Cholelithiasis is formation of stones (gallstones) in the gall bladder. Excessive cholesterol intake combined with a sedentary lifestyle is linked with increased incidences of cholelithiasis. However, some low-fat diets have also been linked to cholelithiasis because the diet appears to free cholesterol from body tissues; then the cholesterol crystallizes in the gallbladder before it has chance to be excreted. Bile contains cholesterol, water, proteins, bilirubin, bile salts (the chemicals necessary to digest fat) and small amounts of copper and other materials. If there is a chemical imbalance (especially too much cholesterol), formation of crystals occur which can harden into stones.

Symptoms of cholelithiasis include:
• signs of inflammation (e.g. uncommon temperature, pulse and respirations)
• vomiting
• jaundice
• positive Murphy's sign
• RUQ tenderness
• nausea
• indigestion
• patient complaints of epigastric pain - The epigastric pain caused by cholelithiasis may also be called biliary colic. The pain is a steady and severe ache in the epigastrium and RUQ (Right Upper Quadrant) that may radiate back to behind the right scapula or to the right shoulder. The pain usually begins suddenly after a fatty meal and lasts for 1 to 3 hours.

Furthermore, a family history of obesity, diabetes mellitus and pregnancy have also been linked to higher incidences of cholelithiasis. Cholelithiasis is responsible for about 90 percent of the cases of cholecystitis, or inflammation of the gallbladder. Women between ages 20 and 50 are about three times more likely to have gallstones than men. After the age of 50, however, the rate of gallstones is about the same for men and women.

Medical management of cholelithiasis centers on:
• pain control
• prevention of infection
• maintenance of fluid and electrolyte balance

Meperidine hydrochloride, an opioid analgesic, is the drug of choice for pain control because morphine sulfate is believed to cause spasms of the gallbladder, biliary ducts and the sphincter of Oddi. Treatment for cholelithiasis usually involves surgical removal of the gallbladder. The surgical procedure may be cholecystectomy via laparoscopy or a traditional cholecystectomy.

Cholelithiasis can be effectively prevented if we take care of our body, take control over what we eat and lead an active lifestyle.


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