GALLSTONES (Cholelithiasis) |
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GALLSTONES (Cholelithiasis)
DESCRIPTION
Gallstones are in the gallbladder (the organ under the liver that stores bile). Most gallstones are composed primarily of cholesterol. They are not cancerous. The gallbladder and bile ducts are involved. They are more common in women, but adolescents and adults of both sexes can be affected. 10% of the U.S. population--and 20% of those over 40 -- have gallstones.
Appropriate health care includes:
Self-care.
Doctor's treatment.
Surgery to remove the gallbladder and stones in the bile ducts.
Medications and lithotripsy (shockwave treatment) can sometimes remove gallstones.
SIGNS & SYMPTOMS
Colicky pain in the upper right abdomen or between the child's shoulder blades.
Nausea and vomiting.
Bloating or belching.
Intolerance for fatty foods (indigestion, bloating, and belching).
Jaundice.
No symptoms in about 40% of cases.
CAUSES
Unknown, but following are the most common theories:
Failure of the child's gallbladder to empty competently.
Alterations in bile mucus.
Increased bilirubin (See Glossary) concentration in bile.
Infection in the tubes that carry bile out of the child's liver.
RISK FACTORS
Recent illness, such as coronary-artery disease, cirrhosis of the liver, or disorder of the small intestine.
Family history of gallstones.
Genetic factors. Some ethnic groups are more susceptible. About 70% of Native Americans have gallstones.
Obesity.
Excess alcohol consumption.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures, except for your child to eat a low-fat diet (See Appendix 28).
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as blood count; blood chemistry; CAT or CT scan (See Glossary); and ultrasound (See Glossary).
X-rays of the child's gallbladder.
POSSIBLE COMPLICATIONSInfection or rupture of the gallbladder.
PROBABLE OUTCOME
Many children with gallstones have no symptoms. For those who do, the disorder is curable with surgery.
TREATMENT
HOME CAREIf your child has gallstones and experiences pain in the upper right abdomen, apply heat to the area. If the child's pain worsens or continues more than 3 hours, call your doctor.
MEDICATION
For minor discomfort, use non-prescription drugs such as acetaminophen.
Your doctor may prescribe oral medication to try to dissolve the child's stones. This treatment is still experimental.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions, except for your child to rest during attacks of gallbladder colic.
DIET & FLUIDS
During an attack, your child can sip water occasionally, but should not eat.
At other times, the child should eat a low-fat diet (See Appendix 28).
OK TO GO TO SCHOOL?When appetite returns and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of gallstones.
Your child's temperature rises to 101F (38.3C) or higher.
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