Cholelithiasis is a condition in which small calculi form in the gall bladder. Also known as gallstones, in a reference to the common name for the calculi which cause it, cholelithiasis is often asymptomatic, with patients only becoming aware that they have choleliths or gallstones during routine medical screening. There are a number of treatment options for this condition, depending on whether or not a patient is experiencing symptoms, and how severe these symptoms are.
Several different kinds of choleliths can form in the gallbladder, classified by the types of materials present in the calculi. The most common are formed from cholesterol, while black and brown gallstones contain other materials. Treatment approaches can vary, depending on the type of gallstones involved. The causes of gallstone formation are unclear, although women and older adults appear to be at increased risk.
Sometimes, the body successfully passes gallstones. In other cases, someone has the condition, but experiences no symptoms and remains unaware. It is also possible for people to develop biliary colic, characterized by intermittent pain in the upper right quadrant of the abdomen. Contrary to popular belief, particular dietary choices do not appear to predispose people to cholelith formation, and eating meals which contain particular ingredients will not necessarily trigger pain in the gallbladder.
In some patients, cholelithiasis turns into an obstruction, which can lead to the development of intense pain as well as infection. In these patients, treatment is absolutely necessary. The most typical treatment for cholelithiasis is a cholecystectomy, in which the gallbladder itself is removed, along with the stones. In some cases, lithotripsy, a procedure to break up the stones, may be recommended. Medications can also be used to break up the stones, if they are cholesterol stones, so that they can be passed naturally. Lithotripsy can be problematic because the stones often return, which means that the patient will experience problems in the future.
Often, the approach to cholelithiasis is simply to wait and see. Unless surgery is clearly indicated, patients may feel that the risks of the surgery combined with lifestyle changes required to adapt to gallbladder removal are simply not worth it. Patients may also prefer to wait and see if they can pass the stones before pursuing a surgical treatment option. Individual cases vary, so it is important to talk with a doctor about the various options available before making a decision about how to manage gallstones.