肺癌筛查指南：适用人群与检查流程

Overview

Gallstones are hard, pebble-like deposits that form in your gallbladder, a small pear-shaped organ located under your liver that stores bile (a digestive fluid that helps break down fats). There are two main types of gallstones: cholesterol gallstones (the most common, made of hardened cholesterol) and pigment gallstones (made of bilirubin, a waste product from broken-down red blood cells). Many people have gallstones and never experience symptoms; these are called silent gallstones.

Signs & Symptoms

Symptoms usually occur when a gallstone blocks one of the bile ducts that carry bile from your gallbladder to your small intestine. Common symptoms include sudden, intense pain in your upper right abdomen (just below your ribs), pain that radiates to your back between your shoulder blades or under your right shoulder, nausea, and vomiting. Gallstone pain (often called biliary colic) can last for several hours, and it often flares up after eating a high-fat meal.

Causes & Risk Factors

Gallstones form when the chemical balance in your bile is disrupted. This can happen if your bile contains too much cholesterol or bilirubin, or if your gallbladder does not empty quickly or completely enough to release stored bile. While the exact cause varies from person to person, several risk factors increase your likelihood of developing gallstones:

• Being assigned female at birth, especially if you are 40 or older
• Having an overweight or obese body mass index (BMI)
• Eating a diet high in saturated fat, sugar, or refined carbohydrates
• Leading a sedentary lifestyle with little regular physical activity
• Having a family history of gallstones
• Living with type 2 diabetes or insulin resistance
• Taking hormone replacement therapy or high-dose birth control pills
• Experiencing rapid weight loss, such as after bariatric surgery or very low-calorie diets
• Having liver disease, such as cirrhosis

Diagnosis

If your provider suspects you have gallstones, they will start with a physical exam, checking for tenderness in your upper right abdomen. They will likely order one or more of the following tests to confirm a diagnosis:

Treatment & Management

Treatment for gallstones depends on whether you are experiencing symptoms. Asymptomatic silent gallstones usually do not require treatment. For mild, infrequent symptoms, your provider may first recommend lifestyle changes to avoid triggers. For frequent or severe symptoms, treatment options include: medications to dissolve small cholesterol gallstones (such as ursodiol, which can take months or years to work and may not prevent stones from returning), or surgery to remove the gallbladder (cholecystectomy). Laparoscopic cholecystectomy, which uses small incisions and a tiny camera, is the most common surgical treatment and has a fast recovery time. Open surgery, which uses a larger abdominal incision, is only needed in rare cases.

Living With It

If you have asymptomatic gallstones, maintaining a healthy lifestyle is the best way to reduce your risk of future symptoms. If you have had your gallbladder removed, most people can eat a normal, balanced diet within a few weeks of surgery. Some people experience temporary diarrhea, bloating, or gas after surgery, which usually improves on its own. If you still have your gallbladder, avoid foods that trigger your symptoms (usually high-fat, fried, or greasy foods) and eat smaller, more frequent meals to reduce gallbladder strain.