Some of the risk factors for gallstone formation can be modified, such as obesity. By maintaining a healthy weight through proper diet and exercise, a person can reduce the chances for gallstones. People with diabetes tend to have a higher risk for gallstones, so keeping weight under control may prevent gallstones from developing. A low-carbohydrate diet and regular physical activity may help prevent gallstones. Also, one should avoid diets that result in losing weight very quickly as risk of developing gallstones will increase.
Most people who have "silent" gallstones in the gallbladder don't require treatment. People with intermittent pain can try avoiding or reducing their intake of fatty foods.
If someone has gallstones in the gallbladder that cause repeated attacks of pain, the doctor may recommend removing the gallbladder. This type of surgery is called a cholecystectomy.
People who have gallstones may develop problems when the gallbladder becomes inflamed. This is called acute cholecystitis. In these cases, sufferers are hospitalized so they can receive fluids intravenously, and antibiotics are usually given as soon as the problem is suspected. If the diagnosis is certain and surgery is not considered risky, the gallbladder is usually removed during the first day or two of the illness.
Today, almost 90% of cholecystectomies in Canada are performed using laparascopic surgery under general anaesthesia. The surgeon makes small incisions in the abdomen and inserts surgical instruments as well as a video camera that projects a magnified view of a patient's internal organs onto a monitor. The gallbladder is removed through one of the incisions. Most people are able to go home after the surgery, but some people may require an overnight stay for additional monitoring.
Open cholecystectomies may be performed if complications are discovered, such as infection or scarring from previous operations. A surgeon may start using laparascopic techniques then switch to open surgery if such a complication is found. In very obese individuals, an open cholecystectomy may be easier to perform.
A person can live normally without a gallbladder. Once removed, bile flows from the liver through the ducts and directly into the small intestine. No change in diet is necessary, although the more frequent flow of bile to the small intestine may lead to diarrhea.
For people who are not able to have surgery, a medication called ursodeoxycholic acid can be used to help dissolve the gallstones. This medication takes about 6 months to work and is effective in only about 50% of people who use it. Gallstones usually come back once a person stops taking the medication.
Shockwaves can be used to break up gallstones in a procedure called lithotripsy. However, surgery is still preferred as gallstones are likely to return if the gallbladder is not removed.
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