Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Dr. Barbara Kaiser-McCaw Hecht is Director of Hecht Associates, Inc., consultants in Medical Genetics based in Jacksonville, Florida. Dr. Hecht is a Diplomat of the American Board of Medical Genetics both in Clinical Cytogenetic (Chromosome Genetics) and Medical Genetics (Genetic Counseling). Dr. Hecht attended Stanford University from which she received a BA and an MA in Biology.
Frederick Hecht, MD, lives in Scottsdale, Arizona. Dr. Hecht is a Pediatrician and Medical Geneticist and is certified by both the American Boards of Pediatrics and Medical Genetics. Dr. Hecht was born and raised in Baltimore and attended Dartmouth College in Hanover, N.H. and the Sorbonne at the University of Paris receiving his BA degree cum laude with distinction from Dartmouth.
The intravenous cholangiogram or IVC is a radiologic (x-ray) procedure that is used primarily to look at the larger bile ducts within the liver and the bile ducts outside the liver. The procedure can be used to locate gallstones within these bile ducts. IVC also can be used to identify other causes of obstruction to the flow of bile, for example, narrowings (strictures) of the bile ducts and cancers that may impair the normal flow of bile.
To do an IVC, an iodine-containing dye is injected intravenously into the blood. The dye is then removed from blood by the liver which excretes it into the bile. The iodine is concentrated enough just as it is secreted into bile that it does not need to be further concentrated by the gallbladder in order to outline
the bile ducts and any gallstones that may be within them. The gallbladder is not always seen on an IVC since the iodine-containing bile may bypass the gallbladder entirely and empty directly into the small intestine.
Occasional serious allergic reactions can occur to any iodine-containing dye. These reactions can usually be treated but they rarely may result in the death of the patient.
The IVC is not used nearly as much today as it used to be. Its use always was limited because it did not work when there was more than a minimal amount of jaundice, and many of the conditions it was used for caused substantial jaundice. The IVC has been largely replaced by other diagnostic procedures -- by ERCP (endoscopic retrograde cholangiopancreatography), endoscopic ultrasound and, increasingly, by MRI cholangiography, none of which are affected by jaundice.
Gallstones are stones that form when substances in the bile harden. Gallstones (formed in the gallbladder) can be as small as a grain of sand or as large as a golf ball. There can be just one large stone, hundreds of tiny stones, or any combination. The majority of gallstones do not cause symptoms.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Gallstones are "stones" that form in the gallbladder or bile ducts.
The common types of gallstones are cholesterol, black pigment, and brown pigment.
Cholesterol gallstones occur more frequently in several ethnic groups and are associated with female
gender, obesity, pregnancy,
oral hormonal therapy, rapid loss of weight,
elevated blood triglyceride levels, and Crohn's disease.
Black pigment gallstones occur when there is increased destruction of red blood cells, and brown pigment gallstones
occur when there is slow flow and infection of bile.
The majority of gallstones do not cause symptoms.
The most common symptoms of gallstones are biliary colic and cholecystitis.
Gallstones do not cause intolerance to fatty foods,
belching,
abdominal distention, or
gas.
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