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| Pigment gallstones are more likely to affect the elderly, people with cirrhosis, and those with chronic hemolytic anemia, including sickle cell anemia. About 15% of people with stones in the gallbladder also have stones in the common bile duct (choledocholithiasis), which sometimes pass into the small intestine but also may lodge in the duct and cause distention, infection, or pancreatitis. The risk of people with gallstones developing mild symptoms is 1% to 3% annually. Large or fatty meals can precipitate the pain, but it usually occurs several hours after eating, often at night. Scarring causes the gallbladder to become stiff and thick. A physical exam often reveals tenderness in the right upper area of the abdomen in acute cholecystitis and sometimes in biliary colic. CDCA has significant side-effects, auch as diarrhea and abnormal liver tests. The rate of dissolving is about 1mm per month. The addition of cholesterol-lowering medications, known as "statins", like lovastatin (Mevacor) and simvastatin (Zocor), improve the effectiveness of UDCA therapy. Prognosis; Complications Simple pain, rather than serious complications, is the first symptom of gallbladder disease in over 90% of people with stones, therefore waiting has few serious consequences. |
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