Contributed by: Healthians Team

What are gallstones?

Gallstones are little stone fragments that develop in the gallbladder or bile duct (the largest duct in the liver). A gallbladder is a little bag beneath the liver that stores bile juice (which assists digestion) generated by the liver. A bile duct is a tube that helps bile flow from the liver to the gallbladder. These stones can range from the size of a pea to that of a golf ball.

Types of gallstones: 

There are mainly two types of gallstones:

  • Cholesterol gallstones: Cholesterol gallstones are yellow or green in color and are formed from fatty substances or undissolved cholesterol in the blood. These hard stones can form in the liver, making it difficult for bile juice to break down and digest cholesterol. According to research, over 80% of gallstone instances are caused by an excess of cholesterol in the blood.
  • Pigment gallstones: The pigment gallstones are created from excess bilirubin (a substance found in the liver bile). Bilirubin is created in the bile duct when the old red blood cells break down in the liver. The pigment gallstones are dark in color and may cause skin and eyes to turn yellow, which signifies jaundice. According to research, pigment gallstones in the blood may be the source of nearly 20% of gallbladder stones.

Symptoms of gallstones

Gallstone symptoms might vary depending on the size of the stones. Long-term pain, on the other hand, may be the most obvious sign of gallstones. The following are some of the most frequent signs and symptoms of gallstones:

  • Pain in the stomach that lasts for several hours
  • Pain in the upper right abdomen, just below the rib cage
  • Back or shoulder pain on the right side
  • Nausea
  • Digestive problems like heartburn, indigestion, and gas
  • Frequent occurrence of fever and chills
  • Chest pain
  • Dark-colored urine
  • Yellow eyes and skin (indicating jaundice)

What causes gallstones?

Although the precise cause of both cholesterol and pigment gallstones is unknown, physicians believe that the following factors may contribute to gallstone formation:

  • Excess cholesterol in the bile: Bile juice aids in cholesterol digestion, but when the amount of cholesterol in the bile rises, gallstones form in the gallbladder.
  • Excess bilirubin in the bile: Cirrhosis (liver disease), infections, and blood disorders can cause the liver to generate too much bilirubin, increasing the risk of gallstones in the gallbladder.

Who is at risk of being affected by gallstones?

Gallstones may commonly affect if you are:

  • A women
  • A person above the age of 40 years
  • A person with a family history of gallstones
  • Obese
  • Having a high cholesterol diet and low fiber diet
  • Pregnant
  • Having diabetes
  • Affected by Crohn’s disease
  • Using birth control pills
  • Fasting and lost a huge amount of weight in a small amount of time

Diagnosis of gallstones

  • Ultrasound: It’s the most common way to detect a gallstone, and it’s also the most accurate. High-frequency sound waves are sent to the tissues in this procedure, and the echoes are captured as photos and videos of the body’s internal structures.
  • Blood test: A liver function test (LFT) is used to assess liver health and determine if the gallbladder has any stones. Although an LFT is not commonly done to check for the presence of stones, it does determine if the gallbladder indicates any inflammation caused by the stones.
  • CT Scan: The gallbladder’s health is determined by a CT scan (computerized tomography scan). It generates a cross-section picture of the gallbladder and provides a more exact and accurate image.
  • Magnetic resonance imaging (MRI): Magnetic resonance cholangiopancreatography (MRCP) is a procedure that includes the use of massive magnetic and radio waves to scan the gallbladder for the gallstones and create accurate images of them.
  • Endoscopic retrograde cholangiopancreatography (ERCP): In ERCP, the doctor inserts an endoscope (a small tube with a tiny camera attached)  from the mouth to the stomach. This procedure not only supports the doctor in diagnosing the gallstone, but it can also aid in the treatment of the stone if it is found in the bile duct. However, if the stone is lodged in the gallbladder, endoscopy will not be able to remove it.

Gallstone surgery

A cholecystectomy is the surgical removal of the gallbladder. One of two methods is used to remove it:

  • Laparoscopic cholecystectomy: Surgeons most commonly perform laparoscopy rather than open surgery. The patient’s abdomen is given multiple tiny cuts, and a laparoscope (a thin tube with a tiny video camera attached) is placed into one of the incisions. On a computer screen, the camera shows enlarged pictures from within the body, providing the doctor a good view of the inside. The surgeon can then perform the operation and remove the gallbladder through one of the incisions. This surgery may not take long and the patient is generally allowed to go home the same day. Physical activity, on the other hand, should be resumed only after a week post-surgery.
  • Open cholecystectomy: When the gallbladder is in critical condition, an open cholecystectomy is performed. The surgeon may create a 4 to 6-inch incision in the belly to remove the gallbladder, and the procedure is usually planned from the start. It’s possible that a few weeks in the hospital may be necessary to fully heal. Physical activity, on the other hand, can be resumed after a month.

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