Gallbladder disease treatment options
It important to know modern gallbladder disease treatment options.
The majority of gallstones are asymptomatic; indeed, 10% develop symptoms and sign of gallstones in gallbladder disease. Symptomatic gallstones manifest as either biliary pain or cholecystitis.
The patients experience a severe pain if the gallbladder disease stone affect to the cystic ducts. Biliary colic is not the right name, as the pain is not rhythmical and its intensity decrease and increase according to the form of colic. Usually at this time patient visit clinic for treatment of gallbladder disease.
Typically, the gallbladder pain occurs suddenly and persists for about 2 hours, if it continues for more than 6 hours a complication such as cholecytitis or pancreatitis may be present. Pain is usually present in the right side of the liver, under the arm and shoulder.
The pain travels to the back as well. Tenderness of gallbladder mimics intrathoracic disease, oesophagitis, and myocardial infarction.
Dyspepsia, flatulence and food rich in fat combine to cause gallstone dyspepsia. These symptoms are best known as dyspepsia rather than the symptoms caused by the gallstones. These symptoms are also known as non-ulcer dyspepsia.
A plain abdominal x-ray can show the 20% patients shows the calcified gallstones. The method to choose is for diagnosing gallstones, CT scan is used for the oral cholecyrography. MRCP is becoming increasingly available and can demonstrate gallstones and their complications.
Asymptomatic gallstones found are not treated as they are formed because they do not usually show the symptoms of pain and indigestion.
The gallstones are removed by surgical method using minimal access technique. These stones can be removed mechanically by dissolving and fragmenting its inside the gallbladder.
UDCA – Oral administration of the bile acid can provide the medication of gallstones. Gallbladder disease treatment with drug therapy is suitable for the removal of the stones with the diameter of 15 mm in the radiolucent gallstones.
The symptoms such moderate obesity provides the sign for the drug treatment. 75% of patients fulfill the criteria and makes the treatment a success. The expensive and widely non-available therapy is extracorporeal shock wave.
To follow litho trip it is important to remove the gallstones mass within the gallbladder with the help of bile salt therapy. Lithotripsy treatment is suitable very few patients, as only 30% of all patients can go under this treatment. All therapies have the 50% recurrence of the stones.
Gallbladder and Cholecystitis
The prominent feature is pain in the right upper abdomen but also in the back along with the right shoulder. Differentiation between biliary colic and acute cholecystitis may be difficult to note as the features portraits cholecystilis includes severe and prolonged pain, fever and lecocytosis.
Tenderness of hypochondrial and worse stimulation of rigidity and gallbladder mass is observed. Jaundice occurs in less than 10% of the patients and it is usually due to presences of the stones in the bile duct, according to cancerFactsMD.com website.
Peripheral blood leucocytosis is not common in elderly patients. Inflammation can be minimal in the patients, maybe minimal. Minor increase of plasma transaminaes and plasma amylase concentration may be encountered. To dectect acute pancreatitis the plasma amylase should be measured which may be a potentially serious complication of gallstones.
The abdomen and chest x-rays reveal the gallstones radio-opaqueness. It is important to check it because of the interabiliary gas produces gallstone and can exclude a perforated viscus along with the lower lobe pneumonia. Thickness due to cholectilis can be detected with ultrasonography of gallstones present in gallbladder.
Medication recommended is complete rest, pain relief, intake of antibiotics and maintains of fluid balance. Moderate pain is relieved using dicolofenac, and more severe pain should be relieved by pethidine. Antibiotics are required.
In the medication of severely ill patients a cephalosporin antibiotic and metronidazole is provided. Intravenous therapy maintains the fluid balance. To stop vomiting nasogastic aspiration is given as medication. The inflammation may development to other diseases such as an emphysema or perforation and peritonitis with medical treatment is resolves with chelecystitis.
Complications can be formed such as emphysema or perforation develops while medical therapy, urgent surgery is required. As the onset of symptoms occurs, operation should be done in with five days. 2-3 months. It is no longer favored after 2-3 moths. It is not recommend delaying in surgery.
If the gallbladder is not removed, the biliary colic or stone recurrence occurs.
Gallbladder Carcinoma treatment
Following the surgery for gallstones may incidentally diagnose the condition. There are repeated attacks of pain and later it continues as jaundice to unexpected weight loss. In the right hypochondrium of a gallbladder, a mass of stones can be formed. LFTs show cholestasis and gallbladder calcification may be found on x-ray.
Diagnosis of tumor is done by the ultrasonography and CT scan determines its stages. The treatment to it is surgical removal of it, to prevent the tumor to grow beyond the walls of gallbladder to liver, lymph nodes and other tissues. The expected life of such patients is short; they typically live for one year after its onset.
Patients with SOD who are predominantly female present with symptoms and signs indicative of either biliary or pancreatic diseases. Biliary type SOD experience recurrent episodic biliary-type pain with patients.
They have often had cholecytectomy but the gallbladder may be intact. Patients with pancreatic SOD usually present with unexplained recurrent attacks of pancreatitis. The diagnosis excludes gallstones.
It’s demonstrating includes a dilated or slowly draining bile duct. The gold standard for diagnosis and is associated with a high rate of procedure-relation pancreatitis. All biliary SOD patients with type I disease and the majority of those with type II are treated with endososcopic sphincterotomy.
The results are good but patients should be warned that there is a high risk of complications, particularly acute pancreatitis.
Type III patients with typical pain but normal cholangiography and laboratory tests should be offered medical therapy with nifedipine and low dose tricyclic antidepressant drugs, such as amititriptyline for gallbladder disease treatment.
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