CSA11 Cholelithiasis

Agustin, Denzel
Carreon, Saira
Lacson, Berlon
Section: NU-202 | Group 11
Case Study Questions
1. What are Marcia’s risk factors for cholelithiasis?
- The major risk factors for cholelithiasis are the 5Fs, which stand for fair, fat, female, fertile, and
forty. Marcia is a 42-year-old female; her BMI is 35.2, which falls under the overweight category;
therefore, Marcia is fat. Even though these factors are based on statistics, they are controversial
as they add up to a kind of stereotype, and solely basing them on these factors may overlook
patients and lead to misdiagnosis. Additionally, rapid weight loss is also a risk factor for this
disease. Marcia was once 210 pounds and lost 75 pounds after her gastric bypass surgery a year
ago, although this is not rapid weight loss as the usual timeframe for gastric bypass patients to
lose weight is 12–18 months after surgery. Also, ethnicity may increase the risk of this disease.
Native Americans have the highest incidence of gallstones and appear genetically predisposed
to secrete higher cholesterol levels in the bile, and Marcia is a Pima Indian, which is a North
American Indian. In conclusion, Marcia has 4 out of 6 risk factors, which are fat, female, forty,
and ethnicity.
2. What symptoms did Marcia have that are consistent with a diagnosis of cholelithiasis?
- In some cases, cholelithiasis may not cause any symptoms, but in the case of Marcia, symptoms
such as pain in the right upper part of her abdomen, nausea, vomiting, and fever are symptoms
that are consistent with a diagnosis of cholelithiasis.
3. What is the cause of the pain associated with cholelithiasis?

- When gallstones move through the duct (tube) leading to the stomach, they may become
impaled. This prevents bile from leaving the body and causes gallbladder spasms. Usually,
there will be a sharp pain, like being sliced by a knife, under the rib cage on the upper right
side or in the middle of your abdomen. The pain might be so great that breathing would be
hard.
4. What are the treatment options for cholelithiasis? Explain each.
- Cholelithiasis treatment options are determined by a number of criteria, including the patient's
symptoms, the size and location of the gallstones, and any accompanying problems. The following are
the primary therapeutic options:
● Medications: In some circumstances, doctors may give medications to dissolve gallstones or
improve symptoms, such as ursodeoxycholic acid (UDCA), which is a medication that can
dissolve tiny cholesterol gallstones over time. This treatment is most successful for patients
who have specific types of gallstones and is not appropriate for everyone. Another example is
pain medicines, which may be administered non-prescription or prescription to manage
symptoms such as stomach pain during gallstone attacks.
● Endoscopic Procedures: These procedures involve the use of a thin, flexible tube called an
endoscope to remove or break down gallstones. An example of these procedures is
Endoscopic retrograde cholangiopancreatography, or ERCP is a common endoscopic
technique that combines endoscopy with X-ray to detect and remove gallstones from the bile
ducts. Endoscopic ultrasound, or EUS, is another treatment that can be used to find and
remove gallstones in the bile ducts or to guide other operations.
● Surgery: Surgical removal of the gallbladder, known as cholecystectomy, is the most common
and definitive treatment for cholelithiasis. It is advised in cases of symptomatic gallstones, big
gallstones, or when nonsurgical methods are ineffective or inappropriate.
5. Explain the relationship between rapid weight loss and the development of cholelithiasis.
- Over time, losing additional weight can assist obese people in lowering their risk of gallstone
formation. However, rapid weight loss can result in gallstone formation for the same reasons
as obesity does: altered bile acid, lecithin, and cholesterol ratios, and impaired gallbladder
function. Also, during the process of rapid weight loss, the metabolism of fat by the body
leads to an increased secretion of cholesterol into bile by the liver, potentially resulting in the
formation of gallstones.
REFERENCES:
Davis, J. L. (2008, January 3). Weight Loss Surgery: What to Expect the First Year. WebMD.
https://www.webmd.com/obesity/features/weight-loss-surgery-what-to-expect-the-first-year
Professional, C. C. M. (2022, May 3). Gallbladder Disease. Cleveland Clinic.
https://my.clevelandclinic.org/health/diseases/22976-gallbladder-disease
Lee, S., Chung, C., Ko, K. H., & Kwon, S. W. (2011, January 1). Risk factors for the clinical course of
cholecystitis in patients who undergo cholecystectomy. Korean Journal of Hepato-Biliary-Pancreatic
Surgery. https://doi.org/10.14701/kjhbps.2011.15.3.164
Mayo Clinic. (2021, August 20). Gallstones - Symptoms & causes - Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214
Johns Hopkins Medicine. (2021, October 16). What Causes a Gallbladder Attack?
https://www.hopkinsmedicine.org/health/conditions-and-diseases/what-causes-a-gallbladder-attack
Mayo Clinic. (2021, August 20). Gallstones - Diagnosis & treatment - Mayo Clinic.
https://www.mayoclinic.org/diseases-conditions/gallstones/diagnosis-treatment/drc-20354220
Johns Hopkins Medicine. (2021, August 8). Gallstones.
https://www.hopkinsmedicine.org/health/conditions-and-diseases/gallstones#:~:text=As%20the%20body%2
0metabolizes%20fat,to%20become%20overconcentrated%20with%20cholesterol.

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Agustin, Denzel

Section: NU-202 | Group 11

Case Study Questions

1. What are Marcia’s risk factors for cholelithiasis?

3. What is the cause of the pain associated with cholelithiasis?

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