Gallstone disease and Sphincter of Oddi Dysfunction (SOD)

Biliary stones are a widespread disease in socioeconomically developed countries. In Italy it is estimated that about 3-4 million people are carriers of stones or have already undergone surgery to remove the gallbladder. The presence of bile oversaturated with cholesterol (lithogenic bile) causes this substance to precipitate creating bile sludge and microcrystals inside the gallbladder, which over time tend to calcify with the formation of stones. This occurs more easily if the gallbladder shows disturbances in its contractile activity. Rapid weight loss as a result of excessive weight loss diets can be a precipitating factor.

Approximately two-thirds of stone-bearing individuals have no symptoms or complaints. Bloating, poor digestion, stomach weight, belching, sometimes present in these people, are not usually related to stones and often persist or even worsen after cholecystectomy surgery. Biliary colic is the most common symptom: it is manifested by sudden onset pain, often nocturnal, rather intense, cramp-like localized in the upper abdomen, radiating to the right side and back. The indication for surgical treatment arises precisely when biliary colic appears. If the stones migrate into the choledoco, obstructive jaundice (yellow coloration of the skin), acute cholangitis, acute pancreatitis can be determined.