Gallstones (Cholelithiasis) in Children
Our body produces numerous substances within itself that satisfy a number of functions. The liver produces bile, which aids digestion in the stomach as well as the intestine. Similarly, cholesterol is also necessary within the body in a healthy amount. However, when either of these levels gets disturbed or exposed to some uncontrolled factors, they can lead to the formation of gallstones, which can be quite painful.
What are Gallstones and Its Types
In a nutshell, there are certain digestive fluids in the body that tend to harden into a thick mass and form inside the gallbladder. At times, these find their way inside a duct or a passage and end up blocking it, causing the gallbladder to be inflamed. These gallstones are usually one of the two types mentioned below.
1. Stones Formed by Bilirubin
Bilirubin is a special juice secreted in the stomach and is used primarily by the liver. At times, this juice can collect together and become stiff, resulting in the formation of a stone. If a child has leukaemia or issues with liver functioning including any infections, the chances of bilirubin stone formation are higher.
2. Stones Formed by Cholesterol
Cholesterol is present throughout the body in various proportions. Very rarely do children have cholesterol stones since they are mostly observed in adults with cholesterol issues such as old people, obese or pregnant women, and so on.
How Common is Cholelithiasis in Children
For parents wondering can kids get gallstones, the evidence might point towards rare incidents but the possibility surely exists. It is highly observed in kids who have poor eating habits or suffer from diabetes, obesity as well as haemolytic anaemia amongst other health conditions.
Causes of Gallstones in Kids
Gallstone formation is rare in children but is definitely not unheard of. There are some specific causes that have been known to be the culprit behind those.
Some children are born with a propensity for diabetes while there are a few others that do develop type 2 diabetes pretty early in life. Such children have to face numerous health issues, and the formation of gallstones is also one amongst those.
2. Cholesterol Reduction Drugs
Some children might be born with circulatory or heart-related disorders, making it necessary to take medications that work in reducing cholesterol within the body. However, these medicines consequently end up increasing the levels of cholesterol in the bile, increasing the chances of it solidifying and forming gallstones.
3. Genetic Reasons
At times, gallstones can be inherited genetically from parents or even a generation before it. Since various factors could induce the formation of gallstones, any family members suffering from it do automatically elevate the risk of the child suffering from it, too.
4. Obese Children
One of the major problems plaguing humanity today, obesity is a health issue for many but its consequences can manifest in different forms as well. The presence of obesity has a direct link with the increase of cholesterol levels in the body, which ultimately end up putting the child at a higher risk of experiencing gallstone related problems.
Signs and Symptoms of Gallstones
Gallstones are formed within the body. So they can only be detected by doctors using specific machines and techniques. However, if your child is suffering from gallstones, there are some strong signs that he will definitely exhibit.
- The pancreas of the child would be inflamed.
- He will have a high fever.
- He will also experience some protracted pain.
- Bouts of vomiting might occur.
- There will be a sensation of nausea.
- The area between the shoulder blades on the back will begin to ache.
- His upper abdomen will experience sudden and sharp pains.
- The right shoulder of the child would begin aching as well.
Risks and Complications
It is quite necessary to detect gallstones quickly and carry out treatment procedures as soon as possible. If left unattended and allowed to develop further, there is a risk of complications occurring in the child.
- Although quite rare, there have been instances where the gallstones have perforated the gallbladder extensively.
- Since the gallstones block various ducts and passages, systemic infections and inflammations such as cholecystitis and cholangitis might occur.
- As long as the gallstone is blocked, the most common complication is the pancreatic inflammation. Though painful, it isn’t serious and reduces once the stone has passed through the duct.
How is Gallstones Diagnosed
Doctors usually conduct a diagnosis of gallstones by making use of numerous tests, based on the intensity and necessity of diagnostic clarity.
- General blood tests give an idea of any infection being present.
- Ultrasounds can provide an approximation of any gallstones.
- Endoscopic ultrasounds reach deeper for better imaging.
- CAT scans are advanced and suggested for enhanced results.
- MRCP, or magnetic resonance cholangiopancreatography, helps visualize the gallbladder ducts.
- ERCP, or endoscopic retrograde cholangiopancreatography, shows the areas surrounding the liver, pancreas, and gallbladder clearly.
- Cholescintigraphy or HIDA scan provides information about the contracting ability of the gallbladder.
- At times, an X-ray of the abdominal region might be suggested as well.
Treatment of Gallstones in Children
In the case of paediatric gallstones treatment, their surgical removal is the best way to prevent any complications and relieve the pain caused by them. There are a few major ways this can be achieved successfully.
1. The ESL Procedure
Also known as electrohydraulic shockwave lithotripsy, this is highly recommended for children who might not be conducive to an invasive surgery. Here, the stone is coerced into passing through the duct by shattering it into smaller pieces.
2. Open Cholecystectomy
Quite a complex surgical process compared to others, this is usually conducted when the stone is situated weirdly within the gallbladder. The surgery begins from the abdomen and proceeds ahead thereafter.
3. Laparoscopic Cholecystectomy
A minimally invasive surgical technique, laparoscopy allows surgeons to access the abdomen via the stomach and extract the gallbladder completely.
Simple Tips to Prevent Gallstones in Kids
Thankfully, there are quite easy ways to prevent the formation of gallstones in a child. This can be achieved by adhering to some simple everyday habits.
1. Sticking to a Meal Schedule
When children end up skipping any major meal, the bile secretion in the body gets disturbed, which may increase chances of gallstone formation. Even fasting can result in the same, which should be highly avoided for kids.
2. Adhering to a Healthy Diet
Cholesterol intake should be controlled right from childhood. The affinity for fast-foods can increase cholesterol levels and form gallstones. For kids that are already obese, an exercise schedule to keep the weight in check would be beneficial.
When to Call a Doctor
Most of the times, the pain due to gallstones disappears once it successfully clears the blocked duct by passing through it. However, you should not hesitate to call the doctor if you observe any of the following in your child.
- Presence of a high fever with repeated chills
- A yellowish shade on his skin and eyes, indicating jaundice
- Excruciating pain in the abdomen that is unbearable for the child
Treatment of paediatric cholelithiasis is not as scary as it seems and medical advances have made the procedures even more effective. Sticking to a healthy lifestyle and nipping any problems in the bud can help reduce the chances of any situation worsening into a medical complication.
Also Read: How to Deal with Kidney Stones in Kids?