In majority of the patients, symptoms of gall bladder stone occur when they start causing obstruction or blockage of the bile ducts.

The most common symptom in patients is biliary colic caused by blockage of ducts.

It is a very specific type of pain, presenting as the only symptom in about 80% of patients who develop symptoms. Biliary colic occurs when gallstones suddenly occlude or block the cystic duct or the common bile duct.

Characteristically, biliary colic comes on suddenly or builds rapidly to a peak over a few minutes.

  • It is a constant pain but may vary in intensity while it is present.
  • It can last from few minutes to 4-5 hours. If the pain lasts more than 4-5 hours, it means that a complication usually  cholecystitis has developed.
  • The pain usually is severe, but movement does not affect the pain. In fact, patients often walk about or writhe (twist the body in different positions) in bed trying to find a relaxing position.
  • Patients often complaint of feeling of vomiting.
  • The pain usually occurs  just below the sternum or breast bone.
  • Sometimes, the patient may also complain of pain in right upper abdomen just below the ribs.
  • Patients often complain of dyspepsia  which is abdominal bloating and discomfort after eating.

 

                       Complications of gall stones

Biliary colic is the self-limiting ,most common symptom of gallstones but sometimes the patient can have more serious symptoms depending upon complications of gallstones.

Cholecystitis

Cholecystitis means inflammation of the gallbladder. With cholecystitis, there is constant pain in the right upper abdomen along with fever. It is painful to move and the patient usually lie still.

Cholangitis

Cholangitis is a serious condition associated with infection of bile and bile ducts. Patients with cholangitis are very sick with high fever , jaundice and elevated white blood cell counts. Cholangitis may result in sepsis if not intervened timely.

Gangrene

When  the inflammation of gall bladder becomes so severe that it cuts off the blood supply  to the gallbladder, then gangrene of the gall bladder occurs.Without blood, the tissues forming the wall of the gallbladder die, and this makes the wall very weak often resulting in  rupture of the gallbladder. The infection may spread to the whole of the abdomen resulting in severe sepsis but in majority of the patients, the rupture is confined to a small area around the gallbladder (a confined perforation).

Jaundice

Jaundice is a condition  which results due to obstruction of flow of bile into the intestine. The bilirubin  tends to accumulates in the body resulting in jaundice. The obstruction can be due to gallstones, but other conditions like tumors or malignancy of the bile ducts needs to be ruled out.

Pancreatitis

Pancreatitis means inflammation of the pancreas and results from pancreatic duct obstruction due to slippage of gallstones. If a gallstone slips from gall bladder and obstructs the common bile duct just after the pancreatic duct joins it, flow of pancreatic juice from the pancreas is blocked. This results in inflammation within the pancreas. Pancreatitis due to gallstones usually is mild, but it may cause serious illness and even death.gall-stone-updated (1)

Pyocoele

Pyocoele of the gall bladder is usually a sequel of cholecystitis when the gallstones permanently block the cystic duct resulting in infection and accumulation of pus within the gall bladder.

Sepsis

Sepsis is a condition in which bacteria from the infected gall bladder or bile ducts enter into the blood stream and  spread and involve  the whole body. Patients often present as high grade fever, raised counts, fall in blood pressure. it is an emergency condition and if not dealt in a proper manner may even result in death. Low immunity, diabetes, old age often predispose to the development of sepsis once infection of the gall bladder starts.

Cancer

 Cancer of the gall bladder can occur in less than 1% of the population having gall stones especially if the size of the stone is large and the patients tend to keep over a prolonged period of time.

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