1. Gallstones By Erfu Wang, Kaesh Chowdhory, Jae Yoon Chung, and Jun Young Kang

2. What are Gallstones? Gallstones (choleliths) are lumps of hard material (hardened liquid bile) that can range in size from a grain of sand to a golf ball. Gallstones can be formed anywhere within the biliary tract (the path by which bile is secreted by the liver on its way to the small intestine). (Caution: Next slide contains graphic content.)

3. Types of Gallstones and Causes - I Cholesterol Stones ▫ Usually yellow-green in color. ▫ Made primarily of hardened cholesterol. ▫ Accounts for ~80% of gallstones. ▫ Usually formed when bile contains too much cholesterol, too much bilirubin, not enough bile salts, or when the gallbladder does not empty itself as it should.

4. Types of Gallstones and Causes - II Pigment Stones ▫ Small, dark stones made of bilirubin. ▫ Tends to develop in people with cirrhosis, biliary tract infections, and hereditary blood disorders (such as sickle cell anaemia, when too much bilirubin is formed).

5. Causes of Gallstones - Cont

6. ▫ Women between 20 and 60 years of age are twice as likely to develop gallstones as men. ▫People over age 60 are twice as likely to develop gallstones than younger people. ▫ Drugs that lower cholesterol levels in blood actually increase the amount of cholesterol secreted in bile, which can increase the risk of gallstones. ▫People with diabetes generally have high levels of fatty acids called triglycerides, which increase the risk of gallstones.

7. Spotting the Symptoms The symptoms of gallstones usually occurs suddenly, and can be in the form of… ▫ Steady pain in the upper abdomen that increases rapidly and can last up to hours. ▫ Pain in the back between the shoulder blades. ▫ Pain under the right shoulder. ▫ Nausea or vomiting. ▫ Abdominal bloating. ▫ Recurring intolerance of fatty foods. ▫ Belching. ▫ Gas. ▫ Indigestion.

8. Dangers of Gallstones Because gallstones can be formed anywhere within the biliary tree, there are many places where it can interfere with our system. ▫ The obstruction of the common bile duct is choledocholithiasis. ▫ Obstruction of the outlet of the pancreatic exocrine system can cause pancreatitis. ▫ Obstruction of the biliary tree can cause jaundice.

10. The Anti-Gallstones Drink (s) Studies has shown that men and women who drinks five or more cups of coffee a day has a reduced risk of developing gallstones. Studies has also shown that consuming two units of alcohol a day cuts the chance of developing gallstones by a third.  “Moderate alcohol below recommended limits is associated with good health.” – Professor Chris Hawkey, British Society of Gastroenterology

12. Treatment by Surgery There are many ways to remove gallstones. The most commonly used method nowadays is removal via. laparoscopic cholecystectomy. ▫ Laparoscopic cholecystectomy is when the gallbladder is surgically removed through a tiny incision at the navel. ▫ There is no incision pain that usually accompanies a standard abdominal surgery, and the patient will be able to return home on the very same day of – if not, the day after the surgery. ▫ There is also no scarring on the abdomen, since the cuts made are very small.

14. Bibliography Miller, Julie. “Gallstones.” Parkville Surgery Patient Info. http://www.parkvillesurgery.com.au/gallstones_condition.html Rodgers, Griffin. “Dieting and Gallstones.” National Institute of Diabetes and Digestive and Kidney Diseases. http://win.niddk.nih.gov/publications/gallstones.htm Aldridge, Susan. “Coffee reduces gallstone risk.” Health and Age. http://www.healthandage.com/Coffee-reduces-gallstone-risk Anonymous. “Alcohol reduces gallstone risk.” BBC News. http://news.bbc.co.uk/2/hi/health/8073844.stm