Maritime health: What is the Gallstone and Gallbladder disease? How to treat it?

The gallbladder is a small, pouch-like organ found underneath the liver. Its main purpose within the body is to store and concentrate bile, which is produced by the liver to help digest fats. Bile is passed from the liver into the gallbladder through a series of channels known as bile ducts.

The bile is stored in the gallbladder and, over time, becomes more concentrated, which makes it better at digesting fats. The gallbladder releases bile into the digestive system when it is needed.

Gallstones are formed when substances, such as cholesterol, bile pigments and/or calcium salts, harden into a solid form. When gallbladder blockage or another obstruction persists, it can cause gallbladder inflammation called Cholecystitis. Although Cholecystitis is very treatable, if left untreated it can become severe.

Symptoms

Signs and symptoms may include:

• Severe abdominal pain, especially at the top right-side or centre of the abdomen
• Pain that spreads to the back or right-hand shoulder blade
• Nausea that occurs at the same time as abdominal pain
• Abdominal pain that is linked to eating a fatty meal
• Jaundice (yellowing of the skin or eyes)
• Clay coloured stools or dark urine

Normally, the pain lasts for a period of 30 minutes but begins to subside after one hour. An attack of biliary colic usually lasts less than six hours.

Prevention

Good lifestyle choices can assist in reducing the risk of gallstones. To prevent gallstones, seafarers must understand the importance of avoiding crash diets or a very low intake of calories (less than 800 calories daily).

It is important to consume fibre provided by:

• Raw fruits and vegetables
• Cooked dried beans and peas
• Whole-grain cereals and bran

Avoid eating excess fat.

Studies have shown that moderate consumption of olive oil (about two tablespoons a day) can lower the chances of developing gallstones. Researchers found that the incidence of gallstones is relatively low among people who live in areas where olive oil consumption is high.

Lecithin (a natural substance used as a thickener in food products such as ice cream and mayonnaise) may prevent gallstones by keeping cholesterol from solidifying in the gallbladder.

Treatment

The treatment of gallbladder disease depends on the type of disease present. When it comes to treating gallstones, there are three options:

• A ‘watch and wait’ approach if there are no symptoms.
• Surgery to remove the gallbladder and the stones.
• Medication to break up the gallstones.

The most common indication of gallbladder disease is gallstones. Gallstone and gallbladder disease only require treatment if they cause symptoms (such as abdominal pain) or complications (such as jaundice or pancreatitis). In these cases, keyhole surgery to remove the gallbladder is advisable. Medications are rarely used to treat gallstones, although they are used to treat the pain of gallbladder disease.

The prescribed treatment will depend on how the disorder is affecting the patient and if they are at risk for ongoing gallbladder disease and accompanying pain. Gallbladder removal is the most common treatment for gallstones that causes ongoing signs and symptoms, infections or other complications.

Alternatively, if the gallbladder removal surgery is deemed too risky, gallstones can be dissolved with drugs that are taken orally.

Source: UK club; Safety4sea