Gallstones (cont.)

Medical Author:

Jerry R. Balentine, DO, FACEP

Jerry R. Balentine, DO, FACEP

Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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There is no permanent medical cure for gallstones. Although there are medical measures that can be taken to remove stones or relive symptoms, they are only temporary. If a patient has symptoms from gallstones, surgical removal of the gallbladder is the best treatment. Asymptomatic (producing no symptoms) gallstones do not require treatment.

Extracorporeal shockwave lithotripsy (ESWL): A device that generates shock waves is used to break gallstones up into tiny pieces.

• These tiny pieces can pass through the biliary system without causing blockages.
  
  
• This is usually done in conjunction with ERCP to remove some stones.
  
  
• Many people who undergo this treatment suffer attacks of intense pain in the right upper part of the abdomen after treatment.
  
  
• The effectiveness of ESWL in treating gallstones has not been fully established.

Dissolving stones: Drugs made from bile acids are used to dissolve the gallstones.

• It may take months or even years for the gallstones to all dissolve.
  
  
• The stones often come back after this treatment.
  
  
• These drugs work best for cholesterol stones.
  
  
• They cause mild diarrhea in many people.
  
  
• This treatment is usually offered only to people who are not able to have surgery.

If an individual goes to an emergency department, an IV line may be started, and pain medication and antibiotics may be given through the IV.

If the patient's health permits it, the health care practitioner will probably recommend surgery to remove the gallbladder and the stones. Surgical removal helps prevent future episodes of abdominal pain and more dangerous complications such as inflammation of the pancreas and infection of the gallbladder and liver.

• If there is no infection or inflammation of the pancreas, the operation to remove the gallbladder can be performed immediately or within the next several days.
  
  
• If there is inflammation of the pancreas or infection of the gallbladder, the patient will most likely be admitted to the hospital to receive IV fluid and possibly IV antibiotics for several days prior to the operation.

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