Gallstones Overview
Gallstones are stones or lumps that develop in the gallbladder or bile duct when certain substances harden. Usually the gallstones are made of cholesterol and hardened deposits of digestive fluid that can form in the gallbladder.
The gallbladder is a small pear-shaped sac like organ located on the right-hand side of the abdomen, just beneath the liver. It holds a digestive fluid called bile that’s released into your small intestine. Bile is a liquid produced by the liver to help digest fats. Some of the chemicals that exist in the gallbladder can solidify into either one large stone or several small ones.
About 20 million people in the United States are diagnosed with gallstones. According to a study about 10 percent of the adults in the industrialized countries develop gallstones.
Gallstones are very common and routinely asymptomatic. However, about ten percent of people who are diagnosed with gallstones will develop noticeable symptoms within 5 years.
Types of Gallstones
Types of gallstones that can form in the gallbladder include:
- Cholesterol gallstones: The most common type of gallstone, called a cholesterol gallstone, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but may contain other components.
- Pigment gallstones: These dark brown or black stones form when your bile contains too much bilirubin.
Signs and Symptoms of Gallstones
Gallstones can lead to pain in the upper right abdomen or the center of your stomach. Patients with gallstones may experience gallbladder pain from time to time after you eat foods that are high in fat, such as fried foods, but the pain can occur at almost any time. Pain caused by gallstone issues usually lasts for only a few hours, but it can feel severe.
The primary symptom of gallstones is pain that comes on suddenly and quickly gets worse. This pain can occur on the right side of the body, just below the ribs, between the shoulder blades, or in the right shoulder.
Following are the common signs and symptoms of a gallbladder infection, or inflammation of the gallbladder:
- Chills
- Confusion
- Diarrhea
- Fever
- Itchy skin
- Loss of appetite
- Restlessness
- Sweating
- Nausea
- Rapid heartbeat (tachycardia)
- Vomiting
- Yellowing of the skin and whites of the eyes (Jaundice)
Causes of Gallstones
Exact causes of why gallstones develop is unknown. Researcher think gallstones may result from the following conditions:
- The bile contains too much cholesterol: Usually, the bile contains enough chemicals to dissolve the cholesterol excreted by the liver. But if the liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.
- The bile contains too much bilirubin: Bilirubin is a chemical that’s produced when the 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.
- The gallbladder doesn’t empty correctly: If the gallbladder doesn’t empty completely or regularly enough, bile may become very concentrated, contributing to the formation of gallstones.
Risk Factors of Gallstones
- Being pregnant
- Diabetes
- Family history of gallstones
- Going through high-dose estrogen therapy
- Having a gene variant that the risk of developing gallstones
- having a high intake of dietary fat
- Over 60 years of age
- Living sedentary lifestyle
- Native American heritage
- taking cholesterol-lowering drugs (statins)
- taking oral contraceptives
Complication of Gallstones
Following are some of the complications of gallstones:
- Inflammation of the gallbladder: A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.
- Blockage of the common bile duct: Gallstones can block the tubes (ducts) through which bile flows from the gallbladder or liver to the small intestine. Severe pain, jaundice and bile duct infection can result.
- Blockage of the pancreatic duct: The pancreatic duct is a tube that runs from the pancreas and connects to the common bile duct just before entering the duodenum. Pancreatic juices, which aid in digestion, flow through the pancreatic duct.
A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and most of the time requires hospitalization.
- Gallbladder cancer: Patients with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very small.
Other complications of Gallstones
Following are some of the other potential complications of gallstones:
Biliary Colic
When a stone gets stuck in the opening of the gallbladder and will not easily pass through, the contraction of the gallbladder may cause severe pain. When this happens, an individual may experience a painful condition called biliary colic.
The pain is felt in the upper part of the abdomen, but can also exist in the center or to the right of the abdomen. Pain is more common about an hour after eating, especially if an individual has had a high-fat meal.
The pain will be constant, last a few hours, and then subside. Some people will experience non-stop pain for 24 hours, while others may experience waves of pain.
Infection
If the gallstones have caused a gallbladder infection, the person with the condition may have a fever and experience shaking and shivering. In the majority of gallstone infection cases, patients will be hospitalized for the removal of the gallstone.
Jaundice
If a gallstone leaves the gallbladder and gets stuck in the bile duct it may block the passage of bile into the intestine. The bile will then seep into the bloodstream, causing signs of jaundice.
In most cases, this complication will require the surgical removal of the gallstone. For some patients, the gallstone eventually passes into the intestine.
Pancreatitis
In case a small gallstone passes through the bile duct and blocks the pancreatic duct, or causes a reflux of liquids and bile into the duct, the patients might develop pancreatitis.
Prevention of Gallstones
Risk of developing gallstones cane be reduced through the following measures:
- Eat more high-fiber foods: Include more fiber-rich foods in your diet, such as fruits, vegetables and whole grains and foods which are high in fiber.
- Don’t skip meals: Try to stick to your usual mealtimes each day. Skipping meals or fasting can increase the risk of developing gallstones.
- Lose weight slowly: If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose one or two pounds a week.
- Maintain a healthy weight: Obesity and being overweight increase the risk of developing gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get. Once you achieve a healthy weight, work to maintain that weight by continuing your healthy diet and continue to exercise.
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