By Medical Edge July 19, 2011 12:00 AM

Dear Mayo Clinic: I have heard that sometimes people have gallstones and don’t even know it, while others have severe pain because of them. am I at greater risk if some of my family members have had them? How will I know if I have gallstones?

Reply: It is true that even if you develop gallstones — a condition in which digestive fluid hardens into pebble-like deposits — you might not even notice. in fact, many are discovered by chance during an abdominal X-ray or ultrasound exam for some other reason. That’s because in most patients, gallstones do not cause symptoms.

In other cases, though, you know all too well something’s wrong. Gallstones can cause attacks of pain, known as gallbladder attacks, in your upper abdomen or chest.

Your gallbladder is a pear-shaped sac that sits beneath your liver. The gallbladder’s main job is to store bile — a thick, greenish-brown liquid that’s produced by the liver. after you eat, your gallbladder contracts, pushing bile through a small tube called the common bile duct into the upper portion of your small intestine.

There, the bile helps your body absorb fats, cholesterol and certain vitamins. Gallstones form when components of bile harden into crystals. Most gallstones are made of cholesterol. It is possible to have just one gallstone or hundreds, ranging in size from a grain of sand to a golf ball.

Gallstones may form because of changes in the composition of bile, such as an increased amount or proportion of cholesterol. in other cases, the gallbladder muscle loses some of its squeezing power, so it doesn’t empty completely. Infection and inflammation also can damage the gallbladder and trigger the development of gallstones.

Factors that may increase your risk of cholesterol gallstones include: Obesity and excess weight, pregnancy, high-fat, high-cholesterol or low-fiber diet, family history of gallstones, diabetes, liver disease, Crohn’s disease, rapid weight loss, certain cholesterol-lowering medications and medications that contain estrogen.

Gallstones usually settle at the bottom of your gallbladder, where they’re unlikely to cause problems. Symptoms may arise if a stone migrates up the neck of the gallbladder and blocks the flow of bile out of the gallbladder or through the bile duct. a blocked gallbladder or bile duct can cause intense pain in your abdomen that may extend to your shoulder blade, chest or arm. The pain is sometimes accompanied by nausea and vomiting.

A gallbladder attack often subsides as the stones move. But if the blockage persists, your gallbladder can become inflamed or infected. This condition is called acute cholecystitis and requires treatment in a hospital where you’ll likely receive fluids, pain relievers and antibiotics intravenously. Treatment also includes surgery to remove the gallbladder (cholecystectomy), usually within 24 to 48 hours.

If you think you’ve had a gallbladder attack, see your doctor. Seek medical attention immediately if the pain is persistent and severe, if you have a fever or chills, or if your skin or the whites of your eyes are yellowish. if your gallstones aren’t causing any symptoms, you do not need treatment. if you have frequent attacks, your doctor will likely recommend that you have your gallbladder removed.

After your gallbladder is removed, bile flows directly from your liver into your small intestine. You’ll still be able to digest food. and you’ll be able to get back to your usual activities, with or without a gallbladder. — John Poterucha, M.D., Gastroenterology, Mayo Clinic

Send questions to medicaledge

@mayo.edu.

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Entry Filed under: pain in lower right abdomen

I've been having stomach problems for a couple of years, mostly in the form of nausea, discomfort and mild pain on the right of my upper abdomen after eating anything containing fats. After determining that I didn't have an ulcer and putting me on a drug to suppress excess stomach acid, my doctor eventually referred me for an ultrasound scan.

The scan showed that my gallbladder was very tightly contracted even though I had been fasting. Consequently, the radiologist and surgeon believe that I probably have gallstones or a damaged/diseased gallbladder and I am waiting for a date for surgery to have it removed.

What concerns me slightly is that everyone says that the usual symptoms of gallstones are frequent bounts of severe cramping pain in the right side. I have only experienced this once, and it didn't last more than an hour or so (although it was extremely painful). my usual symptoms are much vaguer and milder, although still rather debilitating and unpleasant.

I've also started to feel pain in my lower abdomen as well now.

Has anyone else experienced additional or unusual symptoms with gallstones, beyond the classic symptoms of a typical attack?

Pleuritis and pleurisy are two terms that are often used synonymously, although pleuritis is the inflammation of the pleura while pleurisy refers to any irritation of the pleura that leads to pain (pleuritic pain). the signs, symptoms and causes of both conditions often overlap.

Pleurisy is more often associated with chest pain that is described as a sharp stabbing pain. it may exacerbate during breathing and coughing. the nature of pain in pleurisy is described further under pleuritic pain. Depending on the part of the pleura that is irritated, the pain may refer to the neck, shoulder or upper abdomen.

Other signs and symptoms that may be seen with pleurisy includes :

• Pleural effusion which is the fluid around the lungs.
• Shortness of breath as a result of shallow inhalation due to pain, restricted expansion of the lung due to a pleural effusion, or pathology of the air sacs in the lung which is associated with pleural involvement.
• Dry cough although a productive cough may be seen with bronchitis and pneumonia.
• Fever with infectious causes, certain autoimmune diseases and sometimes with malignancies.
• Pleural frictional rub is the sound similar to stiff leather creaking which is seen with pleuritis and is most prominent in fibrinous pleuritis. it is known as a pleuro-pericardial rub if it is only audible near the pericardium during deep inspiration. Read more on pericardial frictional rub under pericarditis symptoms.

Infections

The most common cause of pleuritis is a viral infection.while it may arise with viral infections of surrounding areas or even systemic infections, viral pleuritis is often seen in outbreaks caused by the coxsackie B virus. it tends to affect adolescents and young adults and is a self limiting infection that resolves with just supportive treatment.

Other common causes of pleuritis is often related to infection of the lungs as is seen with pneumonia and tuberculosis. Spread to the pleura may not always occur but is usually seen as the disease progresses. A lung abscess or empyema (pus within the pleural cavity) may also involve the pleura. Infection may also spread from the pericardium in infectious pericarditis.

Non-infectious

Trauma to the chest, exposure to radiation in the treatment of pulmonary and mediastinal cancers and hypersensitivity to certain drugs may cause pleuritis. This is similar to the causes of pericarditis and it is not uncommon for both the pleura and pericardium to be affected simultaneously.

Other non-infectious conditions that may affect the lung and also involve the pleura includes bronchiectasis (non-infectious causes), lung infarcts and pulmonary embolism. Pleuritis may also be seen with a spontaneous pneumothorax.

Non-infectious causes may also include systemic conditions and connective tissue diseases like rheumatoid arthritis, systemic lupus erythematosus (SLE) and uremia.

Tumors

Primary malignant tumor of the pleura is known as a mesothelioma and is often associated with asbestos exposure. Tumors of the lung or bronchi, mediastinum and secondary spread from distant site (matastases) may involve the pleura.

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For the past 4 days I have been experiencing pain in my upper abdomen only at night. It gives me the urge to go to the bathroom but it doesnt relieve the pain. When I vomit, my food comes out covered in mucus. Im thinking its either an ulcer or acid reflux but I never get heartburn. Please help.

By: Linda Stevens Mcdonald

Gallstones generally form when there is an excessive amount of cholesterol present inside the gall bladder or they can even form under conditions where the gall bladder does not empty itself out as often as it should. an individual who has gallstones may experience symptoms such as problems with digestion of food, aching or pain in the area of the upper abdomen and even vomiting and fever.

Digestive problems would be indicated by a feeling of nausea or vomiting, bloating discomfort, pain the the abdominal areas and a feeling of tightness in the stomach. It is also important to know that these indigestion symptoms could be caused by gallstones but again it could have resulted from any other infection or disease. It is therefore important to visit and consult a doctor about the symptoms experienced.

A person who has gallstones in the gallbladder may also experience a feeling of pain and some discomfort in the upper abdominal areas. the pain felt in the upper abdomen may even last for a couple of hours but usually subsides within a period of about 30 minutes. another area where a person affected with gallstones is likely to experience pain is the area just beneath the right shoulder.

Gallstones not only occur in the gall bladder but sometimes they may even enter the bile duct which is the convergence of three different ducts. When a gallstone enters the common bile duct it creates an obstruction and may cause symptoms such as skin and eyes turning yellowish in color and fever as well.

If an individual is having any of these symptoms that might indicate the presence of gallstones, he/she should go and see a doctor immediately to diagnose the condition as soon as possible.

For more information and further details about gall bladder disease you can see the site gallbladdersymptoms for information on gallstones symptoms and other gall bladder symptoms and how to treat such infections.

If you are 1 of the unfortunate people forming gallstones you know only to well how anxiety is difficult. you could already have dealt with strong sustainable pain and tenderness. the pain may have been so terrible that you really vomit.

If one of the front seems to be familiar with how one may be sure that those who must be signs for gallstones? Expressly in most cases what indications and also symptoms that you can treat one attack of gallstones? And how you are dealing with gallstones after you find you’ve trained?

Many gallstones are known as silent stones. These stones will show no symptoms and also really not affect the organ system. Nevertheless, many stones require care. the following is a list of the most common symptoms of gallstones.

-Sharp ache usually occurs at the location of the upper abdomen.-This ache begins often within a few minutes after a meal.-This agony may continue as a several hours.-Biliary pain may move up closer to the shoulders.-Indicator gallstones can also integrate a fever, vomiting and nausea.

These symptoms are probably mainly created from small stones like formations. They can be tiny as sand and as important as a golf ball also. Large amounts of cholesterol in the bile may harden into stones. Bile helps with absorption as for fat that is found in the gallbladder. Bile flows from small conduits called tubes. These ducts to carry the bile from the gallbladder in the small intestine. {When gallstones move and also block all these ducts raises pressure causing your suffering} occur.

Whenever you set that you’re experiencing one of all these signs and symptoms, bile calculations that you can also access your doctor. your doctor will probably finish some the following criterion: CT scans, blood, ultrasound and HIDA analysis reviews. Ultrasound is the most familiar controls. Sound waves are bounced off the coast of gallbladder, creating an image. Using this image doctors are probably relevant spots of one of these formations of gallstones. It is only once good prognosis, which can begin to follow a treatment program.

Receiving a diagnosis of a health care professional might suggest three remedies 1. They consist of an operation, oral dissolution therapy and treatment for dissolution also contact. with the operations of gallstones, gallbladder is truly removed. Even if you live perhaps without gallbladder bile those thinking of an operation can be very scary. there is usually a period of recovery and the possibility of complications. Contact dissolution remains experimental. Nevertheless, oral dissolution or the use of drugs is fairly common. the downside to this treatment is not any potential negative effects, but it might require years for all the stones break down.

There is hope for those who feel uncomfortable by the above process. there are natural answers regarding passing of gallstones, using common elements found in the kitchen pantry. Accumulation at you, to carry out those research as well as determine the very best remedy for gallstones to follow.

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My internist suspects that I may have some gallstones due to location/quality of pain and nausea that seems to come and go at will. I've also been having a lot of gas and multiple bms everyday, although not diarrhea. can that be another symptom of gallstones?

Here are the symptoms of gallstones: steady pain in the right upper abdomen that increases rapidly and lasts from 30 minutes to several hours
•pain in the back between the shoulder blades
•pain under the right shoulder
•prolonged pain—more than 5 hours
•nausea and vomiting
•fever—even low-grade—or chills
•yellowish color of the skin or whites of the eyes
•clay-colored stools

I'd also have your internist check you for appendicitis. these are the symptoms for appendicitis:
The abdominal pain usually
•occurs suddenly, often causing a person to wake up at night
•occurs before other symptoms
•begins near the belly button and then moves lower and to the right
•is new and unlike any pain felt before
•gets worse in a matter of hours
•gets worse when moving around, taking deep breaths, coughing, or sneezing
•loss of appetite
•nausea
•vomiting
•constipation or diarrhea
•inability to pass gas
•a low-grade fever that follows other symptoms
•abdominal swelling
•the feeling that passing stool will relieve discomfort

These symptoms also mimic these diseases too:
•intestinal obstruction
•inflammatory bowel disease
•pelvic inflammatory disease and other gynecological disorders
•intestinal adhesions
•constipation

Typically, symptoms of gallstones include localized pain and nausea (which you've described) and steatorrhea (fatty stools). this often causes stools to be very smelly and sometimes rather loose. Multiple BMs per day and excess gas can be signs of gallbladder disease, though your symptoms should be evaluated with a seperate physician if your confidence in your internist feels shaky.

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I have pain in my upper abdomen and it feels like eating aggravates it. the pain can get so severe that it makes me vomit and I also have diarrhea. this has been going on for about 3 days now.

You should go to the hospital. both conditions can be extremely serious. They can do blood tests, also an ultrasound can be used for pancreatitis. They might do an endoscopy as well. but I really would go to the nearest ER if you think you might have either of those. I don't know that you'd be able to tell the difference yourself anyway.