupted, these pigment stones primarily appear as biliary grit in the bile ducts.

Risk of infection if a gallstone blocks the bile duct

The stones cause further problems in the bile duct. "If a gallstone blocks the bile duct and prevents the bile from flowing into the intestine, bacteria can spread. This increases the risk of infection (cholangitis) with fever and chills," says Dr. Lunow.

Jaundice (icterus) is also possible. External signs are dark urine, pale stools, yellowish skin and eyeballs. "A scar-like narrowing can develop at the narrow passage in the bile duct, which impedes the flow of bile even after the stone has passed," explains the internist and medical director of the Praxisklinik Bornheim near Cologne and Bonn.

Gallstones do not necessarily have to migrate for them to cause problems. Gallstones can also cause inflammation at their point of origin in the gallbladder, cholecystitis. Due to the constant mechanical irritation, the gallbladder wall calcifies and becomes inelastic. The result is visible in an X-ray as a so-called "porcelain gallbladder". "If the gallbladder loses its elasticity in this way, it can no longer contract completely and dysfunction occurs. In addition, the risk of developing gallbladder cancer increases," says Dr. Lunow.

Inflammation of the pancreas is also possible, as the bile duct and pancreas often flow together into the duodenum. If a gallstone is in an unfavorable position here, the secretion of the pancreas also builds up.

"From the age of 40, the risk of developing gallstones increases. Women are affected two to three times more often than men if they take estrogens for oral contraception or as part of hormone therapy," explains Dr. Lunow. In addition, overweight people in this age group are at greater risk if there is a family history of gallstones.

Treatment of gallstone disease in the practice clinic Bornheim

However, the expert for prevention and Diagnostics Gallstones can be quickly identified. "If the patient describes the symptoms, we can quickly find out with a simple ultrasound scan and blood test," says Dr. Lunow. Even small gallstones can be easily seen in an ultrasound. In the blood, elevated levels of the enzymes gamma-GT (enzyme gamma-glutamyl transferase) and AP (alkaline phosphatase) are also found, in addition to bilirubin.

The treatment of gallstone disease (cholelithiasis) depends on the type of symptoms. "In the case of acute biliary colic, the main focus is on medication to combat pain and cramps. In the case of inflammation, antibiotics are recommended," says Dr. Lunow. At the same time, in most cases, a strict diet must be followed. diet “We decide which measures are appropriate in each individual case together with the patient in our practice clinic after a precise Check-up. "

This also applies if gallstones keep recurring and causing problems. A possible procedure depends on the location of the gallstone: sometimes it is enough to make a small incision at the opening of the bile duct into the small intestine so that the stone can pass by itself. If the gallstone is in the bile duct, it can be removed using special wire loops (e.g. Dormia loop) as part of an endoscopic retrograde cholangiography (ERCP). If the stone is in the gallbladder and keeps causing inflammation, surgical removal of the gallbladder (cholecystectomy) is indicated in the long term.

"If you eat a balanced diet and avoid rich, fatty meals, you can live very well without a gallbladder. Of course, it is better to reduce the risk of gallstones from the outset. The nutritionists at our practice clinic can help with this," says Dr. Lunow.

(Image: Martha Kosthorst/Fotolia.com)