Gallstone or Batu Karang
Masalah dan Solusi Penyakit Batu Karang or
Gallstone
Gallstones are pieces of solid material found in the gall bladder.
They are usually one of two major types:
Cholesterol Gallstones
- (accounting for about 80% of cases)
Pigment Stones
- composed mainly of calcium salts of bile pigments (about 20% of cases)
Gallstones vary in size and numbers.
Why do Stones Form in the Gall Bladder?
Gallstones form when certain chemicals in the bile, either cholesterol or bile pigment, start to clump together. These clumps become the core from which larger stones can grow. It is not clearly understood why some people get stones and others do not.
However, there are certain factors which may increase your risk of developing stones. These are:
Middle-aged women who are overweight and have had multiple pregnancies
A high calorie, low fibre diet
Women on long-term birth control pills or on hormone replacement therapy
Overweight
What are the Symptoms?
Symptoms are usually:
Excessive flatulence
Nausea or vomiting
Upper abdominal discomfort only described by the patient as "gastric"
Central or right-sided upper abdominal pain
Pain felt at the back between the shoulder blades
Stones are best detected by an ultrasound examination of the gall bladder.
Consequences of Gallstones
Gallstones may remain "silent" and cause no problems to the patient. However, some stones will cause troublesome symptoms and will require treatment. Some gall bladders can become infected resulting in a condition known as acute cholecystitis. Such a patient will usually develop fever and experience pain in the right side of the upper abdomen. These patients need antibiotics and early surgery.
Treatment
If the gall bladder containing stones causes problems to the patient or if it becomes infected, it must be removed. It is not enough to remove only the stones. As the gall bladder functions as only storage organ, patients can live without their gall bladder. They may be troubled by the passage of frequent loose motions immediately after surgery. This usually improves with the passage of time. The "windy" feeling tends remain for a long time after surgery but it is usually less troublesome. The surgical procedure by which the gall bladder is removed is known as a cholecystectomy.
There are two ways in which this procedure is done:
An open cholecystectomy
This is the traditional method by which the gall bladder is approached via a moderately long incision. It is safe and has stood the test of time. However, it is a more painful procedure than the newer method and it takes a longer time to heal.
The newer method, laparoscopic cholecystectomy, commonly described as key-hole surgery
This procedure requires the surgeon to make four very small incisions in the right side of the upper abdomen. A camera system is introduced through one opening. This allows the image of the gall bladder to be projected onto a video screen. The surgeon then introduces instruments through the other three incisions.
By looking at the screen the surgeon is able to dissect and remove the gall bladder. This procedure is less painful and the patient recovers faster. It is the now the predominant method of gall bladder surgery, but cannot be used to remove all gall bladders.
Non-surgical methods of treatment
• Oral Bile Acid Therapy
• Contact Dissolution Therapy
• Extracorporeal Shock Wave Lithotripsy
Penyakit Batu Karang -
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