Gallstones

The gallbladder is a pear-shaped organ that’s located in the right side of your abdomen, directly behind your liver. Your gallbladder contains bile, a digestive fluid, that’s released into your small intestine. Hardened deposits of digestive fluid that form in your gallbladder are called gallstones. Gallstones can range in size from the size of a grain of sand to the size of a golf ball. While some individuals develop only one gallstone at a time, others develop many at the same time. Not everyone who has gallstones will experience symptoms from them. However, surgery is typically required for those who do experience gallstone symptoms.

Symptoms

Gallstones cause no symptoms in some people. For others, gallstones cause several symptoms. Symptoms of gallstones include sudden and intense pain in the upper right side of your abdomen, pain between the shoulder blades in your back, nausea and vomiting, sudden and intense pain below your breastbone in the middle of your abdomen, and right shoulder pain. Pain from gallstones lasts from several minutes to a few hours.

Types of Gallstones

Two types of gallstones can develop in your gallbladder.

Cholesterol Gallstones: Cholesterol gallstones are mainly made up of undissolved cholesterol, but they can also contain other compounds. They are often yellow in color and are the most common type of gallstone.

Pigment Gallstones: When your bile contains too much bilirubin, pigment gallstones form. These gallstones are dark brown or black in color.

Causes and Risk Factors

The exact cause of gallstones isn’t known. However, doctors have a few theories about why gallstones form.

Too Much Cholesterol in the Bile: Normally, your bile possesses enough chemicals to dissolve the cholesterol produced by your liver. However, if your liver produces too much cholesterol, your bile may not be able to dissolve all of it. Any excess cholesterol may form crystals or gallstones.

Your Gallbladder Empties Incorrectly: Your bile can become very concentrated, leading to the creation of gallstones, if your gallbladder doesn’t empty itself completely or often enough.

Too Much Bilirubin in Your Bile: When your body breaks down red blood cells, bilirubin is created. Some conditions cause your liver to produce too much bilirubin, such as biliary tract infections, liver cirrhosis, and some blood disorders. An excess of bilirubin can result in gallstone creation.

There are several risk factors that put you at an increased risk of developing gallstones. These factors include being female, being pregnant, being 40 years of age or older, being Native American, consuming a high-fat diet, having diabetes, having liver disease, rapidly losing weight, consuming a high-cholesterol diet, leading a sedentary lifestyle, being Mexican-American, having a family history of gallstones, consuming a low-fiber diet, and being overweight or obese. Additionally, taking medications that have estrogen in them, such as hormone therapy drugs or oral contraceptives puts you at higher risk of developing gallstones.

Diagnosis

If you have gallstone symptoms, there are several tests your doctor may order to check for gallstones. For instance, an abdominal ultrasound or computerized tomography (CT) scan can show the presence of gallstones in your gallbladder. A hepatobiliary iminodiacetic acid (HIDA) scan, magnetic resonance imaging (MRI) scan, or an endoscopic retrograde cholangiopancreatography (ERCP) can be done to determine whether a gallstone is lodged in your bile duct. If a gallstone is discovered during an ERCP, it can be removed during the procedure.

Treatment

If you don’t have any symptoms of gallstones, you most likely won’t need any treatment for them. A couple of treatment options are available to you if your gallstones are causing symptoms.

Gallbladder Removal: Gallstones frequently recur. You don’t need your gallbladder; and you are still able to effectively digest food once your gallbladder has been removed. For these reasons, your doctor may recommend that you have your gallbladder surgically removed.

Medication: Your doctor can prescribe medication to dissolve your gallstones. However, these medications may take months or years to dissolve the stones, and stones often recur if you stop taking the medicine.

Gallstones can cause intense abdominal, back, and shoulder pain. If you have symptoms of gallstones, talk with your doctor about them. If you have gallstones, medication to dissolve them or surgical removal of your gallbladder can alleviate your symptoms and prevent future problems.