Metabolism of Lipids 9 Sections27 LessonsLifetime
Cholelithiasis
- Formation of stones in the Gall bladder is known as Cholelithiasis.
- Symptoms may include severe colicky pain in right hypochondrium especially after taking a fatty meal accompanied with nausea and vomiting.
- Pain may radiate in between the shoulder blades.
- If long standing and they block the cystic duct then it may be accompanied by jaundice.
- Small stones in the Gall bladder may not cause any symptom for years or life long.
- These are called “Silent stones“.
- Most common in females who are fair, fatty, around forty years of age and fertile.
– Remember “5Fs”
- Female
- Fair
- Fatty
- Forty
- Fertile
Causes
- The movement of cholesterol from the liver into the bile must be accompanied by the simultaneous secretion of phospholipids & bile salts.
- If this dual process is disrupted and more cholesterol is present than can be solubilized by the bile salts and phosphatidylcholine present, the cholesterol may precipitate in the gallbladder, leading to cholesterol gallstone disease, or cholelithiasis.
- This is typically caused by a decrease of bile acids in the bile.
- Cholelithiasis also may result from increased secretion of cholesterol into bile, as seen with the use of fibrates (for example, gemfibrozil) to reduce cholesterol (and triacylglycerol) in the blood.
Treatment
- Laparoscopic cholecystectomy (surgical removal of the gallbladder through a small incision) is currently the treatment of choice.
- However, for patients who are unable to undergo surgery, oral administration of chenodeoxycholic acid to supplement the body’s supply of bile acids results in a gradual (months to years) dissolution of the gallstones.
- Cholesterol stones account for over 85% of cases of cholelithiasis, with bilirubin and mixed stones accounting for the rest.
Effective efforts Tysm sir