(CHOLELITHIASIS)
Definitions
Presence of stones in the gallbladder is referred to as cholelithiasis. If gallstones migrate into the ducts of the biliary tract the condition is referred to as choledocholithiasis. Gall stone are crystalline concretions formed within the gall bladder by accretion of bilecomponents. Presence of gallstones in the gallbladder may lead to acute cholecystitis, an inflammatory condition. Presence of gallstones in other parts of the biliary tract can cause obstruction of the bile ducts. The large yellowish calculus is probably composed largely of cholesterol, while the greenish to brownish color of the other stones suggests these are composed of bile pigments.
Gallstones can be divided into the following types:
Cholesterol stones: They vary in color from light yellow to dark green or brown and are oval 2 to 3 cm in length often having a tiny dark central spot.
Pigment stones: Pigment stones are small, dark stones made of bilirubin and calcium salts that are found in bile.
Mixed stones: Mixed gallstones common constituents are calcium carbonate, palmitate phosphate, bilirubin, and other bile pigments.
Signs and symptoms
Gallstones may be asymptomatic. These gallstones are called "silent stones". A characteristic symptom of gallstones is a intense pain in the upper right side of the abdomen, often accompanied by nausea and vomiting, that steadily increases. Pain almost always happen at night belching, gas and indigestion.
Pathophysiology
Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts. Besides a high concentration of cholesterol, two other factors seem to be important in causing gallstones. The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become over concentrated and contribute to gallstone formation. The second factor is the presence of proteins in the liver and bile that either promote or inhibit cholesterol crystallization into gallstones. In addition, increased levels of the hormone estrogen as a result of pregnancy, hormone therapy or the use of combined (estrogen-containing) forms of hormonal contraceptives, may increase cholesterol levels in bile and also decrease gallbladder movement, resulting in gallstone formation.
Diagnosis
A positive Murphy's sign(a painful spot just below right ribs on abdomen) is a common finding on physical examination.
Gallstone can visualized in the gallbladder by ultrasound image.
Homoeopathic medicines
Carduus mar, Chelidonium, Cholesterinum, Colocynthis, Olea europa, Mentha piperita, Ginkgo biloba, Ammi visnaga, Gentiana lutea, Tilia europea.
CASE
This is the case of a man [Mr. k. k.] aged 53 years. He came with severe pain in epigastric region and right side of abdomen,nausea, vomiting, distention, burning urination with pain in right renal region. Symptoms were aggravated by eating after fatty food. He was advised for USG abdomen.
USG: - 6 mm CALCULUS SEEN IN THE UPPER CALYX OF RIGHT KIDNEY AND MULTIPLE SMALL CALCULI IN GALLBLDDER this is the case of Cholelithiasis and Nephrolithiasis.
He was prescribed following medicines on 05/03/10
A) BERBERIS VULGERIS Q
B) CALCARIA CARB 10M/2
C) CATHERIS 30
D) CHOLISTRINUM 3X
He was called after fifteen days.
On 22/03/10 abdomen pain was better, no nausea, no vomiting. No burning in urine.
He was given same medicines for three months.
On 10/06/10 he had no pain abdomen, no nausea, no other symptoms. He was advised for USG abdomen.
USG: - NO CALCULUS SEEN IN GALLBLADDER, 5.4 mm CALCULUS IN RIGHT KIDNEY.
He was repeated medicines for kidney stones.
A) BERBERIS VULGERIS Q
B) CANTHERIS 30
C) TRIBULUS TERRESTRIS Q
Dr. G. S. Bhatnagar
D.H.M.S. B.H.M.S.
Research officer
Sewa Mandir
Mobile 9829978284
E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com
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