Gallstone for Dummies

    Content

1. How Did It Started?
2. Gastric or Gallstone? 
3. Why Do People Have Gallstone? 
4. Why is gallstone painful as hell? How long does it last?
5. How do we treat gallstone? 
6. Can We Live Without Gallbladder?
7. Should the gallbladder be removed ?
8. When to seek emergency treatment?
9. What are the other alternatives than removal?

cholesterol and pigment types of gallstones

How Did It Started? 

This is a sharing of my own experience as a gallstone patient. To begin with, I’m a career person. Being a full-fledged engineer, I live a negligence lifestyle with a poor diet that led me to a series of painful years. My daily consumption was rather excessively taken, untimed and lack of nutrition. Typically kick-started my day with instant meals from a convenience store and it has been a habitual practice since the start of my career. Being in a highly demanding industry, hectic lifestyle has brought about heavy distress. I'm not entirely blaming it as its sole factor, it all finally came down to the choice we made. From the distress, I often take heavy dinner from fast food outlets as an alternative to unwind. With lack of exercise, the diet has slowly taken a toll on my health. Year over year, I was proficiently good in exorcising vital gifts given by god. Oh, how I wished I’m that proficient at everything. 

Gastric Or Gallstone? 

Good question. Even to any experienced medical practitioner, there was no way to be sure if the pain you described was caused by gallstone or gastritis without performing imaging methods. Confronting a typical GP clinic, you will probably be asked typical questions describing your pain, severity and its location. Before long you will be asked to lay flat and there goes the gentle touch from a hand of a million $ worth medical scholar. Probably to find out if you are brilliantly trying to slack off from work or genuinely in pain. 

 

To beginners in this gallstone community, the pain typically started with a discomfort at the abdomen area similar to gastritis pain. The time it came to me, I thought I was bloated over spicy meals I had for dinner because I’m intolerant to spices. Wasn’t really bugging me at first. It was mild until later it developed into a severe pain at my upper right portion of abdomen typically at late night. The pain later conjugated through my back in the later month. In the event of an attack, the pain lasted overnight without any rest. Would you imagine? The world described toothache is somewhat as painful as laboring a baby (probably an old saying to get kids to brush their teeth). Damn I was furious at the fact that nobody actually ranked gallstone at least next in the line after it. 

 

No matter what position you may try to comfort yourself with, you will end up crawling upside down and I believe some people may end up with more ridiculous yet creative poses they can think of at that moment to subside the pain. “Was it gastric?” I began to ask myself. I wasn't a picky eater to begin with. A year after it started, the attack was getting more frequent and more intense. There was one time my friend had to pull-off from the road because I felt like throwing up. That same night I went for a scan to find out that this pain was actually from that of a gallstone; concentrated bile elements forming stones within the gallbladder. They seemed surprised with the scan results that they needed a senior doctor to confirm the result. Says one of the doctors, “this occurrence is more common to females and elders.. it's very uncommon for males to have this problem and to top with that you are like only 25”.

 

 

Why Do People Have Gallstone? 

 

Basically, gallstone can be one from a few types. It varies depending on the condition you may have initially or developed along the way. There are mainly cholesterols or pigment types of stone formation.  There probably is very little way to identify which you may carry. Probably the only way is to dissect yourself out and look at its morphology. You get to see the stones if you choose to undergo gallbladder removal. (that’s the fun part you get after performing the surgery anyway).

 

For pigment types of stones, science has yet to discover its actual cause of formation as it may come from multiple factors from the body system. We however know that it is built from an unconjugated bilirubin along with some degree of calcium salts. Upon removal, the stones are typically black/brown in colour. As for cholesterol stones, they begin to form when the solubility capacity of cholesterol in the gallbladder has exceeded its saturation point and from that point onwards, they nucleate into crystals that then we call gallstone. As the name suggests, most cholesterol stones are pale yellow in colour. They do not contain calcium carbonate and therefore radiolucent. That means you can only detect these stones by radiology other than x-ray. 

It is true that gallstones are more common on a specific demographic such as those at an advanced age, obese & women but nevertheless, the statistics nowadays are changing with the change of our lifestyle diet. Here is a thing for us to ponder, earlier generations used to stuff themselves with more organic elements, not junk. Need that testimonial? Ask around our parents how they were fed in their earlier times. Their meals were more balanced with proper nutrients stuffed with mainly home-cooked recipes filled with natural ingredients. People used to be less worried with issues like chemically induced grown meat or vegetables tainted with pesticides, preservatives or even advertising deceptions from wax coatings. Most importantly, people used have little options for canned food, artificial ingredients and chemicals in the meal but what do we see today? From time to time, we are looking at more artificial choices in the market, MSG is a must in every meal, glucose indexes (GI) are excessively high in snacks and with the aid of every convenient store displaying the vast majority of junk elements instead of essential diets. The market itself has changed into that direction. Peek into the store fridge and you will see more instant meals replacing fresh meals. With those stuffed into our body system every single day, would it still be a wonder that our health declines? 

Why Is Gallstone Painful As Hell? How Long Does It Last?

 

To understand that we have to first know the event mechanism. In normal conditions, our body readily produces bile to help digest our food consumption. There goes our gallbladder to store bile just below the pancreas so that whenever food is in presence it can respond at a better efficiency. Bile breaks down fats into fatty acids and each meal involves the transaction of bile transferred from gallbladder going through a small duct into our duodenum. When a person suffers from gallstone, the severity of pain is very dependent on the size of the stone. Why is that? As the bile are being transferred from the duct into our stomach, the stone may or may not follow the stream of bile flow. Big or dense ones may settle down in the bottom however small ones go up and potentially trapped in the duct. In my case, my baby stones consist of multiple stones up to 7mm while my cystic duct opening allows only up to 5mm. Let’s not do the math as these figures are merely estimation from radiology (Ultrasound and CT scan); accuracy may depend on the handling skills of the technician/doctor. 

 

In layman terms, my stones are slightly larger than my duct and got entrapped in the bile movement. That is when your gallbladder and cyst duct begin to swell and with little clearance it begins to harass other organs in its way; that's when you will ultimately enter the pain fiesta. Imagine somebody took your gallbladder and rubbed it onto other organs. Do you find that it will be tickling? 

 

Ideally, the pain subsides only if the stone falls back to the bottom. I was lucky (and most of the time) my pain doesn't escalate to worse. That is however long after the food processing is over. Take a look at the following summary on the time taken for bile to convert those chunks of meals to reduce it into a mass resembling a porridge. 

Taken from: Experiments and Observations on the Gastric Juice, and the Physiology of Digestion: by William Beaumont

God knows how much regret you had on that last meal. On the other hand, if the stone is stuck somewhere deeper in between the cyst duct, it may cause further complications that we all wish to avoid. The pain may last longer. My typical hours of pain events usually last about 6-8 hours overnight while my longest record lasted for two days straight. That happened when I first relocated to Singapore. I was bed ridden for more than 48 hours without meals and drinks. The next day the pain subsided and the very moment I took a step out to fill my stomach again, my feet went tremble; I kinda lost balance, out of energy to even walk. I meant this greatly, is a big DO NOT to attempt such a prolonged attack. By the time you realize the pain did not go away and that the pain is very severe you should consider the risk that you may experience complications and immediately seek treatment (I will later explain in what situation you should seek a doctor).

How Do We Treat Gallstone? 

 

A most common question but sadly with very little alternatives to those who asked. So how do you treat gallstone? By far, most of the medicinal practitioners that I visited gave almost a definite answer to my enquiry; gallbladder removal surgery. Basically, it is a three- or four-point incision surgery that gives your abdomen a small area of cut and removes your gallbladder. The instrument basically has a few parts of sharp pointed scissors to cut a few points of incision, to disassemble the gallbladder and finally remove it out from one of the incision points.

 

I’m more than reluctant to remove my gallbladder. Wouldn't want a piece of me being cut out from my body for some bad reasons. It is a wonder that these really are the best solution to these problems. In my thoughts, aren't modern medications too focused on removing the symptoms rather than cure it? We always look at the short term and a quick fix for everything. For instance, whenever we have fever we choose to stuffed in paracetamols and it's not only for fever are they not? Be it pain injury, migraine or flu, each medical visit caters more pills for treatments. Very little doctors who actually advise you to change lifestyle or diets apart from removing your symptoms. Be clear that visiting a modern practitioner is meant to cure your symptoms. But if you are looking for a long-term solution to health and vitality, you will need another option.

 

Let’s not blame the scholar perhaps if we are in their place the thoughts may come the same. modern medical technology has developed in that direction as well. In the early years people were cut open at full length incision (major surgery) for gallbladder removal until the recent years’ laparoscopy became vast and more available to most hospitals. The surgery has become more simplified and claims are that patients being discharged to walk out over the same day of procedure. How wonderful it may sound; laparoscopy can be riskier than it sounds. Patients may encounter complications; visceral injury and artery bleeding during process. Some may even suffer from infections from the injury. Of course, none of the doctors will expose the risk of the procedure as it would dishearten and cloud your decision. But if anybody insists on undergoing the removal of gallbladder, do not be disheartened by my thoughts too. Success rate of the laparoscopy are considered very high unless you are an obese. The surgery will take a couple of hours, you get discharged and from that point onwards most patients will intermittently feel uneasy or discomfort (or pain) only in the first few weeks. Your body will need time to adjust to the invasive procedure before you finally get back on track. 

 

Can We Live Without Gallbladder?

 

Back to the point, gallbladder is removed because it is the source of the pain you are suffering. Removing gallbladder does not kill you earlier or make your life very much different compared to amputating a leg or two. Remember that gallbladder function is merely to store bile produced in the body. It acts as a storage. Our body still readily produces enough bile to digest foods on a daily basis. The only set back is when you choose to have a heavy meal or accidentally overeaten way out of your body digesting capacity, you tend to have indigestion. Vomiting will be more than a friend of yours. The fact that the storage of bile is reduced, your ability to process excessively taken meals will be in jeopardy. The amount of food you will be taking will be less and you are advised to take meals more frequently in a little amount. To be honest, that's how we all should do it but are we ready for the fixated lifestyle awaiting that decision? God has created us in a flexible system to cater for our errors but if we plan to remove it, we might as well be ready for a sterner way of diet. Not everybody wants to remove that finite gift of life. It doesn’t grow back. 

 

Should The Gallbladder Be Removed?

 

Ultimately, it all came down to the decision of the very owner of the organ, you. In my point of view, if the symptoms do not interrupt your day to day activities there is no need to haste the procedure. In caution, you should also align yourself with knowledge about the symptoms and know when to seek immediate treatment. Acute cholestasis (gallstone attack) can be very disturbing and at some point, life-threatening. You are carrying a time-bomb above your pancreas that will go off if left unattended. If the organ ruptures, you will then experience jaundice (yellowish in the eye) caused by the dispersion bilirubin from your gallbladder tainting your whole-body delivering system. With the rupture of the gallbladder you are then prone to infections and surgery will be more complicated and riskier. We therefore must understand the level of damage to be taken from leaving the gallstone untreated. 

If you can change the lifestyle from that point onwards it is probably a good thing that you leave your gallstone intact and look for other alternatives for cure however if you have very little self-control, it is a very slim hope for saving.

 

When To Seek Emergency Treatment?

 

Bear in mind that having a gallstone is like carrying a time bomb. It could go off anytime if you are unable to refrain from heavy meals. Not only overeating, there are various taboo food you have to watch out for. It’s a total no to fried foods, oily ones, cheese, ice cream, butter, peanuts and anything else that you knew a challenge to your stomach to digest. With regard to this food taboo and lifestyle, nobody know yourself better than you are. If you can’t keep a promise to yourself to only consume in moderation, you might as well seek surgical options. Nobody can tell when will the next attack actually kills you. Long before anybody can, you already experience first hand life after death. A sad story from a friend of mine, his father who suffered years of gallstone pain was unfortunately unable to perform surgery due to other health reasons. He eventually lose the ability to digest and thrown up every meal he took. In the later, death came to fetch this great father leaving the family into years of sadness. 

A severe attack of gallstone bring about complications when the stone that got stuck in the cyst duct for a prolonged time. As mentioned earlier the pain will be un-bearable. You may throw up multiples of times. The more severe the attack, the higher chances that your organ might rupture. If that does happen, bilirubin will be exposed into the bloodstream and it travels throughout your vein. That’s when you begin to notice the change in the eye ball turning yellow (the color of bilirubin pigments). These phenomena are called jaundice. Although it can be treated, the more worrisome from the rupture is the infection you'd suffer from. Chances that although you immediately brought to the emergency, the surgery will tend to be more complicated and riskier. To all of these reasons, consult with yourself before taking risks. It is very important to understand the body capability before making a decision.   

 

What Are The Other Alternatives Than Removal? 

 

Other alternatives include drug-based medicine meant for elderly or for those who are unfit to undergo surgery. These methods are more lengthy and time consuming as it took years to break down the stones and most of the practitioners stopped suggesting this procedure to patients. Other than these, there are a few stone flushing techniques you can always find on the net but bear in mind that there are no scientific records to prove its effectiveness and its risk assessment. 

As for myself, I did a research on a few options and tried myself in combination of science and faith. It has worked out good for me and it will most likely work out the same to those with similar conditions with me. I began with multiples of 7mm stones and in the later years, it downsized to 4.5 mm stones and finally down to 3mm which with ease it came out from my duct without any complications. Now that its gone, I continued to have balanced meal with appropriate portions according to my energy needs. I wish to not have the stones reformed again. Yes, with inappropriate meals ongoing, it can eventually develop again.

To whoever seek for an alternatives other than surgery, do not give up on hope. I'd be gladly to consult your condition and provide opinions and if you are keen, I can lay out in more detail options that you can try that would suit your daily lifestyle. I have years of pain experiences and believe me I have tried various of methods to flush out mine. Although I'd like to remind again , this method requires a consistent healthy diet commitment and a good self refrain. Nobody will be able to save you before you decided to help yourself first. 

Perhaps if there is somebody that you knew who might need a help with the alternatives, be sure to read throughout the reminders in this blog to understand the risk on the table. surgery may still imply to those in critical conditions. Do not hesitate to consult for opinions. Feel free to ring me up to ask on the details from me. The blog is intentionally to share informative content to help you understand your condition. To know more in detail the how's, you can reach me at these links. Wish everybody a good health and stay happy always!

Whatsapp: +60175404915 : Najmi 

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Remark: these images are obtained from online sources I do not owned any of it