In evaluating treatment options for cholelithiasis, there are two important questions. The first is: are the stones causing symptoms or complications? If they are not, then management should be watchful waiting. If stones are causing symptoms or complications, then the patient's ability and willingness to undergo surgery must be assessed. For patients who are able and willing to undergo surgery, cholecystectomy is the treatment of choice and provides definitive management. In most cases, it can be completed laparoscopically with minimal risk of morbidity or mortality. In certain cases, an open approach may be necessary. For patients who are not able or willing to undergo surgery, consideration should be given to dissolution with UDCA or to fragmentation with lithotripsy. Only rarely should symptomatic or complicated stones be treated with endoscopic sphincterotomy alone. With any management option short of cholecystectomy, there is a substantial risk of recurrent stones and symptoms.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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