Follow to 5/19/98 Question

  Ivery much appreciate the reply to my posting on 5/19/98. To follow-up, the last two times I have had my stool samples checked, there was no blood, so I hope this is an area I can relax a bit about now. However, at my insistence, I had an abdominal ultrasound which showed the presence of gallstones. Could any of the conditions I descibed on 5/19/98 be caused by gallstones or perhaps are the gallstones a byproduct of my other problems? I realize, of course, that they could be totally unrelated, but was looking for an informed opinion. The reply I recieved on 5/25/98 was very informative and reassuring. I hope you can refer back to my original message to put all of my medical conditions in context and answer this posting as well. I was also wondering if gallstones or an improperly functioning gallbladder could contribute to weight loss? Thanks a lot!
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Dear Stephen S,
Gallstones are a common clinical finding.  I do not believe that the stones are either causing your problem or the result of your clinical symptoms.
In North America, virtually all gallstones are made of cholesterol that is synthesized in the liver.  The bile becomes supersaturated with the cholesterol and the cholesterol starts to precipitate, eventually forming a stone.  The preciptitation process is analagous to what would happen if you added sugar to a glass of water.  Some of the sugar would go into solution but eventually you would see sugar at the bottom of the glass.
Gallstones can have many different presentations.  Usually, people will come to the doctor with the complaint of pain in the right abdomen under the ribs.  the pain starts approx 45 min after eating and increases progressively over about an hour before gradually subsiding.  Although this symptom is said to be precipitated by the eating of fat, the pain can be brought on by many different foods.  Sometimes the presentation of gall stones can be very dramatic with severe abdominal pain ( pancreatitis) or pain, jaundice and fever (cholangitis) We do not suggest that the gall bladder be removed unless there has been a history of biliary colic or the other preesentations.  Atypical abdominal pain is not an indication for gall bladder surgery.
Best of luck.
HFHSM.D.-rf
*keywords: gall stones
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