Cholelithiasis: diagnosis and current therapeutic options

More than 20 million people in the United States have gallstones and some 500,000 cholecystectomies are done annually. The cost to the American public is approximately 1.5 billion dollars per year. Biliary pain or "colic" is the classic presenting symptom in gallstone disease, occurring in 5 to 10 percent of symptomatic patients. Of significance is that 10 to 30 percent of symptomatic patients will present with atypical complaints, while 80 percent of people with gallstones are asymptomatic. It is crucial that a detailed history of clients' symptoms be ascertained to ensure an accurate diagnosis. New treatment modalities for cholelithiasis recently have been developed. These include oral bile salt therapy and gallstone lithotripsy. Knowledge of these options and their applications to symptomatic clients will enable health care providers to better formulate plans of education and intervention for clients with gallstone disease.