Check-up:This week Marion Kerrlooks at where gallstones come from
I was diagnosed with small gallstones a few months. But I am now wondering how stones got into my gallbladder in the first place?
Digestion of fats in the small intestine is aided by bile, a digestive juice manufactured by the liver and stored in the gallbladder. Bile is made up of bile salts, acids and pigments and also contains cholesterol, which is dissolved by bile acid.
If the amount of cholesterol in the bile increases or the amount of bile acid is reduced, then some of the cholesterol remains undissolved in the gallbladder and may develop into gallstones. Bile is released from the gallbladder through the bile duct and into the small intestine, where it assists with digestion.
Gallstones may be present for many years without causing any problems or symptoms. However, if a stone becomes lodged in the bile duct it can cause a blockage of the bile and result in inflammation and infection causing acute and severe pain.
Bile can also accumulate in the blood causing jaundice - giving a distinctive yellow hue to the skin.
I've been put on tablets called ursodeoxycholic acid. How do these work?
When gallstones are small, conservative treatment may be recommended, although the advent of minimally invasive surgery has lessened its use. Deoxycholic acid is actually a substance found in natural bile. Its job is to regulate the amount of cholesterol in the blood by controlling the amount that passes into the bile.
When the cholesterol level in bile is reduced, bile acid is then able to dissolve the small stones in the gallbladder. A low-cholesterol, high fibre diet is usually recommended to increase the chance of successful dissolution.
As I don't feel any different since starting on the tablets I don't really see any point in continuing to take them. I also worry about their possible side effects.
The most common side effect reported with ursodeoxycholic acid is diarrhoea and the drug is not usually recommended for people with atherosclerosis (fatty plaques in the blood vessels), as they can increase the level of cholesterol in the blood, or those with disorders of the liver as they can interfere with liver functions.
Treatment with medication can take years to dissolve the stones completely, so you are unlikely to feel the benefits for some time. But I'd advise you not to discontinue treatment without seeking medical advice first as gallstones can recur when treatment is stopped.