Gallstones: Symptoms, Risk factors, Treatments

Overview

Gallstones are hard, pebble-like pieces of solid material that form from cholesterol or bilirubin in your gallbladder. These gallstones range in size. Some stones are as small as a grain of sand, while others are as large as a golf ball. Having just one gallstone or more than one gallstones are both possible.

There are two main kinds of gallstones:

• Cholesterol stones. These yellow-green stones are the most common kind, accounting for 80% of gallstone.
• Pigment stones. These stones are made of bilirubin and are smaller and darker.

Symptoms

In many cases, people with gallstones experience no symptoms, and thus they even don’t realize that they have gallstones. These stones can be called “silent gallstone”. This condition usually requires no treatment. But if gallstones cause a blockage, symptoms may occur, including:

• Sudden and rapidly intensifying pain in the upper right portion of your abdomen
• Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
• Back pain between your shoulder blades
• Pain in your right shoulder
• Nausea or vomiting

Causes

Doctors don’t know what exactly makes gallstones form in your gallbladder, but it is thought that gallstones may take shape when:

• Your bile contains too much cholesterol
• Your bile contains too much bilirubin
• Your gallbladder doesn’t empty correctly

Risk factors

Your risk of gallstones will be increased if you:

• Are female
• Are 40 or older
• Are a native American
• Are a Mexican-American
• Are overweight or obese
• Are sedentary
• Are pregnant
• Eat a high-fat diet
• Eat a high-cholesterol diet
• Eat a low-fiber diet
• Have a family history of gallstones
• Have diabetes
• Lose weight very quickly
• Take medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
• Have liver disease

Complications

Gallstones may lead to some complications, such as:

• Inflammation of the gallbladder

If a gallstone becomes lodged in the neck of the gallbladder, your gallbladder will be inflamed, causing severe pain and fever.

• Blockage of the common bile duct

Gallstones may block the tubes through which bile flows from your gallbladder or liver to your small intestine, leading to jaundice and bile duct infection.

• Blockage of the pancreatic duct

Gallstone may also block the pancreatic duct. Due to the blockage, pancreas will be inflamed and cause intense, constant abdominal pain.

• Gallbladder cancer

Having a history of gallstones will increase your risk of gallbladder cancer, but this case is very rare.

Diagnosis

Your doctor may use the following tests and procedures to diagnose gallstones:

• Tests to create pictures of your gallbladder

Images created by an abdominal ultrasound or a CT scan may be analyzed to look for signs of gallstones.

• Tests to check your bile ducts for gallstones

Tests such as a hepatobiliary iminodiacetic acid (HIDA) scan, magnetic resonance imaging (MRI) or endoscopic retrograde cholangiopancreatography (ERCP) can help your doctor determine whether a gallstone is causing blockage.

• Blood tests to look for complications

Blood tests can help your doctor confirm whether you have complications caused by gallstones.

Treatment

Treatment is not necessary unless you have symptoms. Based on your symptoms and the result of diagnosis, your doctor will decide whether you need treatment. Treatment options usually include:

• Surgery to remove the gallbladder (cholecystectomy)

Considering that gallstones often recur, your doctor may recommend surgery to remove the gallbladder. Without gallbladder, bile will flow directly from your liver into your small intestine. After the removal, your digestive ability will not be affected. But you may sometimes have temporary diarrhea.

• Medications to dissolve gallstones

You can take medications by mouth to help dissolve gallstones. However, it usually takes months or years to dissolve gallstones, and they will form again once you stop the treatment. In some cases, medications are not effective. Therefore, this option is not commonly recommended. It is reserved for people who can’t have a surgery.

Keyword: gallstones.

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