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Suggest Treatment For Gall Stone Removal

Posted on Fri, 12 Dec 2014

Question: hi doctor,
I'm attaching the report of my brother's ultrasound report. is surgery inevitable here?

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Cholecystectomy need not always be done

Detailed Answer:
Hello

Thanks for the query

Most general population will have gall stones but all gall stones need not be operated.
Operation for the removal of gall bladder is necessary if

1. There is pain abdomen
2. Fever raised WBC in blood count
3. Raised total bilirubin
4. Recurrent gall bladder infections due to gall stones.

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Rakesh Madhyastha (40 minutes later)

thanks doc. for my brother the pain has subsided, but his stomach is now feeling tight and heavy.. please note that he has gastritis problem. Will it help to drink a lot of water to flush this 5mm stone? Or is there any medication he can try? He is Kuwait and would like to visit XXXXXXX if surgery is the option.

Answered by Dr. Rakesh Madhyastha (10 hours later)

Brief Answer:
Drinking water will not help

Detailed Answer:
Hello

Thanks for the query

I am sorry for the short delay in my reply, it was a very busy day at the hospital

1. Drinking water will not help in case of gall stones. Drinking plenty of water is advised for kidney stones
2. For gastritis I recommend Tab Esomeprazole twice daily before food. But most important is to follow a regular diet
3. Tab Ursodiol is used medically to dissolve the gall stones, it has helped in many of my patients.
4. Mild symptoms can be managed medically without operating

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (2 hours later)

No problem. Thanks for the detailed answer and prescription. as noted, the pain has subsided however brother is worried on how to handle if the pain reappears.. he prefers to flush the stone using your prescription ..is it advised to take some pain killer just in case the pain reappear.? If yes, could you prescribe one?

Answered by Dr. Rakesh Madhyastha (4 hours later)

Brief Answer:
Aceclofenac will be a good pain killer

Detailed Answer:
Hello

Thanks for getting back, I am glad I was of help.

1. Unfortunately I am not authorized to prescribe medications on this portal. I can only make suggestions. You will need to approach a GP for a prescription
2. If the pain re appears I suggest Tab aceclofenac twice daily for not more than 3 days, if the pain is unbearable and is associated with fever and vomiting then please approach a hospital immediately as the gall bladder itself might have got infected and will require treatment with antibiotics
3. If your brother is taking Aceclofenac then he has to take an antacid prior to that as he is suffering from gastritis issue as well

I hope I was of help

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (2 days later)

this is the continuation of the case I had discussed couple of days ago. My brother is diagnosed with gallstones and was under medication. the recent blood test shows high bilrubin count. please advise on how to proceed. I'm not sure if surgery can be performed now...attaching a few reports for your reference

Answered by Dr. Rakesh Madhyastha (9 minutes later)

Brief Answer:
Stone gall stone

Detailed Answer:
Hello

Thanks for getting back

The gall stone in extremely small and might not warrant a surgery however if the bilirubin is raised then this small stone must be blocking the flow of bile. Please attach the liver function test report, it will be of help to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (31 minutes later)

Thanks Doctor. the report attached previously is the only test that had performed now.

Answered by Dr. Rakesh Madhyastha (6 hours later)

Brief Answer:
ERCP can be done

Detailed Answer:
Hello

Thanks for getting back with the liver function report, the total bilirubin is extremely high which means that the gall stone is impacted.

If you do not want to undergo operation for it then I recommend you to approach a gastroentrologist, they will do a procedure known as ERCP. It is minimally invasive and does not require a full blown surgery.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (45 minutes later)

Hi Doctor, we are getting mixed information now. One of the doctor he consulted there told that the high bilrubin is because he has gall stones. He recommended to be on medication for a week and do the test another time , next week to decide on the next steps. Is it safe that way, given that brother is now feeling really better since yesterday.?

Answered by Dr. Rakesh Madhyastha (26 minutes later)

Brief Answer:
Follow up

Detailed Answer:
Hello

Let me add clarity if you are getting confused. High bilirubin is because of the gall stones

It is safe to wait and see in these situations

1. There is no pain abdomen
2. There is no fever and vomiting
3. There is no itching or altered sensorium ( high bilirubin causes confusion and severe itching)
4. Repeat bilirubin is showing a decreasing trend

Regards

Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar