Gallstones

What is Gall bladder?

Gall bladder is a small organ below the liver in the upper right abdomen. It’s a pouch that stores bile, a green-yellow liquid that helps with digestion.

What are Gallstones?

80 %  of gallstones are formed when there’s too much cholesterol in the bile. Other 20 percent of gallstones are made of calcium salts . The exact reason behind formation of gallstones is still unknown.

Having too much cholesterol in your bile can lead to yellow cholesterol stones. These hard stones may develop if your liver makes more cholesterol than your bile can dissolve.

Symptoms

Gallstones can lead to pain in the upper right abdomen. You may start to have gallbladder pain from time to time when you eat foods that are high in fat, such as fried foods. The pain doesn’t usually last more than a few hours.

Symptoms (Biliary Colic)  

1. Indigestion
2. Stomach pain
3. Nausea 
4. Vomiting
5. Colored stools
6. Colored Urine
7. Burp
8. Diarrhea 

Asymptomatic Gallstones

Gallstones actually don’t cause pain. The pain usually occurs when the gallstones blocks the movement of bile from the gallbladder.

Gallstones are detected through X-rays or during abdomen surgery.

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Gallbladder Cancer - Tests and Diagnosis

Cancer that begins from gallbladder is called as Gallbladder Cancer. In most of the cases, cancer is found when the gallbladder is being treated for chronic inflammation or for the removal of stones in the gallbladder( gallstones).

If the surgeon suspects ‘cancerous growth’,  he sends the gallbladder to be screened under the microscope- to ascertain the extent of the spread (growth) of cancerous cells.

Various test are conducted to diagnose the cancer are:

Blood Test: to assess the functioning of liver. This test enables the doctor to determine the root cause of the symptoms.

Imaging Test 

• Ultrasound
• Magnetic resonance imaging (MRI)
• Computerized tomography (CT) Scan 

Determine the extent to which the cancer has spread

• Laparoscopy  (Explorative Surgery)

      Examine Bile Ducts

• Endoscopic retrograde cholangiopancreatography (ERCP)
• Magnetic Resonance Cholangiography(MRCP)
• Percutaneous transhepatic cholangiography (PTHC or PTC)

Additional Imaging Tests - to asses the spread of cancer, whether it has remained confined to the original site (Localized) or has spread to other organs (Metastatic)

• CT of the chest and abdomen 
• Diagnostic sonography (ultrasonography)
• Magnetic resonance imaging (MRI) of the liver
• Positron Emission Tomography (PET) 

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The Gallbladder and Cancer

Gallbladder

What is Gallbladder?

The gallbladder is a pear-shaped organ that lies just below the liver in the right upper abdomen.

The gallbladder stores bile, a yellow, brown or greenish liquid made by the liver that aids in digestion of  fat.

When food is being broken down in the stomach and intestines, bile is released from the gallbladder through a tube called the common bile duct.

This tube( common bile duct) connects the gallbladder and liver to the duodenum, first part of the small intestine.

Gallbladder (Anatomy)

The wall of the gallbladder has 3 main layers of tissue.

1. Innermost Layer (Mucosal) 
2. Middle Layer (Muscularis) 
3. Outer Layer (Serosal )

Gallbladder cancer starts from the innermost layer and then subsequently spreads to the other layers. Gallbladder cancer is difficult to detect initially, primarily because there are no visible  symptoms. And when the symptoms emerge they are symptoms of various other problems and by then its too late.

Risk Factor(s )

• Porcelain gallbladder (Chronic gallbladder inflammation)
• Gall stone (Cholelithiasis)
• Gallbladder polyps
• Chronic salmonella infection
• Cyst in the bile duct
• Age
• Ethnicity
• Gender ( more prevalent among women’s)

Symptom(s)

• Abdominal pain
• Loss of appetite
• Nausea or vomiting
• Fever and bloating
• Jaundice

Treatment

• Mainly depends on the extent to which the cancer has spread.
• If surgery is still an option.
• If cancer has returned.
• General health and age of the patient.
• Gallbladder cancer can be cured only if it is found in early stages ( Stage 1 or Stage 2)  i.e before it has spread to other organs.

After the cancer has spread to other body parts, nothing much can be done. Palliative treatment remains the only option. Palliative care aims at improving the patient’s quality of life by controlling symptoms and complications as a result of disease and treatment.

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Know Cancer, Prevent Cancer

Cancer of the gallbladder is one of the cancer with a extremely poor diagnosis. Most of the gallbladder cancer patients die within one year of the detection.

Gallbladder cancer shows a large geographic variation and is comparatively common  in females and in certain ethnicities . Gallstones are the most common cause of this type of cancer. 

After much research, certain risk factors we’re identified :

1. Smoking
2. Alcohol
3. Obesity and certain specific dietary habits 
4. In women, reproductive history also seem to be the prominent reason.

Keeping close watch on the symptoms, knowing the various risk factors and taking preventive measures can help preventing cancer( to some extent, else their is no specific reason -anyone can develop cancer).

 If detected early, cancer can be treated.

Although gallstones are closely associated with high risk, and most people with untreated gallstones over a period of time develop infection and eventually cancer. But there have been cases where gallstone didn't cause any harm and people with gallstone have lead an absolutely healthy life.

Aging is an inevitable process and many factors like genes, lifestyles, diet and environment determine longevity. Cancer generally occurs when body has weak immune system- at old age that's when body is already fighting many disease(s) and surgery is not always the option. People who have cancer in family tree are the most common victims.

Know cancer, Prevent cancer!

Prevent - Gallstones

Prevention is always better then cure. So to have a healthy life and that too with your loved one is easy: Remember the following and you can save yourself from all the pain and suffering. Reduce your risk of having gallstones :

Don’t skip meals:  Always try to have all the three  meals at your usual times every day. Fasting or skipping meals, increases the risk of having gallstones.

Healthy diet: Include lot of fruits and vegetable in your diet. 

Exercise: Obesity and being overweight can also increase the risk of gallstones.

Love yourself and give at least 30min of your day to your body. Try to maintain a healthy weight and exercise to retain it.

Lose weight gradually:  If you are overweight and need to lose weight, go slow. Loosing weight rapidly can increase the risk of having gallstones.