Overview of the causes, risk factors, signs and symptoms and treatment of gallstones.
Gallstones, also known as choleliths or cholelithiasis, are small, solid, pebble-like particles that develop in the gallbladder. The gallbladder is a small, pear-shaped sac that is located just under the liver in the right upper abdomen. The gallbladder stores bile that is produced by the liver cells. Bile helps with the digestion of fats. When we eat foods high in fats, the gallbladder contracts and pushes the bile through a small tube-called the common bile duct-that carries it to the small intestine, where it helps with digestion.
Components of bile include water, cholesterol, fats, bile salts, proteins and bilirubin-a product that results from the normal breakdown of red blood cells in the liver. Gallstones form when the bile stored in the gallbladder hardens into pieces of stone-like material.
Generally, there are two types of gallstones: cholesterol stones and pigment stones.
A cholesterol stone, which is more common, accounts for about 80% of all cases of gallstones. Cholesterol stones form when cholesterol hardens in the bile.
Pigment stones are small, dark stones made up of the pigment bilirubin.
Gallstones vary in size from as small as a grain of sand to as large as a golf ball. It may develop in the gallbladder as hundreds of tiny stones, just one large stone, or a combination of both.
Risk Factors
Gallstones are more common among older adults; women; American Indians; Mexican Americans; people with diabetes; those with a family history of gallstones; people who are overweight, obese, or undergo rapid weight loss; and those taking cholesterol-lowering drugs.
Causes
Scientists believe that cholesterol stones form from imbalances in bile components such as when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason why these imbalances occur is not yet fully known.
Pigment stones tend to develop in people who have liver cirrhosis, biliary tract infections, or hereditary blood disorders—such as sickle cell anemia—in which the liver makes too much bilirubin. But the cause of pigment stones is not fully understood.
Symptoms
Many people with gallstones have no symptoms. These gallstones are called "silent stones", which usually does not require treatment.
Symptoms may occur when gallstones create a blockage in the bile ducts. Symptoms of blocked bile ducts include steady pain in the right upper abdomen that intensifies rapidly and lasts from 30 minutes to several hours; pain in the right shoulder or the back between the shoulder blades. Because the pain occurs suddenly, it is often called a gallbladder "attack". Gallbladder attacks often follow after a fatty meal, and they may occur during the night.
If you think that you have experienced a gallbladder attack, notify your doctor immediately. If the blockage remains, this may cause an infection or rupture of the gallbladder, which leads to more complications.
Warning signs
You should see your doctor immediately if you have
Often, gallstones are discovered during routine tests for other health conditions. When gallstones are suspected to be the cause of symptoms, the doctor is likely to do an ultrasound exam—the most sensitive and specific test for gallstones. Since gallstone symptoms may be similar to other conditions such as heart attack, appendicitis, pancreatitis, and hepatitis, an accurate diagnosis is very important.
Other diagnostic tests may be performed such as computerized tomography (CT) scan, Cholescintigraphy (HIDA scan), Endoscopic retrograde cholangiopancreatography (ERCP), blood tests for a more accurate diagnosis or to rule out other conditions. Visit the Gallstones Diagnosis Page for a more comprehensive discussion about the diagnosis of gallstones.
Treatment
Treatment for gallstones may include removal of the gallbladder or through medications.
Treatment may not be required if you have gallstones that do not cause symptoms. If you are having frequent gallstone attacks, your doctor may recommend that you have your gallbladder removed. The operation is called a cholecystectomy.
Nonsurgical approaches are used only in special situations such as—such as when a patient has a serious medical condition preventing surgery—and only for cholesterol stones. Nonsurgical approaches may include oral dissolution therapy and contact dissolution therapy. For a more elaborate discussion on treatment options for gallstones, visit the Gallstones Treatment Page.
Further Reading:
Gallstones - Description, causes, symptoms, diagnosis and treatment of gallstones.
Reference: National Digestive Diseases Information Clearinghouse (July 2007). Gallstones (NIH Publication No. 07–2897). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS. Web URL: http://digestive.niddk.nih.gov/ddiseases/pubs/gallstones/
This Page Last Revised: August 3, 2012
Gallstones, also known as choleliths or cholelithiasis, are small, solid, pebble-like particles that develop in the gallbladder. The gallbladder is a small, pear-shaped sac that is located just under the liver in the right upper abdomen. The gallbladder stores bile that is produced by the liver cells. Bile helps with the digestion of fats. When we eat foods high in fats, the gallbladder contracts and pushes the bile through a small tube-called the common bile duct-that carries it to the small intestine, where it helps with digestion.
Components of bile include water, cholesterol, fats, bile salts, proteins and bilirubin-a product that results from the normal breakdown of red blood cells in the liver. Gallstones form when the bile stored in the gallbladder hardens into pieces of stone-like material.
Generally, there are two types of gallstones: cholesterol stones and pigment stones.
A cholesterol stone, which is more common, accounts for about 80% of all cases of gallstones. Cholesterol stones form when cholesterol hardens in the bile.
Pigment stones are small, dark stones made up of the pigment bilirubin.
Gallstones vary in size from as small as a grain of sand to as large as a golf ball. It may develop in the gallbladder as hundreds of tiny stones, just one large stone, or a combination of both.
Risk Factors
Gallstones are more common among older adults; women; American Indians; Mexican Americans; people with diabetes; those with a family history of gallstones; people who are overweight, obese, or undergo rapid weight loss; and those taking cholesterol-lowering drugs.
Causes
Scientists believe that cholesterol stones form from imbalances in bile components such as when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason why these imbalances occur is not yet fully known.
Pigment stones tend to develop in people who have liver cirrhosis, biliary tract infections, or hereditary blood disorders—such as sickle cell anemia—in which the liver makes too much bilirubin. But the cause of pigment stones is not fully understood.
Symptoms
Many people with gallstones have no symptoms. These gallstones are called "silent stones", which usually does not require treatment.
Symptoms may occur when gallstones create a blockage in the bile ducts. Symptoms of blocked bile ducts include steady pain in the right upper abdomen that intensifies rapidly and lasts from 30 minutes to several hours; pain in the right shoulder or the back between the shoulder blades. Because the pain occurs suddenly, it is often called a gallbladder "attack". Gallbladder attacks often follow after a fatty meal, and they may occur during the night.
If you think that you have experienced a gallbladder attack, notify your doctor immediately. If the blockage remains, this may cause an infection or rupture of the gallbladder, which leads to more complications.
Warning signs
You should see your doctor immediately if you have
- pain lasting for more than 5 hours
- experience nausea and vomiting
- fever—even low-grade—or chills
- yellowish color of the skin or whites of the eyes
- clay-colored stools
Often, gallstones are discovered during routine tests for other health conditions. When gallstones are suspected to be the cause of symptoms, the doctor is likely to do an ultrasound exam—the most sensitive and specific test for gallstones. Since gallstone symptoms may be similar to other conditions such as heart attack, appendicitis, pancreatitis, and hepatitis, an accurate diagnosis is very important.
Other diagnostic tests may be performed such as computerized tomography (CT) scan, Cholescintigraphy (HIDA scan), Endoscopic retrograde cholangiopancreatography (ERCP), blood tests for a more accurate diagnosis or to rule out other conditions. Visit the Gallstones Diagnosis Page for a more comprehensive discussion about the diagnosis of gallstones.
Treatment
Treatment for gallstones may include removal of the gallbladder or through medications.
Treatment may not be required if you have gallstones that do not cause symptoms. If you are having frequent gallstone attacks, your doctor may recommend that you have your gallbladder removed. The operation is called a cholecystectomy.
Nonsurgical approaches are used only in special situations such as—such as when a patient has a serious medical condition preventing surgery—and only for cholesterol stones. Nonsurgical approaches may include oral dissolution therapy and contact dissolution therapy. For a more elaborate discussion on treatment options for gallstones, visit the Gallstones Treatment Page.
Further Reading:
Gallstones - Description, causes, symptoms, diagnosis and treatment of gallstones.
Reference: National Digestive Diseases Information Clearinghouse (July 2007). Gallstones (NIH Publication No. 07–2897). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), NIH, DHHS. Web URL: http://digestive.niddk.nih.gov/ddiseases/pubs/gallstones/
This Page Last Revised: August 3, 2012
