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3 of 3 Premium Clicks used this month SUBSCRIBE Print + Online Subscriber Activation | Register x Forgot Password | Need an Account? e-edition | subscribe | newsletter | deals Home News Latest Stories New Bear Creek project trades blackberries for native plants Emergency Services, March 9 Phoenix Garden Club strives to help make Weed green again Ashland police confirm Hannah Thomas-Garner is safe with her father Oversold Central Point monster truck show leaves fans out in cold Crime, Courts and Emergency Services Emergency Services, March 9 Ashland police confirm Hannah Thomas-Garner is safe with her father Emergency services, March 8 Jackson County searchers looking for missing man Emergency services, March 7 Politics and Elections Ex-Merkley aide chosen as Oregon secretary of state Ashland: Budget increase, swimming pool funding discussion on council agenda Judge upholds Phoenix's moratorium on medical marijuana dispensaries Ballots on Jackson County marijuana tax go out Friday Brown's inauguration brings hope to local lawmakers Education Willow Wind students raise money for water District considers options to keep school tracks open, safe Ashland School District learns why its anti-bullying rating was low Ashland district rethinks transfer approval process MSD to save taxpayers nearly $10.5 million by refinancing Environment Catastrophic wildfires expected in Southern Oregon this summer The new normal under climate change? Lost Creek Lake algae bloom subsides Lost Creek Lake logjam could become hazard for boaters Made in the Shade State News Federal judge orders speedier Klamath wildlife refuge management plan Former Josephine County students sue school district over alleged abuse Ex-Merkley aide chosen as Oregon secretary of state Eastern Oregon dig uncovers ancient stone tool Team tracks new baby orca Nation - World Obituaries Jaime Winston Tucker Death Notices Joseph Elsworth William "Les" Mason Irene Meredith Weather Photo Galleries Since You Asked Videos Web Cams Mail Tribune 100 Shareable Bank of America is predicting a massive Tesla collapse Mars One attracts science fiction geeks and people who hate society This $1 million Mercedes is like an armored private jet for the road Sports Latest Stories No. 19 Stanford scores Pac-12 title No. 6 Badgers keep up hot pace OSU pitching holds off Fresno State Allred cashes in at Karibana Rare professional boxing card is on tap Varsity 541 College Sports No. 19 Stanford scores Pac-12 title No. 6 Badgers keep up hot pace OSU pitching holds off Fresno State Beavers must move on after losses Ducks on the Rise Pro Sports Allred cashes in at Karibana Dolphins, Suh near $114 million deal Murray lifts Britain into Davis Cup quarters T-Wolves snap Blazers' win streak, 121-113 Lowly Philadelphia knocks off Atlanta Community Sports Business Latest Stories Silvio Calabi: Mercedes-Benz ML250 raises the diesel 4×4 stakes Business briefs: March 7 Blog: A Few of Our Favorite Places New construction prices jump 18.2 percent in Jackson County CEO Rieder leaving Erickson March 31 Real Estate News Business briefs: March 7 New construction prices jump 18.2 percent in Jackson County People In Business People in Business: Feb. 28 People in Business Transportation CEO Rieder leaving Erickson March 31 Lodging gains bode well for travel industries Medford airport flies past January record Agriculture Harry & David announces new president Warm winter has fruit growers poised for action Briefcase: Business briefs for Feb. 21 Opinion Latest Letters to the Editor, March 9 Kathleen Parker: 'Just look at him' Letters to the Editor, March 8 George Will: Obama needs GOP to approve the TPP Dana Milbank: Hillary vs. Hillary Editorials Our View: Cheers and Jeers Our View: Take it slow on legal marijuana Our View: Small climate steps add up to big ones Our View: Drawing back the curtain on government Other Views: Brown's list of challenges is lengthy Letters to the Editor Letters to the Editor, March 9 Letters to the Editor, March 8 Letters to the Editor, March 7 Letters to the Editor, March 6 Letters to the Editor, March 5 Columns Kathleen Parker: 'Just look at him' George Will: Obama needs GOP to approve the TPP Dana Milbank: Hillary vs. Hillary Charles Krauthammer: Netanyahu's Churchillian warning Philip Maddocks: Homeland Security is prepared to let its protection of Congress run out after this week Guest Opinions GUEST OPINION: Police, community should work to prevent profiling Guest Opinion: Don't overregulate Oregon's hemp industry Guest Opinion: Predatory banking practices bilk citizens Guest Opinion: Is less education the answer? Guest Opinion: Bill would shore up legal aid funding Lifestyle Latest stories Get A Life: Smell the roses Day Trippin': A picnic lunch at a McCloud River waterfall Home Help: 4 ways to redefine your outdoor space Silvio Calabi: Mercedes-Benz ML250 raises the diesel 4×4 stakes Community blog: The Future is Now Food Community blog: Airy mousse rivals ease of pudding from a box Page Onorato: Please don’t take my Goo Goo Clusters away Season Stepp: Celebrate Pi Day with these tasty pie recipes Tammy Kelly: Bring back the potatoes Pantry pride Home and Garden Home Help: 4 ways to redefine your outdoor space Dear Monty: Home seller seeks to start bidding war Paul Rogers: Looking for signs of new life Home Help: Enhance your home-office experience Specialty painting adds wow to your walls Health Community blog: The Future is Now Dr. Murray Feingold: Cognitive-behavioral therapy shown to help hoarders Dr. Jeff Hersh: Gallstones affect 25 percent of American women Health Watch: Get prepped for spring break HealthStyle: Marriage care and maintenance Hiking Biking Faith More religion events in the Rogue Valley Religion Briefs Religion briefs, Feb. 27 Religion briefs: Friday, Feb. 20 Religion News: Pope makes surprise shantytown visit Milestones and Achievements Exercise helps special-needs kids adjust to airport procedures Engagement: Workman-Wright Anniversary: Hofer New arrivals: Sunday, Feb. 8 Columnist for a Day Rogue Healthy Aging Tempo Latest stories Ashland's First Friday Art Walk showcases new exhibits by regional artists Live Music in Local Clubs Darrin Wayne steps to the plate at Rising Stars Alice DiMicele plays the Unitarian Fellowship Southern Oregon University Wind Ensemble to present 'All American' Theater TMTO's 'Bye Bye Birdie' takes flight Brava! Opera presents classic Mozart and Poulenc Review: 'Fingersmith' a twisting thriller with love TMTO presents 'Bye Bye Birdie' 'Guys and Dolls' a sure bet for dazzling entertainment Music ZEPDRIX! at the Historic Ashland Armory The Bee Eaters play Headwaters Ladysmith Black Mambazo plays the Craterian Theater Live Music in Local Clubs Darrin Wayne steps to the plate at Rising Stars Community Events Ashland's First Friday Art Walk showcases new exhibits by regional artists Jesse Lawson and Joe Moxley host 'Barkeeper' Third Fridays showcases local artists Southern Oregon Rod and Custom Show Dining Sakura Japanese Sushi Restaurant opens in new location Restaurant Inspections: Sunday, March 1 Great Outdoor Grill offers healthful options Restaurant Inspections: Sunday, Feb. 22, 2015 Saigon Xich Lo Vietnamese cuisine Tempo Videos Classifieds Jobs Autos Real Estate FEATURED » Obits Blogs TV Listings Movie Listings Oregon Outdoors Oregon Healthy Living Magazines/Special Sections Business Services NEWS NOW New Bear Creek project trades blackberries for native plants ... Oversold Central Point monster truck show leaves fans out in cold ... Missing teen Hannah Thomas-Garner found safe ... New Bear Creek project trades blackberries for native plants ... Oversold Central Point monster truck show leaves fans out in cold ... Missing teen Hannah Thomas-Garner found safe ... Dr. Jeff Hersh: Gallstones affect 25 percent of American women By Dr. Jeff Hersh More Content Now MailTribune.com By Dr. Jeff Hersh More Content Now Posted Mar. 6, 2015 @ 8:06 am By Dr. Jeff Hersh More Content Now Posted Mar. 6, 2015 @ 8:06 am » Social News p bs:newslist StartDate="20121121" EndDate="p bs:datecalc Months="3"" DateSort="1" UseObjects="1" ObjectClass="81" Taxonomywords="2325,665" ExactTaxonomyMatch="1" Image="1" Count="4" --> Q: My mom had a gallstone that caused her to turn yellow and get sick, but the doctors thought surgery was too risky and recommended removing the stone with an endoscope. Why isn’t this done for everyone? A: The liver and pancreas make various enzymes and fluids to help digest food. The gallbladder sits under the liver and stores bile, a fluid made in the liver from bilirubin, cholesterol and other substances that helps digest fatty foods. The way the “plumbing” works is that a tube from the liver (hepatic duct) merges with a tube from the gallbladder (cystic duct) to form the common duct which eventually merges with a tube from the pancreas (pancreatic duct); from there all the digestive fluids empty through the ampulla of Vater into the small intestine. Gallstones form in the gallbladder and/or bile ducts due to an imbalance of bilirubin and cholesterol; about 10 percent are pigment stones from too much bilirubin, the remaining 90 percent are cholesterol stones. Risk factors for developing gallstones include being female, being overweight, advancing age, family history of gallstones, certain medical conditions (diabetes, Crohn’s disease, others) and others. Gallstones are common, affecting 25 percent of American women by age 60 and 50 percent by age 75. Although less common in men, 25 percent still develop gallstones by age 75. Fortunately, most people never develop any problems or complications from their gallstones. Small stones can pass through the ducts to the intestines with no problem, and very large stones just sit in the gallbladder. Ten to 20 percent of the population develops symptoms from their gallstones (biliary colic), classically manifesting as right upper abdominal pain sometimes radiating to the right scapula, and often accompanied by nausea and/or vomiting. Symptoms often begin after eating a fatty meal, which stimulates the gallbladder to squirt out bile. Stones of a size that pass into the ductal system and then get stuck may block the drainage of the gallbladder, liver and/or pancreas, causing inflammation (cholecystitis, hepatitis or pancreatitis respectively) and possibly predisposing to infection. In most cases the gallstone works its way out of the ducts on its own, the patient’s symptoms then resolving. However, for some people the stone can be firmly “stuck” and a blockage of one or more of the ducts can cause secondary complications such as pancreatitis (inflammation of the pancreas), liver compromise (sometimes leading to jaundice, a yellowing of the skin and white parts of the eyes from a buildup of bilirubin in the blood), infection or other issues. Ultrasound is the most common test used to verify the presence of gallstones, but CT, MRI and other techniques may be required in some patients. Blood tests to evaluate pancreatic and liver function may also be needed. Since the majority of people with gallstones do not develop any problems, no intervention is routinely needed. However, of the 10 to 20 percent of people who suffer an episode of biliary colic, about 70 percent will have another episode within a couple of years. Since the gallbladder is not absolutely needed for good health (the liver can usually secrete sufficient bile, although loose stools are more common after the gallbladder is removed), removal is often recommended after an episode of cholecystitis. In 90 percent of cases the gallbladder is removed via a minimally invasive procedure (laparoscopic surgery) where specialized tube-like surgical instruments are inserted through small incisions in the abdominal wall. For technical reasons, some people are not a good candidate for this approach, or sometimes the laparoscopic surgery must be “converted” to an open surgery where a larger incision is needed to directly visualize the gallbladder and then remove it. For patients whose problematic gallstone does not pass on its own, or who develop complications from a blockage of one or more of the ducts, other interventions may be needed. Some patients may require temporary drainage via a tube stuck directly through the skin into the gallbladder (a percutaneous drainage). An endoscopic retrograde cholangiopancreatogram (ERCP) is where an endoscope (yet another type of specialized tube-like device) is passed through the patient’s mouth into their esophagus (eating pipe), then onward to their stomach and small intestine. From there, the endoscope is guided through the ampulla of Vader retrogradely (in the opposite direction the digestive fluids normally flow) into the ductal system described above. At this point, specialized X-rays may be obtained to verify the diagnosis, and certain treatments may be performed. Although the gallbladder cannot be removed with this approach, an entrapped gallstone may be “snared” and removed (using a specialized addition to the endoscope), lesions suspected of being cancer may be biopsied, an overly narrowed duct can be widened, and if indicated, a stent (a cylindrical device to keep the duct pried open) can be inserted. Patients who are surgical candidates after their clinical condition has improved, even if an ERCP was required, may have their gallbladder removed. Other patients may be treated with medications to help dissolve their gallstones to prevent subsequent episodes of biliary colic. The specific treatments best suited for an individual patient should be made in close consultation with a physician experienced in treating gallbladder disease. For the many people with gallstones who have not had an episode of biliary colic, a watch and wait approach is usually the best option. Jeff Hersh, Ph.D., M.D., can be reached at [email protected]. By Dr. Jeff Hersh More Content Now MailTribune.com By Dr. Jeff Hersh More Content Now Posted Mar. 6, 2015 @ 8:06 am » Comment or view comments /* $( document ).ready(function() { // Jquery mobile is trying to style the button and leaving a blank gry button on top of a white button $("#viafouracoms .vf-comment-controls li.vf-right").html(' Submit '); });*/ » STAY INFORMED Email NewsLetter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. calendar Connect with MailTribune.com Facebook Twitter RSS Back to top Reader Services Reader Services Home Subscriptions Subscriber controls Contact us Submissions Photos Events Letters to the editor Corrections Announcements Obituaries Story ideas Since you asked Alerts Email Alerts RSS Feeds Text Alerts Advertise Media Kit Home Products and services Ad rates Advertising contacts Mail Tribune Daily Tidings The Nickel Shop Our Valley Blogs Stay Informed Email newsletter Sign Up Today Sign up for our newsletter and have the top headlines from your community delivered right to your inbox. 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