Gallstones (Pain, Symptoms, Causes, Diet, and Treatment)

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Let’s Take A Trip Through The Digestive System!
The Fish Immune System: Journal of Experimental Biology. The integration of energy and nitrogen balance in the hummingbird Sephanoides sephaniodes. Their kidneys produce dilute urine for excretion. Although the oil-soluble vitamins. So, they collected all of the birds' feces, making sure that none dried out, and measured the nitrogen content.

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Although they lacked a true spine , they possessed notochords which allowed them to be more agile than their invertebrate counterparts. Fish would continue to evolve through the Paleozoic era, diversifying into a wide variety of forms.

Many fish of the Paleozoic developed external armor that protected them from predators. The first fish with jaws appeared in the Silurian period, after which many such as sharks became formidable marine predators rather than just the prey of arthropods. Most fish are ectothermic "cold-blooded" , allowing their body temperatures to vary as ambient temperatures change, though some of the large active swimmers like white shark and tuna can hold a higher core temperature.

Fish can communicate in their underwater environments through the use of acoustic communication. Acoustic communication in fish involves the transmission of acoustic signals from one individual of a species to another.

The production of sounds as a means of communication among fish is most often used in the context of feeding, aggression or courtship behaviour. They can produce either stridulatory sounds by moving components of the skeletal system, or can produce non-stridulatory sounds by manipulating specialized organs such as the swimbladder.

Fish are abundant in most bodies of water. They can be found in nearly all aquatic environments, from high mountain streams e. With 33, described species, fish exhibit greater species diversity than any other group of vertebrates. Fish are an important resource for humans worldwide, especially as food.

Commercial and subsistence fishers hunt fish in wild fisheries see fishing or farm them in ponds or in cages in the ocean see aquaculture. They are also caught by recreational fishers , kept as pets, raised by fishkeepers , and exhibited in public aquaria. Fish have had a role in culture through the ages, serving as deities , religious symbols, and as the subjects of art, books and movies.

Fish do not represent a monophyletic group, and therefore the "evolution of fish" is not studied as a single event. Early fish from the fossil record are represented by a group of small, jawless, armored fish known as ostracoderms. Jawless fish lineages are mostly extinct.

An extant clade, the lampreys may approximate ancient pre-jawed fish. The first jaws are found in Placodermi fossils. The diversity of jawed vertebrates may indicate the evolutionary advantage of a jawed mouth. It is unclear if the advantage of a hinged jaw is greater biting force, improved respiration, or a combination of factors. Fish may have evolved from a creature similar to a coral-like sea squirt , whose larvae resemble primitive fish in important ways.

The first ancestors of fish may have kept the larval form into adulthood as some sea squirts do today , although perhaps the reverse is the case. Fish are a paraphyletic group: For this reason, groups such as the "Class Pisces" seen in older reference works are no longer used in formal classifications. Traditional classification divides fish into three extant classes , and with extinct forms sometimes classified within the tree, sometimes as their own classes: The above scheme is the one most commonly encountered in non-specialist and general works.

Many of the above groups are paraphyletic, in that they have given rise to successive groups: Agnathans are ancestral to Chondrichthyes, who again have given rise to Acanthodiians, the ancestors of Osteichthyes. With the arrival of phylogenetic nomenclature , the fishes has been split up into a more detailed scheme, with the following major groups:.

For a fuller treatment of this taxonomy, see the vertebrate article. The position of hagfish in the phylum Chordata is not settled. Phylogenetic research in and supported the idea that the hagfish and the lampreys form a natural group, the Cyclostomata , that is a sister group of the Gnathostomata. The various fish groups account for more than half of vertebrate species.

There are almost 28, known extant species, of which almost 27, are bony fish, with sharks, rays, and chimeras and about hagfish and lampreys. About 64 families are monotypic , containing only one species. The final total of extant species may grow to exceed 32, The term "fish" most precisely describes any non- tetrapod craniate i.

As paraphyletic groups are no longer recognised in modern systematic biology , the use of the term "fish" as a biological group must be avoided.

Many types of aquatic animals commonly referred to as "fish" are not fish in the sense given above; examples include shellfish , cuttlefish , starfish , crayfish and jellyfish. In earlier times, even biologists did not make a distinction — sixteenth century natural historians classified also seals , whales, amphibians , crocodiles , even hippopotamuses , as well as a host of aquatic invertebrates, as fish.

In some contexts, especially in aquaculture , the true fish are referred to as finfish or fin fish to distinguish them from these other animals. A typical fish is ectothermic , has a streamlined body for rapid swimming, extracts oxygen from water using gills or uses an accessory breathing organ to breathe atmospheric oxygen, has two sets of paired fins, usually one or two rarely three dorsal fins, an anal fin, and a tail fin, has jaws, has skin that is usually covered with scales , and lays eggs.

Each criterion has exceptions. Tuna , swordfish , and some species of sharks show some warm-blooded adaptations —they can heat their bodies significantly above ambient water temperature. Lungfish have paired lungs similar to those of tetrapods, gouramis have a structure called the labyrinth organ that performs a similar function, while many catfish, such as Corydoras extract oxygen via the intestine or stomach.

Similarly, the surface of the skin may be naked as in moray eels , or covered with scales of a variety of different types usually defined as placoid typical of sharks and rays , cosmoid fossil lungfish and coelacanths , ganoid various fossil fish but also living gars and bichirs , cycloid , and ctenoid these last two are found on most bony fish. Fish species diversity is roughly divided equally between marine oceanic and freshwater ecosystems.

Coral reefs in the Indo-Pacific constitute the center of diversity for marine fishes, whereas continental freshwater fishes are most diverse in large river basins of tropical rainforests , especially the Amazon , Congo , and Mekong basins. Most fish exchange gases using gills on either side of the pharynx.

Gills consist of threadlike structures called filaments. Each filament contains a capillary network that provides a large surface area for exchanging oxygen and carbon dioxide. Fish exchange gases by pulling oxygen-rich water through their mouths and pumping it over their gills. In some fish, capillary blood flows in the opposite direction to the water, causing countercurrent exchange. The gills push the oxygen-poor water out through openings in the sides of the pharynx.

Some fish, like sharks and lampreys , possess multiple gill openings. However, bony fish have a single gill opening on each side. This opening is hidden beneath a protective bony cover called an operculum.

Juvenile bichirs have external gills, a very primitive feature that they share with larval amphibians. Fish from multiple groups can live out of the water for extended periods. Amphibious fish such as the mudskipper can live and move about on land for up to several days, [ dubious — discuss ] or live in stagnant or otherwise oxygen depleted water. Many such fish can breathe air via a variety of mechanisms.

The skin of anguillid eels may absorb oxygen directly. The buccal cavity of the electric eel may breathe air. Catfish of the families Loricariidae , Callichthyidae , and Scoloplacidae absorb air through their digestive tracts. Gar and bowfin have a vascularized swim bladder that functions in the same way. Loaches , trahiras , and many catfish breathe by passing air through the gut.

Mudskippers breathe by absorbing oxygen across the skin similar to frogs. A number of fish have evolved so-called accessory breathing organs that extract oxygen from the air. Labyrinth fish such as gouramis and bettas have a labyrinth organ above the gills that performs this function. A few other fish have structures resembling labyrinth organs in form and function, most notably snakeheads , pikeheads , and the Clariidae catfish family.

Breathing air is primarily of use to fish that inhabit shallow, seasonally variable waters where the water's oxygen concentration may seasonally decline. Fish dependent solely on dissolved oxygen, such as perch and cichlids , quickly suffocate, while air-breathers survive for much longer, in some cases in water that is little more than wet mud.

At the most extreme, some air-breathing fish are able to survive in damp burrows for weeks without water, entering a state of aestivation summertime hibernation until water returns. Air breathing fish can be divided into obligate air breathers and facultative air breathers. Obligate air breathers, such as the African lungfish , must breathe air periodically or they suffocate.

Facultative air breathers, such as the catfish Hypostomus plecostomus , only breathe air if they need to and will otherwise rely on their gills for oxygen. Most air breathing fish are facultative air breathers that avoid the energetic cost of rising to the surface and the fitness cost of exposure to surface predators.

Fish have a closed-loop circulatory system. The heart pumps the blood in a single loop throughout the body. In most fish, the heart consists of four parts, including two chambers and an entrance and exit. The atrium serves as a one-way antechamber, sends blood to the third part, ventricle. The ventricle is another thick-walled, muscular chamber and it pumps the blood, first to the fourth part, bulbus arteriosus , a large tube, and then out of the heart. The bulbus arteriosus connects to the aorta , through which blood flows to the gills for oxygenation.

Jaws allow fish to eat a wide variety of food, including plants and other organisms. Fish ingest food through the mouth and break it down in the esophagus. In the stomach, food is further digested and, in many fish, processed in finger-shaped pouches called pyloric caeca , which secrete digestive enzymes and absorb nutrients. Organs such as the liver and pancreas add enzymes and various chemicals as the food moves through the digestive tract.

The intestine completes the process of digestion and nutrient absorption. As with many aquatic animals, most fish release their nitrogenous wastes as ammonia. Some of the wastes diffuse through the gills. Blood wastes are filtered by the kidneys. Saltwater fish tend to lose water because of osmosis. Their kidneys return water to the body.

The reverse happens in freshwater fish: Their kidneys produce dilute urine for excretion. Some fish have specially adapted kidneys that vary in function, allowing them to move from freshwater to saltwater. The scales of fish originate from the mesoderm skin ; they may be similar in structure to teeth. Fish typically have quite small brains relative to body size compared with other vertebrates, typically one-fifteenth the brain mass of a similarly sized bird or mammal.

Fish brains are divided into several regions. At the front are the olfactory lobes , a pair of structures that receive and process signals from the nostrils via the two olfactory nerves. Behind the olfactory lobes is the two-lobed telencephalon , the structural equivalent to the cerebrum in higher vertebrates.

In fish the telencephalon is concerned mostly with olfaction. Connecting the forebrain to the midbrain is the diencephalon in the diagram, this structure is below the optic lobes and consequently not visible. The diencephalon performs functions associated with hormones and homeostasis. This structure detects light, maintains circadian rhythms, and controls color changes. The midbrain or mesencephalon contains the two optic lobes. These are very large in species that hunt by sight, such as rainbow trout and cichlids.

The hindbrain or metencephalon is particularly involved in swimming and balance. The brain stem or myelencephalon is the brain's posterior. Most fish possess highly developed sense organs. Nearly all daylight fish have color vision that is at least as good as a human's see vision in fishes.

Many fish also have chemoreceptors that are responsible for extraordinary senses of taste and smell. Although they have ears, many fish may not hear very well. Most fish have sensitive receptors that form the lateral line system , which detects gentle currents and vibrations, and senses the motion of nearby fish and prey.

Fish orient themselves using landmarks and may use mental maps based on multiple landmarks or symbols. Fish behavior in mazes reveals that they possess spatial memory and visual discrimination. Vision is an important sensory system for most species of fish.

Fish eyes are similar to those of terrestrial vertebrates like birds and mammals, but have a more spherical lens. Their retinas generally have both rods and cones for scotopic and photopic vision , and most species have colour vision. Some fish can see ultraviolet and some can see polarized light. Amongst jawless fish , the lamprey has well-developed eyes, while the hagfish has only primitive eyespots.

Hearing is an important sensory system for most species of fish. Fish sense sound using their lateral lines and their ears. Experiments done by William Tavolga provide evidence that fish have pain and fear responses. For instance, in Tavolga's experiments, toadfish grunted when electrically shocked and over time they came to grunt at the mere sight of an electrode.

In , Scottish scientists at the University of Edinburgh and the Roslin Institute concluded that rainbow trout exhibit behaviors often associated with pain in other animals.

Bee venom and acetic acid injected into the lips resulted in fish rocking their bodies and rubbing their lips along the sides and floors of their tanks, which the researchers concluded were attempts to relieve pain, similar to what mammals would do. Rose of the University of Wyoming claimed the study was flawed since it did not provide proof that fish possess "conscious awareness, particularly a kind of awareness that is meaningfully like ours".

Rose had published a study a year earlier arguing that fish cannot feel pain because their brains lack a neocortex. Animal welfare advocates raise concerns about the possible suffering of fish caused by angling. Some countries, such as Germany have banned specific types of fishing, and the British RSPCA now formally prosecutes individuals who are cruel to fish.

Most fish move by alternately contracting paired sets of muscles on either side of the backbone. These contractions form S-shaped curves that move down the body. As each curve reaches the back fin, backward force is applied to the water, and in conjunction with the fins, moves the fish forward.

The fish's fins function like an airplane's flaps. Fins also increase the tail's surface area, increasing speed. The streamlined body of the fish decreases the amount of friction from the water. Since body tissue is denser than water, fish must compensate for the difference or they will sink. Many bony fish have an internal organ called a swim bladder that adjusts their buoyancy through manipulation of gases. Although most fish are exclusively ectothermic , there are exceptions.

The only known bony fishes infraclass Teleostei that exhibit endothermy are in the suborder Scombroidei — which includes the billfishes , tunas, and the butterfly kingfish , a basal species of mackerel [42] — and also the opah. The opah, a lampriform , was demonstrated in to utilize "whole-body endothermy", generating heat with its swimming muscles to warm its body while countercurrent exchange as in respiration minimizes heat loss. In the cartilaginous fishes class Chondrichthyes , sharks of the families Lamnidae porbeagle, mackerel, salmon, and great white sharks and Alopiidae thresher sharks exhibit endothermy.

Endothermy, though metabolically costly, is thought to provide advantages such as increased muscle strength, higher rates of central nervous system processing, and higher rates of digestion.

Fish reproductive organs include testicles and ovaries. In most species, gonads are paired organs of similar size, which can be partially or totally fused. In terms of spermatogonia distribution, the structure of teleosts testes has two types: Fish can present cystic or semi-cystic spermatogenesis in relation to the release phase of germ cells in cysts to the seminiferous tubules lumen.

Fish ovaries may be of three types: In the first type, the oocytes are released directly into the coelomic cavity and then enter the ostium , then through the oviduct and are eliminated.

Secondary gymnovarian ovaries shed ova into the coelom from which they go directly into the oviduct. In the third type, the oocytes are conveyed to the exterior through the oviduct. Cystovaries characterize most teleosts, where the ovary lumen has continuity with the oviduct. Oogonia development in teleosts fish varies according to the group, and the determination of oogenesis dynamics allows the understanding of maturation and fertilization processes.

Changes in the nucleus , ooplasm, and the surrounding layers characterize the oocyte maturation process. Postovulatory follicles are structures formed after oocyte release; they do not have endocrine function, present a wide irregular lumen, and are rapidly reabsorbed in a process involving the apoptosis of follicular cells. A degenerative process called follicular atresia reabsorbs vitellogenic oocytes not spawned. This process can also occur, but less frequently, in oocytes in other development stages.

Some fish, like the California sheephead , are hermaphrodites , having both testes and ovaries either at different phases in their life cycle or, as in hamlets , have them simultaneously. Examples of oviparous fish include salmon , goldfish , cichlids , tuna , and eels. In the majority of these species, fertilisation takes place outside the mother's body, with the male and female fish shedding their gametes into the surrounding water.

However, a few oviparous fish practice internal fertilization, with the male using some sort of intromittent organ to deliver sperm into the genital opening of the female, most notably the oviparous sharks, such as the horn shark , and oviparous rays, such as skates.

In these cases, the male is equipped with a pair of modified pelvic fins known as claspers. Marine fish can produce high numbers of eggs which are often released into the open water column. The eggs have an average diameter of 1 millimetre 0. Egg of catshark mermaids' purse. The newly hatched young of oviparous fish are called larvae. They are usually poorly formed, carry a large yolk sac for nourishment , and are very different in appearance from juvenile and adult specimens.

The larval period in oviparous fish is relatively short usually only several weeks , and larvae rapidly grow and change appearance and structure a process termed metamorphosis to become juveniles.

During this transition larvae must switch from their yolk sac to feeding on zooplankton prey, a process which depends on typically inadequate zooplankton density, starving many larvae.

In ovoviviparous fish the eggs develop inside the mother's body after internal fertilization but receive little or no nourishment directly from the mother, depending instead on the yolk. Each embryo develops in its own egg. Familiar examples of ovoviviparous fish include guppies , angel sharks , and coelacanths. Some species of fish are viviparous. In such species the mother retains the eggs and nourishes the embryos.

Typically, viviparous fish have a structure analogous to the placenta seen in mammals connecting the mother's blood supply with that of the embryo. Examples of viviparous fish include the surf-perches , splitfins , and lemon shark. Some viviparous fish exhibit oophagy , in which the developing embryos eat other eggs produced by the mother. This has been observed primarily among sharks, such as the shortfin mako and porbeagle , but is known for a few bony fish as well, such as the halfbeak Nomorhamphus ebrardtii.

This behavior is also most commonly found among sharks, such as the grey nurse shark , but has also been reported for Nomorhamphus ebrardtii. Aquarists commonly refer to ovoviviparous and viviparous fish as livebearers. Fish can produce either stridulatory sounds by moving components of the skeletal system, or can produce non-stridulatory sounds by manipulating specialized organs such as the swimbladder.

There are some species of fish that can produce sounds by rubbing or grinding their bones together. These noises produced by bone-on-bone interactions are known as 'stridulatory sounds'.

An example of this is seen in Haemulon flavolineatum , a species commonly referred to as the 'French grunt fish', as it produces a grunting noise by grinding its teeth together. In a study conducted by Oliveira et al. The sounds emitted by the H. Some fish species create noise by engaging specialized muscles that contract and cause swimbladder vibrations. Oyster toadfish produce loud grunting sounds by contracting muscles located along the sides of their swim bladder, known as sonic muscles [51] Female and male toadfishes emit short-duration grunts, often as a fright response.

The red drum, Sciaenops ocellatus , produces drumming sounds by vibrating its swimbladder. Ocellatus can produce different calls depending on the stimuli involved. Like other animals, fish suffer from diseases and parasites. To prevent disease they have a variety of defenses. Non-specific defenses include the skin and scales, as well as the mucus layer secreted by the epidermis that traps and inhibits the growth of microorganisms.

If pathogens breach these defenses, fish can develop an inflammatory response that increases blood flow to the infected region and delivers white blood cells that attempt to destroy pathogens. Specific defenses respond to particular pathogens recognised by the fish's body, i. Some species use cleaner fish to remove external parasites. The best known of these are the Bluestreak cleaner wrasses of the genus Labroides found on coral reefs in the Indian and Pacific oceans. These small fish maintain so-called "cleaning stations" where other fish congregate and perform specific movements to attract the attention of the cleaners.

Immune organs vary by type of fish. These fish rely on regions of lymphoid tissue within other organs to produce immune cells. For example, erythrocytes , macrophages and plasma cells are produced in the anterior kidney or pronephros and some areas of the gut where granulocytes mature. They resemble primitive bone marrow in hagfish.

Cartilaginous fish sharks and rays have a more advanced immune system. They have three specialized organs that are unique to Chondrichthyes ; the epigonal organs lymphoid tissue similar to mammalian bone that surround the gonads, the Leydig's organ within the walls of their esophagus, and a spiral valve in their intestine. In fact, they are usually unaware that they have gallstones unless symptoms occur.

These "silent gallstones" usually require no treatment. Symptoms usually occur as complications develop. The most common symptom is pain in the right upper part of the abdomen.

Because the pain comes in episodes, it is often referred to as an "attack. Warning signs of a serious problem are fever, jaundice, and persistent pain. When to Seek Medical Care for Gallstones. If a person has an episode or recurring episodes of abdominal pain 30 minutes to one hour following meals, call a health care practitioner for an appointment. Go to a hospital emergency department if the person has this abdominal pain with any of the following conditions: Upon hearing the patient's symptoms, the health care practitioner will probably suspect gallstones.

Because the symptoms of gallbladder disease can resemble those of other serious conditions, he or she will ask the patient questions and examine them to try to confirm this diagnosis and rule out other conditions.

Ultrasound is the best test to examine the gallbladder for stones. These tests are the alternatives to ultrasound and OCG. They are better choices if gallstones have left the gallbladder and moved into the ducts. A chest X-ray may be performed to make sure there are no other reasons for the abdominal pain. As most gallstones are asymptomatic, many times gallstones are diagnosed when the patient undergoes a test for another reason.

After a diagnosis of gallstones, the patient may choose not to have surgery or may not be able to have surgery right away. There are measures the patient can take to relieve the symptoms to include:. Call a health care practitioner if symptoms worsen or if new symptoms appear. Abdominal pain with vomiting, fever, or jaundice warrants an immediate visit to a doctor's office or a hospital emergency department. There is no permanent medical cure for gallstones.

Although there are medical measures that can be taken to remove stones or relive symptoms, they are only temporary. If a patient has symptoms from gallstones, surgical removal of the gallbladder is the best treatment. Asymptomatic producing no symptoms gallstones do not require treatment. Extracorporeal shockwave lithotripsy ESWL: A device that generates shock waves is used to break gallstones up into tiny pieces. If an individual goes to an emergency department, an IV line may be started, and pain medication and antibiotics may be given through the IV.

If the patient's health permits it, the health care practitioner will probably recommend surgery to remove the gallbladder and the stones. Surgical removal helps prevent future episodes of abdominal pain and more dangerous complications such as inflammation of the pancreas and infection of the gallbladder and liver.

The usual treatment for symptomatic or complicated gallstones is surgical removal of the gallbladder. This is called cholecystectomy. Many people who have gallbladder disease are understandably concerned about having their gallbladder removed.

They wonder how they can function without a gallbladder. Most gallbladders are removed by laparoscopic cholecystectomy.

Ron Hines DVM PhD