Gallstones


Gallstones are stones or pebbles formed in the gallbladder of a person. The gallbladder is a very small pear-shaped organ that is placed just beneath the liver. The stones formed in the gallbladder can be very small to the size of a grain and can be big as a golf ball. Before looking into the problem caused by the gallbladder it is important to know the function of the gallbladder.

Gallbladder is a small organ that is beneath the liver and stores and releases a fluid named bile. This bile plays a significant role in the digestive system of our body. When a person eats food, the brain signals the gallbladder to release bile through the biliary duct into the intestine. This bile fluid is responsible for the digestion of food.

After the release of bile, the gall bladder flattens waiting to be filled again with bile. The very purpose of this small pear-shaped organ is the reason for gallstones. The bile contains cholesterol and bilirubin that are formed due to the breakdown of red blood cells. These get accumulated at the bottom of the gall bladder and formed into stones.

The stones so formed don't always cause a problem, but sometimes they get flowed with the bile duct and cause blockage and cause severe pain. The pain is so much that it can make a person faint. The small pebbles cause much more problems than the big ones, as they are carried away very easily.

Gallstones: Causes

Gallstones are classified into two types depending on the elements responsible for the formation of stones. Cholesterol and bilirubin are the two elements responsible for the formation of pebbles.

  • Cholesterol stones. Cholesterol gets mixed with the bile and remains at the bottom and slowly take the formation of stone. These stones are normally yellow and may contain other elements too.

  • Pigment stones. These stones are red and are formed due to excess bilirubin in the bile.

The liver does a variety of functions and purification of the blood is one of the important functions. During purification, the liver breaks the cholesterol from the red blood cells and deposits it as a waste product. Also, bilirubin is formed as a by-product and gets mixed with bile. But the same gets into the gall bladder when bile is formed by the liver.

The following are the important causes of developing Gallstones:

  • Too much cholesterol. Having too much cholesterol in the blood is the main reason for forming gallstones. As they get deposited at the bottom of the gall bladder it forms stones.

  • Too much bilirubin. Some of the infections and conditions force the liver to produce bilirubin more than required. This excess bilirubin causes stones in the bladder.

  • The gallbladder empties itself when you have food and it flattens, but when it doesn't get flattened completely it may cause the formation of stones.

  • Diabetes. People suffering from diabetes may suffer from gallbladder stones more than a normal person.

Gallstones: Symptoms

Gallstones are many times remain there in the bladder without any symptoms and they may be left untreated. It may also not cause any problem till the day it gets in the duct and cause blockage. The blockage will create pain that is too severe to tolerate.

The patient with Gallstones mainly presents with the following symptoms that include:

  • Pain in the ribs, and stomach.

  • Pain in the shoulder.

  • Diarrhoea

  • Gas problem.

  • Nausea

  • Excessive pain in the body.

  • Yellow eyes or jaundice.

  • The main symptom is pain that can last for a few minutes to an hour and may require immediate treatment.

Gallstones: Risk Factors

Several factors play an important role in the development of Gallstones which includes:

  • Genetic factors. People who have a positive family history are more at risk for gallstones.

  • Age. Older people are more at risk for gallstones.

  • Ethnicity. Native Americans are more at risk for stones as they have more cholesterol levels in their blood.

  • Overweight. Obese people are always at risk for stones.

  • Medicines. A person who is taking medicines for hormone secretion like estrogen is more at risk.

  • Liver. Any problem with the liver is also a reason for gallstones.

  • Pregnancy. Pregnant ladies have an increased risk for the formation of stones due to an increase in hormonal activity.

Gallstones: Diagnosis

The diagnosis of the Gallstones is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes:

  • Blood test. A blood test may be required by the doctor to look for important levels of elements in blood and any infection.

  • Urine test. Urine test also provides relevant data for any infection or inflammation.

  • Abdominal Ultrasound. This test will practically check the structure of the stomach and looks for signs of any stones.

  • Endoscopic Ultrasound. This is a very effective method to find the stones that cause blockage in the pipes, this can also be used to clear the path of the bile pipe. In this method, a tiny pipe is inserted with a camera that shows a clear picture of the inside of the body. When the pipe reaches the stomach the doctor will insert a tinier pipe into the pipe and reach the bile duct and then pump dye for removal of the blockage.

Gallstones: Treatment

It is most common that the patient with gallstones has no symptoms of pain and may leave without having notice of the same. The stones are sometimes so tiny that they do not create any blockages and will move out eventually. However, if not lucky enough and if it causes pain the treatment of the same need. The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

Conservative treatment includes:

  • Medicines. Gallstones cause a lot of pain and they can happen at any point in time. Painkillers are usually prescribed to ease the pain for a while.

  • Dissolving gallstones. If the gallstones are not too big, a chance may be taken by your doctor to treat them by dissolving them. Once, it gets broken into much smaller pieces it may not block the way and pass through urine and stool.

Surgical Treatment

Removing the Gallbladder. There is no method of removing stones from the gall bladder, they may be removed from the pipe that it blocks but removing them from the bladder itself is not possible. So, in cases where the stones are causing a lot of pain removal of it is recommended.

Gallstones: Prevention

Some of the measures that can help to prevent Gallstones include:

  • Take a proper meal

  • Maintain a healthy lifestyle.

  • Eat regularly and drink plenty of fluids.

  • If you have stones act accordingly

  • Look for symptoms of pain and avoid harmful food.

  • Exercise light and follow the instruction of doctors.

  • Do not smoke or drink.

  • Do not eat high-cholesterol food.

Conclusion

Gallstones are small stones that are formed in the gall bladder due to cholesterol and bilirubin. These stones are often passed by urine without any effect on the body. But many times it blocks the bile duct and causes immense pain which requires immediate treatment.

Gallstones are normal and it happens to many people. The main reason for it is a high cholesterol diet and any infection with the liver. A balanced diet, exercise, a lot of fluids, etc. are the prevention method.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha

MBBS MS [ OPHTHALMOLOGY ]

Updated on: 18-May-2023

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