Facts about Gallstones

Gallstones are small, pebble-like substances that develop in the gallbladder. The gallbladder is a pear-shaped sac located below your liver in the right upper abdomen. Bile helps the body digest fats. It is made in the liver and stored in the gallbladder.

Gallstones form when liquid, called bile, stored in the gallbladder crystallizes into stones. Gallstones can be as small as a grain of sand or as large as a golf ball. The gallbladder can develop just one large stone, hundreds of tiny stones, or a combination of the two.

What causes gallstones?

Gallstones form when bile contains too much cholesterol, too much yellow pigment bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason these imbalances occur is not known.

Who is at risk for gallstones?

People at risk for gallstones include

  • women—especially those who are pregnant, use hormone replacement therapy, or take birth control pills
  • people over age 60
  • overweight or obese men and women
  • people who fast or lose a lot of weight quickly
  • people with a family history of gallstones
  • people with diabetes

    What are the symptoms of gallstones?

    If gallstones move into the bile ducts and create blockage, pressure increases in the gallbladder and one or more symptoms may occur. This often follows fatty meals, and it may occur during the night. A typical attack (biliary colic) can cause severe pain in the right upper abdomen that increases rapidly and lasts from 30 minutes to several hours and may be associated with nausea and vomiting

    Probability of developing biliary colic is:

    • 12% of patients with gallstones in 2 years
    • 16.5% in 4 years
    • 26% in 10 years

    Who need treatment for gallstones?

    If you have gallstones without symptoms, you do not require treatment. People with any of the following symptoms should see a doctor immediately:

    • prolonged pain—more than 5 hours
    • nausea and vomiting
    • fever—even low-grade—or chills
    • yellowish color of the skin or whites of the eyes

    Most people with gallstones have no symptoms; these gallstones are called “silent stones.” They do not interfere with gallbladder, liver, or pancreas function and do not need treatment.

    How are gallstones diagnosed?

    Gallstones are discovered during tests for other health conditions.

    • When gallstones are suspected to be the cause of symptoms, an ultrasound scan is the most sensitive and specific test.
    • Computerized tomography (CT) scan.
    • Endoscopic retrograde cholangiopancreatography (ERCP) is used to locate and remove the stones from the bile duct.
    • Blood tests are not able to diagnose gallstones. They may be performed to look for signs of infection, blockage, pancreatitis or jaundice.

    How are gallstones treated?

    Surgery

    If you are having frequent attacks of pain, your doctor will likely recommend you have your gallbladder removed by operation called laparoscopic cholecystectomy.

    ERCP

    The gallbladder is an organ people can live without. Your liver produces enough bile to digest a normal diet. Once the gallbladder is removed, bile flows out of the liver through the bile ducts into the small intestine, instead of being stored in the gallbladder.

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