BENGALURU: There is a significant geographical variation in the prevalence of gallstone disease around the globe. It was predominantly a disorder seen in developed countries, however, there is a rising trend in the number of people suffering from this condition in India too, in the recent past. Further, the trend is also shifting from obese people towards young people in their early twenties. A majority of people are ignorant about the nature of gallstone disease and its impact on their health, though it is a common problem and can be cured if treatment is taken at appropriate time. Some present in advanced stages with complications requiring emergency surgery and some cases might result in death.
Increase in prevalence of gallstone disease
Consumption of low vegetable protein and excessive intake of refined sugar increases the risk of gallstones. An unhealthy lifestyle, high saturated fats in the diet, and high waist-hip ratio are significant risk predictors for gallstone disease. Metabolic syndrome, insulin resistance, diabetes, and rapid weight loss due to prolonged fasting are other risk factors for developing gallstones.
Myths around gallstones
Myth: There are several complications in gallstone surgery.
Fact: Like any other surgery, gallstone surgery may have some complications. However, with the advancement in surgical procedures, the risk of complication is low.
Myth: Shockwave therapy may help in removing gallstones.
Fact: Treatment of gallstones with shockwave therapy has several complications. It also has a high rate of recurrence. Thus, this technique is rare.
Myth: All gallstone requires treatment.
Fact: Not all gallstones require immediate treatment. If the patients do not experience symptoms, the doctor may monitor the progression of this disease.
need gallstone surgery?
There are various cases in which a doctor recommends gallstone surgery (cholecystectomy). The conditions include gallstones in the gallbladder, gallbladder inflammation, pancreas inflammation due to gallstones, large gallbladder polyps, and gallstones in the bile duct.
Complications
If the doctor had advised the patient to undergo gall bladder removal surgery, the patient should opt for it as soon as possible. Progression of gallstone disease may result in several complications. Some of them include gall bladder inflammation, bile duct infection, jaundice, acute pancreatitis, gallstone ileus, and gall bladder cancer.
Treatment options
There are both invasive and non-invasive methods. Shock wave lithotripsy (rarely used), oral therapy (to dissolve gallstones), and endoscopic retrograde cholangiopancreatography (removing the stone from the bile duct) are non-invasive methods. The invasive methods include cholecystectomy that involves removal of the gall bladder. The type of surgery depends upon the extent of damage to the gall bladder. The doctor performs open cholecystectomy surgery in case of severely inflamed, scarred, or infected gall bladder. In other cases, the doctors may opt for laparoscopic (keyhole) or robotic cholecystectomy. (The writer is consultant -surgical gastroenterology, Manipal Hospitals, Old Airport Road)