Gallstones are, quite simply, stones that form in the gallbladder. The gallbladder is a small sac-like organ located on the right side of the abdomen under the liver. The gallbladder aids in the digestion of food by storing bile and secreting it into the small intestine when food enters the intestine. Bile is a greenish brown liquid, an enzyme that aids in the digestion of fats in our diet. Bile is produced by the liver and stored in the gallbladder. The bile duct is a narrow tube that carries bile from the liver and gallbladder to the intestine.
Gallstones are small, hard, crystalline masses that form abnormally in the gallbladder or bile duct. They are composed of bile pigments, cholesterol, and calcium salts. They are pieces of solid material that form aberrantly in the gallbladder because cholesterol and pigments in bile sometimes solidify to form hard particles. Gallstones can be either one large stone or several small ones. Gallstones can range in size from tiny grains of sand to large golf ball sized ones. Many people develop gallstones but remain symptom-free and unaware that they have gallstones. Gallstones can cause severe pain if they cause blockage of the bile duct. Some doctors have described gallstones in the bile duct similar to trying to squeeze a golf ball through a straw.
Are there different types of Gallstones?
There are two main types of gallstones – cholesterol stones and pigment stones. Cholesterol stones are usually yellow-green in color. Approximately 80% of all gallstones are cholesterol stones. Cholesterol gallstones form if there is too much cholesterol in the bile. They are the main type of gallstones that occur in people living in developed countries like the USA and the UK. Cholesterol gallstones are not related to cholesterol levels in the blood. Pigment stones are smaller and darker and are made up of bilirubin. Pigment gallstones form if there is too much bilirubin (discarded red blood cells) in the bile, associated with some medical conditions like sickle cell anemia.
Do I have Gallstones?
You may have gallstones and may not experience any symptoms at all. Your doctor may discover the presence of gallstones in your gallbladder on doing x-rays or if you have surgery on your abdomen for some other condition. When symptoms are present, they include pain that radiates into the upper abdomen (usually on the right side or the middle), fever, a yellowish tinge to your skin or eyes (known as jaundice), nausea, vomiting, and light or clay-colored stools. Your healthcare provider will use several tests to confirm a diagnosis of gallstones or gallbladder inflammation. These tests include ultrasound of the abdomen, CT scan of the abdomen, and tests called ERCP, MRCP, endoscopic ultrasound, HIDA scan, and PTCA. Your doctor may also order blood tests that include bilirubin, liver function tests, and pancreatic enzymes.
Why do people get Gallstones?
There are approximately 20 million people living with gallstones in America alone. Gallstones are more common in women, Native Americans, Hispanics, people over the age of 40, and people who are overweight. These are called the 4 Fs of gallbladder disease – Female, Forty, Fertile, and Fat. Gallstones are more common in females due to high levels of the female hormone estrogen. Forty is the premenopausal age for women when estrogen levels spike. Fertile women have higher levels of estrogen. Being overweight or losing weight too quickly can lead to increased incidence of gallbladder disease. Gallstones also tend to run in families. The following factors have been noted to make the development of gallstones more likely:
• Bone marrow transplant or solid organ transplant.
• Failure of the gallbladder to empty properly (more likely during pregnancy).
• Liver cirrhosis and biliary tract infections (causing pigmented stones).
• Medical conditions that cause too many red blood cells to be destroyed (for example, sickle cell anemia).
• Rapid weight loss from eating a very low-calorie diet or after weight loss surgery.
• Receiving nutrition through a vein for a long period of time (intravenous feedings).
• Taking birth control pills.
Other names gallstones include cholelithiasis, gallbladder attack, biliary colic, gallstone attack, and biliary calculus or biliary calculi.