Gall Bladder Stone or Cholelithiasis is a condition where cholesterol monohydrate stone starts coagulating and neucleate together to form stone in gall bladder.
- Ecxess of Cholestrol can be eliminated from body only through Liver, either as free cholestrol in bile or as bile salts.
- Cholestrol is water insoluble.
- Bile salt and lecithin when co-secreted and are mixed with this cholestrol to make it soluble, then can easily be eliminated.
- This cholestrol is in excess beyond saturation limit of the bile – lecithin -cholestrol solution saturation.
- Or if the character or quantity of bile salt and lecithin alters.
- Or if there are any other physiological or structural anomaly of hepatobilliary aparatus to cause stasis of bile.
- Or there are some other metabolic anomalies.
- Or if there is presence of some other metabolites or micro-precipatates of protein or salts like calcium salts that promotes cholestrol crystalisation.
Then this excess cholestrol which was no further able to mix in bile salt and lecithin due to oversaturation starts forming dispersed cholestrol monohydrate crystals, which later agregates and coagulate to neucleate and form Cholelithiasis or Gall Stone or Gall Bladder stone.
So for such formation following three conditions are required.
- Supersaturation of Bile with Cholestrol.
- Kinetically favourable conditions for neucleation of dispersed cholestrol crystals.
- Cholestrol crystals should stay in bile long enough so as to aggregate and form stone.
An its very difficuly to judge or find out any of the risk factors, except genetic and familial predesposition and is found more in men compared to women.
SYMPTOMS of GALL BLADDER STONES
Gall bladder Stones affect 10-20% of population in developed countries.
Upto 80% of Patients will never develop any symptom throughout their life and are called Silent Cases of Gall Bladder Stone and remainder 20 % become symptomatic at the rate of 1-3% per year.
Though most of the patient frequently present with non specific general mild complaints like eructations, GERD, unsatisfactory bowel clearance.
A few patients also present with prolonged mild discomfort in right hypochondrium and lumbar region with occasionall in epigastric region, with sensation as if weight or stone was lodged in the site of discomfort which aggravates on false stepping or jumping , unsatisfactory bowel clearance and other mild digestive derangements.
When Acute Symptom appear they are very severe and may be life threatening which needs immediate medical attention as in most of the cases it sets in whenever there are complications like
- Cholecystitis- Inflamation of gall bladder due to infection or adhering of stone to bladder wall or severe statis and obstruction of downstream of bile due to blockage created by lodging of stone in bile tree, usually such blockages are created by very smallstones which can easily enter cystic and common bile ducts.
- Inflamation of bile tree.
- Pancreatitis is a very severe and life threatening condition may also present along secondary infection.
- Gall Stone illeus when large stone enters adjoining loop of small intestine.
- Empyema, collection of puss in pleural cavity due to secondary infections
Patient with acute symptoms has severe excruciating spasmodic colicky pain in abdomen more pronounced in right hypochondriac region epigastric and umbilical region.
Fever with rigor and chills and it is indicative of secondary infection
DIAGNOSIS of GALL BLADDER STONES
Ultra Sonography is the most common prescribed test.
MRI in cases where unable to detect by USG or accidental finding.
CT Scan in cases where unable to detect by USG or accidental finding.
X rays not specific; very occasionally shadow is visualised in accidental findings, after which the patient is sent for USG for confirmation and proper evaluation of size and severity.
Serum Lipase and Serum Amylase activity with Ultra Sonography of pancreas need to be monitored frequently in cases with acute complaints to rule out pancreas involvement which can be life threatening.
MORPHOLOGY of GALL BLADDER STONE
Gall Bladder Stone consists 50-100% cholestrol.
More the cholestrol more pale yellow colour of stone, Exclusive Cholestrol stones are complete pale yellow in colour.
More the proportion of Calcarea Carbonate and Phosphate, more the stone has Greyish-white to black discoloration from pale yellow.
BEST HOMEOPATHIC MEDICINES for GALL BLADDER STONES
Calcarea flourica is a powerful tissue remedy. Calcarea flourica is a combination of lime and flouric acid. It is a naturally occuring mineral in the body. Calcarea flourica is very useful remedy in the treatment of gallstones. Usually patient presents with prolonged mild discomfort in the right hypochondrium and lumbar region. Gastric derangements, weakness, loss of appetite. Vomiting of undigested food. Indigestion, fatigue and brain fag. Presents with paroxysms of lancinating paind in the right hypochondrium awaking him about midnight with aggravation lying on painful side. Sensation of dull weight and discomfort in the right hypochondrium. Sensitive to cold, to drafts and changes in weather.
Fel tauri is remedy used since ancient time. Fel tauri is a very efficient remedy for gallstones. Fel tauri increases the duodenal secretions, emulsifies fats and increases the peristaltic action of intestine. Liquifies bile and acts as a purgative. Presents with disordered digestion, diarrhoea, obstruction of bile ducts. Eructations and pain in the epigastrium. Gurgling in stomach and epigastric region. Pain in the right hypochondrium with sensation of heaviness. Fel tauri liquifies bile and helps in expulsion of biliary calculi.
Choleatrinum is considered as a specific remedy for gallstones. It helps to relieve pain at once. Useful in obstinate hepativ engorgements, obstinate gall stones. Pain in the right hypochondriac region. Sensation of heavines in the abxomen. Gastric derangements. Reflux of gastric contents with pain in the epigatrium.
Silicea is a deep acting remedy indicated in case of gallstones. Silicea disturbs tbe stomach, causes hiccoughs. Severe pain in abdomen relieved by heat, distension of abdomen with flatulence and rumbling. Tightness accross the abdomen. Disturbed by pressure of clothes and worse after eating. Constipation from inability of rectum to expel faeces. Great straining at stool. Constant urge but cannot expel requiring mechanical aid. Hardness and distension of the region of liver with throbbing pain. Gastric derangements causes hicoughs, nausea, vomiting, disturbs the liver. Silicea is usually very sensitive to extremes of heat and cold.
Carbo vegetabilis is a very effective remedy in patients suffering from gallstones. When Carbo vegetabilis is indicated the patient will be below par, the digestion will be slow and imperfect. Heaviness and fullness sensation. Sensation of weight in the abdomen. All gone sensation not relieved by eating, but after a few mouthfuls there is a sense of repletion. There is great distension of abdomen which is temporarily releieved by belching. Burning in the stomach extending to back and along the spine. Cramping pain forcing patient to bend double.
The action of Cardus marianus is centered on the liver, gall bladder, portal system causing apin, soreness. Pain in the region of liver. Swelling of gall bladder with painful tenderness.Sensation of fullness and soreness. Constipation with hard stool, difficult knotty, alternates with diarrhoea. Poor appetite. Nausea retching and vomiting sensation. Inflammation of gall bladder, pain in the upper abdomen in the region of gall bladder which is accompanied by nausea and vomiting.
Chelidonium majus is one of the most indicated medicine for gallstone. Effective medicine for gall stones and jaundice when there is obstruction of bile ducts.Useful when gallstone colic is shooting, stabbing, tearing and lancinating type extending to back. Colic with constriction as by a string across abdomen. Most important symptom of Chelidonium is constant pain under the right shoulder blade. Suffers from hepatic or gastric symptoms. The tongue is coated thick and yellowish with imprints of teeth. Alternate diarrhoea and constipation. All symptoms are usually right sided.
Calcarea carbonica is one of the indicated remedy in gallstone. Calcarea carbonica is usually suited to fair, fat, flabby constitution. Shooting pain around the liver with discomfort after wearing tight clothing. Sensitive to slightest pressure. Liver region painful when stooping. Presents with severe gall stone colic. Weak digestion. Milk disagrees. Feeling of tumefaction and fullness. Loss of appetite. No desire for food. Constipation. Frequent nausea ezpecially in morning. Cramps in stomach at night. Pains generally shooting or tensive, pressive type with swelling and induration of hepatic region.
Crategus oxyacantha is a excellent heart tonic and also useful in gallstone colic. Acts a a tonic for heart muscles that have becomw weakened due to reduced blood supply to heart as a result of deposits of cholestrol in arteries. Crategus is a very useful remedy in dissolving cholestrol deposits in arteries. Colic with severe pain in the hypochondrium with sensation of heaviness. Presents with difficulty in breathing with slight exertion. Dyspepsia and nervous prostration. Cold extremities.
Colocynthis is indicated in case of choleliathiasis. Colocynth is a ideal remedy when gall stone pain is of a cutting shooting nature and better by bending double or by applying pressure. Worse by cold. Presents with pain in right hypochondriac region with sensation of fullness of abdomen. Colocynth is usually a acjte useful in gall stone colic. Neuralgias with sense of restlessness. Sharp shooting and lightening type of pain.