Gallstones

Overview

Gallstones are hard, pebble-like pieces of material, usually made of cholesterol or bilirubin, that develop in your gallbladder. When gallstones block your bile ducts, they can cause sudden pain, which means you need medical attention right away. This pain is called a gallbladder attack, or biliary colic. If your symptoms continue and they’re left untreated, gallstones can cause serious complications.

There are two main types of gallstones, cholesterol stones, and pigment stones. Cholesterol stones are usually yellow-green in color and are made of mostly hardened cholesterol. Pigment stones are dark in color and are made of bilirubin. Some people have a mix of both kinds of stones.

Causes

Gallstones are thought to develop because of an imbalance in the chemical make-up of bile inside the gallbladder.

In most cases, the levels of cholesterol in bile become too high, and the excess cholesterol forms into stones. You’re more at risk of developing gallstones if you’re:

• Overweight or obese
• Female, especially if you’ve had children
• 40 years old or over

Symptoms

Gallstones often have no symptoms. But if a gallstone becomes trapped in an opening (duct) inside the gallbladder, it can trigger a sudden, intense pain in your stomach that usually lasts between 1 and 5 hours. This type of abdominal pain is known as biliary colic.

Some people with gallstones can also develop complications, such as inflammation of the gallbladder (cholecystitis).

This can cause:

• Persistent pain
• Yellowing of the skin and eyes (jaundice)
• High temperature

When gallstones cause symptoms or complications, it’s known as gallstone disease or cholelithiasis.

Diagnosis

Your doctor will perform a physical examination that includes checking your eyes and skin for visible changes in color. A yellowish tint may be a sign of jaundice, the result of too much bilirubin in your body.

The exam may involve using gallstones diagnostic tests that help your doctor see inside your body. These tests include:

• Ultrasound: An ultrasound produces images of your abdomen. It’s the preferred imaging method to confirm that you have gallstone disease. It can also show abnormalities associated with acute cholecystitis.
• Abdominal CT scan: This imaging test takes pictures of your liver and abdominal region.
• Gallbladder radionuclide scan: This important scan takes about one hour to complete. A specialist injects a radioactive substance into your veins. The substance travels through your blood to the liver and gallbladder. On a scan, it can reveal evidence to suggest infection or blockage of the bile ducts from stones.
• Blood tests: Your doctor may order blood tests that measure the amount of bilirubin in your blood. The tests also help determine how well your liver is functioning.
• Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure that uses a camera and X-rays to look at problems in the bile and pancreatic ducts. It helps your doctor look for gallstones stuck in your bile duct.

Treatment

Most of the time, you won’t need gallstones treatment unless they cause you pain. Sometimes you can pass gallstones without even noticing. If you’re in pain, your doctor will likely recommend surgery. In rare cases, medication may be used.

If you’re at high risk for surgery complications, a drainage tube may be placed into the gallbladder through the skin. Your surgery may be postponed until your risk is lowered by treating your other medical conditions.

If you have gallstones and no symptoms, you can make certain lifestyle changes. Some nutritional supplements you can take include vitamin C, iron, and lecithin. One review found that vitamin C and lecithin can decrease the risk of gallstones. Talk to your doctor about the appropriate dosage of these supplements.

Some people recommend gallbladder flush, which involves fasting and then taking olive oil and lemon juice to help pass gallstones. There is no evidence that this works, and it may even cause gallstones to become trapped in the bile duct.

When To See A Doctor

If you are experiencing gallbladder pain, you should inform your physician as soon as possible, even if your symptoms have gone away. Your doctor will want to make sure that you are not experiencing a problem that will put you at risk for more severe disease in the future.

You should get immediate medical attention if you experience any of the following gallstones symptoms:

• Severe, intense pain that prevents you from getting comfortable
• Pain that increases when you take a breath
• Pain that lasts for more than five hours
• Yellow skin or yellow around the whites of your eyes (called jaundice)
• Fever and chills
• Rapid heartbeat
• Persistent vomiting
• Persistent lack of appetite or unexplained weight loss
• Tea-colored urine
• Clay-colored stools

Summary 

Gallstones are solid, pebble-like substances that develop in the gallbladder, primarily composed of cholesterol or bilirubin. Approximately 10-15% of adults in the United States have gallstones, with women being twice as likely as men to develop them. Gallstones can cause sudden, severe pain, known as a gallbladder attack or biliary colic, especially when they obstruct bile ducts. There are two main types of gallstones: cholesterol stones, which are usually yellow-green and formed from hardened cholesterol, and pigment stones, which are dark and composed of bilirubin. Some individuals may have a combination of both types.

The formation of gallstones is generally attributed to an imbalance in the chemical composition of bile, often resulting from elevated cholesterol levels. Factors increasing the risk of gallstones include being overweight or obese, female (particularly after childbirth), and being over 40 years of age.

While gallstones may remain asymptomatic, they can cause intense abdominal pain when trapped in a duct, potentially leading to complications such as cholecystitis, which is the inflammation of the gallbladder. Symptoms of gallstone disease can include persistent pain, jaundice (yellowing of the skin and eyes), and fever. About 25% of individuals with gallstones develop symptoms requiring medical intervention.

Diagnosis typically involves a physical examination and imaging tests such as ultrasound (the preferred method), CT scans, and endoscopic retrograde cholangiopancreatography (ERCP) to assess the presence of gallstones. Treatment options depend on symptom severity. Asymptomatic gallstones may not require treatment, while 70-80% of individuals with symptomatic gallstones often necessitate surgical intervention, commonly laparoscopic cholecystectomy.

Lifestyle changes and nutritional supplements like vitamin C and lecithin may help reduce gallstone risk. A study found that individuals with higher vitamin C intake had a 27% lower risk of developing gallstones.

It’s crucial to seek immediate medical attention for severe symptoms, including intense pain, jaundice, fever, or changes in urine and stool color. Prompt medical care can prevent serious complications associated with gallstone disease, such as pancreatitis or biliary obstruction.

Disclaimer

This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about gallstones or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.