Gallstones

An Overview

Gallstones are pieces of solid material that form in your gallbladder, a small organ under your liver. If you have them, you might hear your doctor say you have cholelithiasis. Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time.

Your gallbladder stores and releases bile, a fluid made in your liver, to help in digestion. Bile also carries wastes like cholesterol and bilirubin, which your body makes when it breaks down red blood cells. These things can form gallstones. Gallstones usually form in the gallbladder; however, they also may form anywhere there is bile – in the intrahepatic, hepatic, common bile, and cystic ducts.

Gallstones also may move about in the bile, for example, from the gallbladder into the cystic or the common duct.

Gallstone Types

The two main kinds of gallstones are:

  • Cholesterol stones. These are usually yellow-green. They’re the most common, making up 80% of gallstones.
  • Pigment stones. These are smaller and darker. They’re made of bilirubin.
  • Mixed Stones
  • Silent gallstones – unknown gallstones without symptoms.
  • Symptomatic gallstones – causing symptoms.

Symptoms may include:

Biliary colic is a very specific type of pain, occurring as the primary or only symptom in 80% of people with gallstones who develop symptoms. Biliary colic is a recurring symptom. Once the first episode occurs, there are likely to be other episodes. Moreover, there is a pattern of recurrence for each individual, that is, in some individuals the episodes tend to remain frequent while in others they are infrequent.

  •  Pain in your upper belly, often on the right, just under your ribs
  • Pain in your right shoulder or back
  •  An upset stomach
  •  Other digestive problems, including indigestion, heartburn and gas.
  •  Sudden and rapidly intensifying pain in the upper right portion of your abdomen
  •  Back pain between your shoulder blades
  •  Pain in your right shoulder
  •  Nausea or vomiting
  •  See your doctor or go to the hospital if you have signs of a serious infection or inflammation.
  •  Belly pain that lasts several hours
  •  Fever and chills
  •  Yellow skin or eyes
  •  Dark urine and light-colored poop

Causes of gallstones

  • There’s too much bilirubin in your bile. Conditions like cirrhosis, infections and blood disorders can cause your liver to make too much bilirubin.
  • Your gallbladder doesn’t empty all the way. This can make your bile very concentrated.
  • Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.
  • Your bile contains too much bilirubin. Bilirubin is a chemical that’s produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation.
  • Your gallbladder doesn’t empty correctly. If your gallbladder doesn’t empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones.
  • Too much bilirubin in your bile. Bilirubin is a chemical produced when your liver destroys old red blood cells. Some conditions, such as liver damage and certain blood disorders, cause your liver to produce more bilirubin than it should.

Diagnosis

Doctor will do a physical exam and might order tests
Blood tests. These check for signs of infection or blockage, and rule out other conditions.
Ultrasound. This makes images of the inside of your body.
CT scan. Specialized X-rays let your doctor see inside your body, including your gallbladder.
Magnetic resonance cholangiopancreatography (MRCP). This test uses a magnetic field and pulses of radio wave energy to make pictures of the inside of your body, including your liver and gallbladder.
Other imaging tests. Additional tests may include oral cholecystography, a hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP). Gallstones discovered using ERCP can be removed during the procedure.
Blood tests. Blood tests may reveal infection, jaundice, pancreatitis or other complications caused by gallstones.

Gallstone Treatment

You don’t need treatment if you don’t have any symptoms. Some small gallstones can pass through your body on their own.
Most people with gallstones have their gallbladders taken out. You can still digest food without it. Your doctor will use one of two procedures.
Laparoscopic cholecystectomy. This is the most common surgery for gallstones. Your doctor passes a narrow tube called a laparoscope into your belly through a small cut. It holds instruments, a light, and a camera. They take out your gallbladder through another small cut. You’ll usually go home the same day.
Open cholecystectomy. Your doctor makes bigger cuts in your belly to remove your gallbladder. You’ll stay in the hospital for a few days afterward.
Medications to dissolve gallstones. Medications you take by mouth may help dissolve gallstones. But it may take months or years of treatment to dissolve your gallstones in this way, and gallstones will likely form again if treatment is stopped.
Sometimes medications don’t work. Medications for gallstones aren’t commonly used and are reserved for people who can’t undergo surgery.
If gallstones are in your bile ducts, your doctor may use ERCP to find and remove them before or during surgery.

Dangerous Gall Stones

  •  Inflammation of the gallbladder.
  •  Blockage of the common bile duct.
  •  Blockage of the pancreatic duct.
  •  Gallbladder cancer. People with a history of gallstones have an increased risk of gallbladder cancer.

Prevention

  • Some lifestyle changes might lower your risk of gallstones.
  • Eat a healthy diet that’s high in fiber and good fats, like fish oil and olive oil. Avoid refined carbs, sugar and unhealthy fats.
  •  Get regular exercise. Aim for at least 30 minutes, 5 days a week.
  •  Avoid diets that make you lose a lot of weight in a short time.
  •  If you’re a woman at high risk of gallstones (for example, because of your family history or another health condition), talk to your doctor about whether you should avoid the use of hormonal birth control.

Leave a Reply

Your email address will not be published. Required fields are marked *