NH July2022

Advertorial
Dr Ahmad Muhsin Mohammad Nor
Consultant General Surgeon
Sri Kota Specialist Medical Centre
a patient to have fever on top of the pain.
Besides fever, the patient may feel
lethargic and experience chills. Some may
also experience nausea and vomiting. If
a patient has abdominal pain with fever,
they should see a doctor and seek
treatment immediately.
Another symptom that you need to watch
out for is jaundice. Jaundice is a yellowish
discolouration of the body, which initially
begins with the eyes but eventually
spreads to the rest of the body. The
patient may experience itchiness due to
jaundice. If jaundice occurs, it is a sign of
obstruction of the biliary tract and an
urgent admission to the hospital for
further treatment is required.
Who is at risk?
There are several groups of people at risk
of developing gallstone disease. The first
risk factor is hereditary (genetic). Certain
people are more prone to gallstone
disease if any of their close relatives have
had the disease.
Other risk factors are age and gender.
The older we get, the higher the risk due
to the higher amount of cholesterol
circulating in our bodies. Women are also
more prone to gallstones than men. This
may be due to the effect of female
hormones. Thus, oral contraceptive pills
are a risk factor.
Obesity is also a risk factor. The more
obese a person is, the more concentrated
the bile and the higher risk of gallstones.
People with diabetes mellitus are also at
risk due to changes in their cholesterol
metabolism and gallbladder functions.
Other risk factors include the presence of
certain diseases like haemolytic anaemia
or inflammatory bowel disease and
patients on long-term intravenous
nutrition.
Is it a serious condition? What
are the complications?
Gallstones may cause severe complications
due to several reasons, such as
inflammation, infection or obstruction of
the biliary tract. One of the most common
complications is biliary colic which
manifests as constant abdominal pain.
Cholecystitis or an infection of the
gallbladder can occur and, if left untreated,
can worsen to become a collection of pus
in the gallbladder (empyema). This can
lead to gallbladder perforation. If that
occurs, the patient will be severely ill and
needs urgent medical attention.
Other serious complications are jaundice
and inflammation of the surrounding
organs like the pancreas.
How can we prevent gallstone
disease?
You can prevent gallstones by modifying
certain risk factors like obesity and
cholesterol levels through maintaining a
healthy lifestyle and diet. By doing so, you
will also lower your risk of developing
other contributing diseases such as
diabetes mellitus.
How is it treated and
managed?
When patients present with symptoms,
that will lead to further investigations such
as an ultrasound or a computed
tomography (CT) scan of the abdomen.
Once a patient is diagnosed, the treatment
and management of gallstone disease
depend on the severity and condition of
the patient at that time.
A stable patient who does not show signs
of complications such as fever may be
managed with analgesics and an elective
appointment to remove the gallbladder.
However, if there’s a fever, this necessitates
more aggressive management to treat the
underlying infection. The patient will need
hospital admission for commencement of
intravenous antibiotics and an operation
to remove the gallbladder once the fever
and pain subside.
The operation for gallbladder removal is
mostly done now via the laparoscopic
method with small incisions on the
abdomen and insertion of laparoscopic
equipment and camera. The wounds are
small, and most patients recover within
the same day or the day after. A small
percentage of patients with more severe
conditions will need further care in the
hospital for the next few days until full
recovery is achieved.
Natural Health * July 2022 VOL 128
27