For 9 years, I've woken up as a dragon under attack, a persistent burning sensation had instilled in the pit of my stomach, causing pain to spread and radiate throughout my body. The fire burning in my veins, creeping to my throat, begging for release had become an everyday normality for me. This paper will evaluate what cholelithiasis is, the different types of gallstones, what race and gender are most affected, symptoms, modalities used to diagnose cholelithiasis, and the treatments used for cholelithiasis.
Cholelithiasis is the medical term for gallstones, which are located within the gallbladder (Figure 1). It is a major cause of morbidity and mortality throughout the world. According to Lack (2003), there are two major types of gallstones: cholesterol and non-cholesterol pigmented stones. Gallstones are primarily composed of cholesterol, bilirubin, calcium salts, and other substances such as protein, bile acids, fatty acids, and inorganic salts. Classification of gallstones is based on chemical composition. Cholesterol stones are predominantly composed of more than 60% to 70% cholesterol with smaller amounts of calcium bilirubinate. Pure cholesterol stones are rare and can exists containing less than 10% of biliary calculi and over 90% cholesterol. Non-cholesterol stones or mixed cholesterol stones have a lower quantity of cholesterol and are mixed with pigmented substances such as calcium bilirubinate. Pigment stones can either be black or brown; black stones contain calcium bilirubinate and calcium carbonate, and about 50% are radiopaque. Brown pigment stones are generally associated with bacterial infection, particularly enterococci and Escherichia coli (p.415) (Figure 1).
Gallstones are more common in women than men. The ratio of gallstones compared to males and females is 1 to 2. Different races are at a higher risk of gallstones. In the United States about 10% of the general population has gallstones. Europe's statistics are similar to the U.S., except 10% to 20% of the women between the ages of 30 and 50 years and 15% to 40% of women older than 50 years are affected. Higher rates are recorded in Latin American women, with lower rates for sub-Saharan African women, Asian women, and black women living in the United States. Cholesterol stones are highly common in North Americans, especially among Hispanic Americans. They are extremely common in Native Americans who live in both North and South America. Pigment stones are uncommonly seen; approximately 10% to 25% are seen in North America. These stones are more common in Asian population (Owen & Kelly, 2001, p 232-234).
Cholelithiasis symptom may sometimes present as asymptomatic and may be incidentally found. If stone(s) migrate into the common bile duct, also known as choledocholithiasis, symptoms may produce intense spasmodic and recurrent right upper quadrant (RUQ) abdominal pain radiating to the back or right shoulder. Postprandial pain is commonly noted after the patient eats...