Gallstones are the solid deposits of calcium or cholesterol in the gallbladder or near the bile duct.
Gallstones may be the size of a small sand particle all the way up to the size of a golf ball. They may have smooth or irregular surface. There are two types of gallstones.
Cholesterol gallstones composed of mainly cholesterol and may have calcium and bilirubin added to it. Pigment gallstones are brown or black colored small stones formed due to excess of bilirubin in the bile. There may be both types of stones present in a patient. Pigment stones are more prevalent in patients with hemolytic anemia and cirrhosis of liver.
Alternative names
Bile duct stones, Cholecystitis, Choledocholithiasis.
In the human body liver produces bile, a fluid that aids in digestion of fats and is stored in the gallbladder. When this bile becomes chemically unbalanced, the bile transforms in to particles and then into hard stones referred to as gall stones.
Gallstones may be formed due to excess cholesterol from the liver or incomplete or infrequent emptying of the gallbladder.
Older age, overweight/obesity, being female, multiple pregnancies, hormone replacement therapy, fast weight reduction or having very low calorie diet are the risk factors for gallstones.
Diet containing high heme iron like seafood and meat is a risk factor for gallstones. Intravenous feeding for prolonged period of time is a risk factor for gallstones.
Family history of gallstones, metabolic syndrome and diabetes are also risk factors for development of gallstones.
Having the gastrointestinal surgery to reduce weight is also a risk factor for gallstones.
In the past many clinicians used to refer to Gallstones as a disease of four F’s i.e. Fat, Female, Fertile and Forty.
Chronic indigestion - characterized by gas, bloating, nausea and sometimes stomach pain
Upper abdominal pain – a sudden, steady, moderate to intense pain in the region of upper middle and upper right abdomen is a typicality of a gallbladder attack. The pain may occur about an hour or two after a meal but may also occur otherwise and may last up to half an hour to several hours. The pain may radiate towards the back or right shoulder blade. Many a times the pain occurs at the same time of the day.
Nausea, vomiting and fever – nausea and vomiting along with fever and persistent pain is also seen in gallbladder attack.
If there is obstruction of the bile duct due to gallstones then there is yellowing of the skin and whites of the eyes i.e. jaundice ensues. The urine too becomes yellowish while the stool becomes clay colored.
Many a time, gallstones are asymptomatic and they are discovered during tests for other illnesses. Blood tests may be done to check for any infection and levels of pancreatic and liver enzymes and bilirubin. Other tests which can be done to diagnose gallstones are Ultrasonography, Computerized tomography (CT scan), Radionuclide scan (HIDA Scan), Endoscopic retrograde cholangiopancreatography (ERCP), Magnetic resonance cholangiopancreatography or endoscopic ultrasound (EUS).
Most of the gallstones are “silent stones”, it means they are asymptomatic. No treatment is required for such stones.
For gallstones that produce symptoms surgery is the preferred treatment. Surgery could be either Open Surgery or Laparoscopic Surgery.
Other treatment options for gallstones include medications to dissolve cholesterol stones (Bile salt tablets), Sound wave therapy (extra corporeal shock wave lithotripsy), Percutaneous electrohydraulic lithotripsy and Topical gall stone dissolution.
Gallstones may be removed during the procedure called Endoscopic retrograde cholangiopancreatography (ERCP).
In most cases there are no symptoms of gallstones and treatment is not required. In some cases if the gallstones are not treated it may be fatal like if the gallstones obstruct the duct to pancreas it may lead to inflammation of the pancreas i.e. pancreatitis and this requires immediate medical attention.
If gallstones are not treated there could be potentially life threatening situations.
If the gallstone enters the duct towards pancreas then it can cause pancreatitis which is a medical emergency. If gallstones block the common bile duct then it may cause jaundice. People with gallstones are also more likely to develop gallbladder cancer, however, overall gallbladder cancer is not a common occurrence.
If there is sudden abdominal pain accompanied by nausea, vomiting or fever or symptoms of bile duct obstruction then it is better to call the health acre provider for further diagnosis and treatment.
Maintaining healthy body weight, taking sufficient calories (minimum 800 calories per day), regular exercise and having low fat and high fiber diet can prevent development of gallstones. Diet containing more quantities of fruits and vegetables prevents gallstone formation.
