Dr AD Sharma points out public ignorance on gallstone
Source: The Sangai Express / Usham Satyajit

Imphal, December 08 2009: Despite gallstone formation being one of the most common endemic health related problems faced by the people of Manipur, there has been no proper study on the extent of its prevalence, even as lack of proper understanding about the disease has led people to a mass hysteria of going for surgical operation to remove gall bladder regardless of its necessity or not.

While absence of any systematic study to analyse the extent of its prevalence has left out this commonest abdominal health problem from the domain of public health issue, lack of awareness among the people has imposed financial burden apart from needless health complications that could be avoided.

Dr AD Sharma in an interaction with The Sangai Express

Acknowledging wide spread prevalence of gallstone problem among the people, an official source from the State Health Department revealed that there is no such policy to deal with the problem as of now.

There is also no immediate plan of action for organising mass awareness among the people in this regard.

The official, however, added that Advent of ultrasonography (ultrasound) facility has made the task easier the doctors to detect gallstone cases.

In an interview with The Sangai Express, Dr Aribam Devadutta Sharma, an associate professor of GI & Minimal Access Surgery in Regional Institute of Medical Sciences (RIMS), Lamphelpat informed that patients with gallstone cases are being admitted to RIMS Hospital on daily basis.

This is a clear indication on the extent of its wide prevalence among the people of Manipur, though no study on population based incidence has been ever conducted.

There is also no two argument over the fact that like the American and Mexican Indians, Manipuris have a genetic predisposition to gallstone problem.

So, there is the urgency of recognising gallstone as a serious public health issue in the State, he pointed.

However, there is a general misconception among the people to go for surgical operation and remove gall bladder, when it is not required in most gallstone cases, Dr Sharma cautioned.

Medically speaking, gallstone, also term as either cholelithiasis or chronic cholecystitis or acute cholecystitis or choledocholithiasis, etc, are small, hard deposits that can form in the gallbladder, a sac-like organ that lies under the liver on the right side of the abdomen.

Gall bladder functions as an optional store for the bile secreted by the liver which helps the body to digest fats.

Gallstones are form when bile stored in the gallbladder hardens into pieces of stone-like material.

The process of gallstone formation (cholelithiasis) is generally slow, and usually causes no pain or other symptoms.

The majority of gallstones are either the cholesterol or mixed type.

Study reports have concluded that people with diabetes are at higher risk for gallstones, and they also have a higher-than-average risk for other gallbladder problems.

Being overweight and ageing are other significant risk factors for gallstone formations.

Between man and woman, gallstones are also more common among women as pregnancy increases the risk of gall stone formation.

Dr Sharma further explained that there are mainly two types of gallstones namely symptomatic and asymptomatic.

Symptomatic are characterised by jaundice, acute biliary or gall bladder pain , etc.

60 to 90 percent of the cases are asymptomatic where treatment through surgical operation is not essential.

Simple acidity, gas flatulence or vague abdominal comfort has nothing to do with the gallbladder stone and removing gall bladder in such cases will not get rid of the symptoms.

Although gallbladder is not an essential organ and can be safely removed, recommending surgical operation for any gallstone cases without explaining the risks and benefits of surgery versus and no surgery to the patients is not advisable, he added.

In response to a question on the apprehension of the public that consumption of certain foods like dried and other smaller fishes increase the chances of gallstone formations, Dr Sharma informed that no particular food has been incriminated in the formation of stones.

Nevertheless, vegetarians have fewer stones.

As to the public reaction of rushing to seek help of traditional healers to cure stone cases, whether it be of the gall or the kidney, Dr Sharma said medical science does not recommend such treatments.

He went on to said that Laparoscopic Cholecystectomy, more popularly known as key-hope surgery, is the standard worldwide accepted mode of treatment for gall bladder stones that are causing trouble.

This is done through four small surgical incisions on the tummy, one of which is used to put a telescope in to look inside while the other holes are used to put in instruments to free and remove the gallbladder with the stones inside them.

Unfortunately, there has been no comprehensive treatment facilities for gallstones in any of the Government hospitals in the State.