Liver Enlargement In Children

 Dissolution of Gallstones

The doctor can choose the appropriate method of treatment to break up gallstones or gallstones based on the symptoms appearing on the patient and the results of diagnostic tests for him. 

The doctor may resort to observing the patient, or he may resort to a non-surgical solution; Which includes removing stones while maintaining the presence of the gallbladder, and is usually resorted to in cases of cholesterol stones, especially for people who cannot undergo a cholecystectomy, while the surgical solution may be resorted to removing stones by removing the gallbladder in case The presence of pigment stones usually, and it should be noted that a person can live without a gallbladder, because it is a non-essential organ in it. These non-surgical treatments are Extracorporeal Shock Wave Lithotripsy or Bile acid pills.

Pharmaceutical

There are many medicines that have been manufactured in order to overcome the problem of gallstones in the event of suffering from its symptoms; Which can be used if the size of these stones is small, as well as if the stones are not calcified, and it should be noted that the gallbladder must perform its function naturally to be able to use these medicines, and the mechanism of action of these medicines includes getting rid of stones by either dissolving the stones In the gallbladder, or by interfering with the manufacture of gallstones inside the body, in fact, so-called bile acid pills can be used to break up small gallstones, which are available in two forms: Ursodeoxycholic acid and Chenodeoxycholic acid. Each of them can be explained in some detail as follows:

• Chenodeoxycholic acid: Chenodeoxycholic acid is one of the drugs used in the treatment of gallstones by reducing the formation of these stones; This is done by dissolving cholesterol, which may cause stones in the gallbladder, in addition to preventing the liver from producing cholesterol, as well as preventing the absorption of cholesterol from the intestine, and this acid also reduces other bile acids whose high causes damage to liver cells.
• Ursodeoxycholic acid: Ursodeoxycholic acid regulates cholesterol levels in the body by slowing down the rate at which cholesterol is absorbed into the intestines. Gallstones are formed if the person concerned is exposed to it; As is the case when resorting to surgery to lose weight; This is because rapid weight loss makes a person more likely to develop gallstones.

Shock waves break up from outside the body

In rare cases, the doctor resorts to breaking up gallstones by exposing them to shock waves from outside the body (in English: Shock wave lithotripsy) in order to convert them into small particles, and sometimes this method is used in conjunction with bile acid pills; Specifically, ursolic acid, and this technique is one of the modern techniques used in the treatment of gallstones, and is usually performed under general anesthesia or simple sedatives, where the patient lies on a table over a basin of water, and then the location of the stones is determined using ultrasound (in English: Ultrasound), after which high-intensity shock waves are directed at the location of the stone; In order to break the stones into small particles, these particles then pass through the bile duct to the intestines, and this procedure usually takes approximately 45 minutes to an hour, and it should be noted that oral bile acid pills are used for a period ranging from Between 8 to 30 months after this procedure; This is to make sure that the remnants of gallstones are removed from the body. In fact, this non-surgical procedure to treat gallstones is also a common way to treat kidney stones.

In fact, the shock wave lithotripsy procedure from outside the body is a suitable option for patients who cannot undergo surgery to get rid of these stones, and this procedure can also be used for patients who have a single stone with a diameter of less than 2 centimeters if this The stones cause pain, although this technique is no longer widely used; Due to the low number of good candidates for it; In order to use it, the patient’s gallbladder must be able to empty naturally, in addition to the need for the patient not to suffer from any complications or other problems, and according to scientific research published by the Indian Society of Pediatric Surgeons in late 2014, this technique is most useful in Treatment of children suffering from gallstones. In fact, resorting to the shock-wave fragmentation of gallstones from outside the body can lead to the emergence of many common symptoms that appear due to the start of dissolving the gallstones after this procedure, and these symptoms may include the following:

• Feeling of abdominal pain.
• stomach trouble.
• Blood in the urine.
•  fever. constipation or diarrhea;
• Feeling of headache or dizziness.
• The appearance of bruises on the skin.

 It is worth noting that the recovery period after this procedure varies from person to person; It depends on the size of the stones that were removed and the outcome of the stone fragmentation procedure; The larger the size of the gravel, the longer the patient needs to recover. Some patients may return to their usual activities within a few days, while those with large stones may need up to a week to do so, and the patient can use over-the-counter pain relievers such as Paracetamol and ibuprofen ( Ibuprofen) to get rid of pain after the operation after consulting the doctor. The doctor may also recommend dispensing an antibiotic to the patient to avoid any infections. The patient is also advised to drink plenty of fluids during the recovery period to prevent infection or bleeding in the patient after this procedure.

Tips to reduce gallstones

There are many tips and instructions that a person with gallstones can follow to reduce the chance of these stones forming again, as well as to reduce the risk of suffering from them for those who did not have them before. Some of these tips and instructions can be stated as follows:

• Maintaining body weight within the healthy acceptable limits; As mentioned earlier, being overweight increases the likelihood of gallstones forming, and in case you need to lose body weight; This should be done gradually as a rapid decrease increases the chance of gallstone formation.
• Divide your meals into several small meals spread throughout the day, and continue to follow a balanced diet that includes eating breakfast, as this maintains the stability of the level of bile in the body.
• Limit your intake of food rich in fat and cholesterol.
• Eat foods rich in fiber, such as vegetables, fruits and brown rice; It helps digestion and reduces the formation of gallstones, and it also helps to get rid of diarrhea associated with gallstones.
• Monitor and avoid foods that increase symptoms as much as possible, and may include: fatty, spicy or salty food, caffeine, and dairy products.
• doing physical activity; This is to maintain weight and reduce abdominal pain, if any.