Best answer :Make a short note on gall stone?

Make a short note on gall stone:

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Introduction to gall stone:

Gall stone is a solid crystal deposit, which is formed by cholesterol, calcium ions and bile pigments in the gall bladder or bile duct.

If the gall stone is present in the gall bladder , then it is known as Cholelithiasis.

And presence of the gall stone in the bile ducts is known as Choledocholithiasis.

In women gall stone is very common than in case of men.And gall stone increase in incidence in both sexes and all races with age.In the United States the prevalence of gall stones is 8.6% in women and 5.5%in men.

File:Gallstones.png ,Image by-BruceBlaus , Source,License-CC BY -SA4.0

The disease gall stone is associated with increased overall mortality, cardiovascular mortality and cancer morality.

The  individual with Crohn diseases have higher risk of gall stone formation , approximately one-third of those wih inflammatory involvement of the terminal ileum.

The size of the gall stone can vary in size from as small as a grain of sand to as large as a golf ball.The composition of gall stone can vary by depending upon age, diet and ethnicity.

Diabetes mellitus, glucose intolerance,and insulin resistance are risk factors for gall stones and high intake of carbohydrate and high  dietary glycemic load increase the risk of cholecystectomy in women.

Types of gall stones:

By depending upon the composition gall stone can be divided into the following types:

Pigment stones:

This is also known as calcium bilirubinate stones account for 15-20 cases of gall stones.The characteristics of pigment stone is ,

It is small, dark stone formed by bilirubin and calcium salt which can be found in bile. Disconjugation of conjugated bilirubin by the action of beta-glucoronidase found in certain bacteria,can lead to the formation of pigment stones.

Cholesterol stones:

Almost 80-85% cases of gall stones are cholesterol stones. Precipitation of cholesterol leads to the formation of cholesterol stones.

The colour of the cholesterol stones can vary from light yellow to dark green or brown.Cholesterol gall stones are  less common in black people, cholelithiasis attribute to hemolysis occurs in over a third or individuals with sickle cell disease.

Mixed gall stones, typically contain

20-80% cholesterol.Other common constituents of mixed gall stones are calcium carbonate, palmitate phosphate, bilirubin,and other bile pigments.

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Causes for gall stone:

  1.Decrease in the amount of bile salts and lecithin.

 2.Excess of cholesterol.

 3.Disturbance in the metabolism of cholesterol.

 4.Increased concentration of calcium ions due to increased concentration of bile.

 5.Obstruction in the flow of bile from the gall bladder.

 6.Damage or infection of gall bladder epithelium.

Gall stone

Symptoms of gall stone :

Cholelithiasis is frequently asymptomatic or may produce symptoms either due to inflammation (biliary colic) or obstruction (obstructive jaundice) following their migration into the cystic or common bile duct.

Cholelithiasis is discovered in the course of a routine radiographer study, surgery or autopsy.Symptoms develop in 20-25% of paitents.

Risk factors for the development of symptoms or complications included women, young age, awareness of having gall stones,and large , multiple and older stones.

The most specific and characteristics symptoms of gall stone is biliary colic.

Treatment of gall stone:

  Non-steroidal and anti-inflammatory drugs (example, diclofenac 50-75mg intramuscularly)can be used to relieve biliary pain.

Laparoscopic cholecystectomy is the treatment of choice for symptomatic gall bladder disease.

Conversion to a conventional open cholecystectomy may be necessary in 2-8%of cases.

There is generally no need for prophylactic cholecystectomy in an asymptomatic person unless the gall bladder is calcified, gallstones are 3cm or greater in diameter or the patient is Native American or a candidate for bariatric surgery or cardiac transplantation.

Cholecystectomy may increase the risk of esophageal, proximal small intestine,and colonic adenocarcinomas because of increased duo-denogastric reflux and changes in intestinal exposure to bile.

✡️✡️ Patients should be referred when they require surgery.

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