If there is no abnormality after gastroscopy due to abdominal pain, gallstone disease may be suspected. Cholelithiasis is a disease in which cholesterol in bile hardens like stones and accumulates in the liver, gallbladder, or bile ducts, causing pain. It is a common disease that occurs in 1 in 10 adults, and the number of patients is increasing.
Causes of Gallstones
A high-fat, high-cholesterol, and low-fiber diet increases the risk of cholelithiasis by increasing cholesterol in bile and reducing bile excretion from the gallbladder. This diet is also prone to obesity, and clinical studies have shown that moderate overweight actually increases the risk of cholelithiasis.
Cholelithiasis occurs twice as often in women than in men, and cholelithiasis is particularly common in obese women. In addition, long-term fasting, rapid weight loss, and the elderly over the age of 60 are also prone to gallstones.
Symptoms of Gallstones
Gallstone disease has a variety of symptoms, including abdominal pain, jaundice, and fever. There may be no overt symptoms at all. Gallbladder gallstones are often asymptomatic throughout the life of the patient, and in such cases, no treatment is required.
However, if a patient experiences pain due to gallstones at least once, active treatment is recommended. This is because, if pain occurs even once, there is a high probability that the symptoms will recur and lead to serious complications.
Pain caused by gallstones is most often caused by gallstones blocking the biliary tract. Most are caused by overeating, but sometimes there is no cause. The pain mainly occurs in the right upper abdomen.
Treatments for Gallstones
Gallstones should be surgically removed if there are symptoms or complications such as acute cholecystitis or acute pancreatitis. However, even if there are no symptoms, preventive treatment is possible.
If the gallbladder wall is calcified, a cholecystectomy is recommended. There is a study that about one-third of these patients develop gallbladder cancer, and if found, prophylactic cholecystectomy is performed.
Cholecystectomy is sometimes performed for pediatric patients or patients with severe concerns about gallbladder cancer. In addition, even if gallstones are present with gallbladder polyps or cholecystic adenomyomatosis, prophylactic cholecystectomy is recommended considering the incidence of gallbladder cancer.
There is a study that the incidence of gallbladder cancer increases by more than 10 times when the size of the gallstone is large (more than 3 cm). Although there is no sufficient evidence for the association between gallstones and gallbladder cancer, prophylactic cholecystectomy is performed for gallstones larger than 2.5 to 3 cm.
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