Gallstones Health Article

Definition

Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball, depending on how long they have been forming.

Alternative Names

Cholelithiasis

Causes, incidence, and risk factors

The cause of gallstones varies. Some stones form when there is too much cholesterol or bilirubin in the bile. (Bile is a liquid that helps the body digest fats.) Other stones form if there are not enough bile salts or if the gallbladder fails to empty properly.

One type of gallstones, called pigment stones, tend to occur in people who have medical conditions that cause the liver to make too much bilirubin. Pigment stones are also more common in persons with liver cirrhosis and biliary tract infections.

Gallstones are a common health problem worldwide. They are more common in women, Native Americans, and people over the age of 40.

Other risk factors include ethnic and genetic factors, obesity, diabetes, cirrhosis, receiving nutrition through a vein for a long period of time (intravenous feedings), and certain operations for peptic ulcers.

Symptoms

There are usually no symptoms. Gallstones are usually discovered when having a routine x-ray, abdominal surgery, or other medical procedure.

Symptoms usually occur if a large stone blocks the cystic duct or the common bile duct. The cystic duct drains fluid from the the gallbladder into the the common bile duct, which is the main duct draining into the duodenum. Together, these ducts form part of the biliary system.

A stone blocking the opening from the gallbladder or cystic duct usually produces a cramping pain in the middle to right upper abdomen. This is known as biliary colic. The pain goes away if the stone passes into the first part of the small intestine (the duodenum). Acute cholecystitis occurs if the stone does not pass into the duodenum.

If the common bile duct is blocked for a long period of time, pancreatitis or cholangitis may result.

Symptoms that may occur include:

• Abdominal pain in the right upper or middle upper abdomen:
  • May be recurrent
  • May be sharp, cramping, or dull
  • May spread to the back or below the right shoulder blade
  • May be made worse by fatty or greasy foods
  • Occurs within minutes of a meal
• Fever
• Yellowing of skin and whites of the eyes (jaundice)

Additional symptoms that may be associated with this disease include:

• Abdominal fullness
• Clay-colored stools
• Excess gas
• Heartburn
• Indigestion
• Nausea and vomiting

It is important to see a doctor if you have symptoms of gallstones. Gallstones are found in many people with gallbladder cancer.