Gallstones: Causes, risk factors and Symptoms

Gallstones are stones or lumps that develop in the gallbladder or bile duct when certain substances such as cholesterol, calcium bilirubinate, and calcium carbonate harden. If they block the bile duct they can be extremely painful.

Updated: November 30, 2017

Gallstones are stones or lumps that develop in the gallbladder or bile duct when certain substances such as cholesterol, calcium bilirubinate, and calcium carbonate harden. If they block the bile duct they can be extremely painful.
The gallbladder is a small sac like organ in the upper right part of the abdomen. It is located under the liver, just below the front rib cage on the right side. It is part of the biliary system, which includes the liver and the pancreas and transports bile and digestive enzymes. Bile, also called gall, is a greenish-brown liquid, produced by the liver to help in the digestion of fats. Bile contains several different substances, including cholesterol and bilirubin and is stored and concentrated in the gallbladder until needed.  The gallbladder contracts and injects bile into the small intestine through a small tube called the common bile duct to helps to break down fats when we eat a high-fat, high-cholesterol meal. Every time we eat, bile is released into the intestines to assists in the digestive process.

What are Gallstones?

When the chemical substances present in the gallbladder such as, cholesterol, calcium bilirubinate, and calcium carbonate are out of balance and are  harden, gallstones may form.
There are two main types of gallstones:

Cholesterol gallstones:

If there is too much cholesterol in the bile, these type of gallstones are formed.

Pigment gallstones :

These form when the bile has too much bilirubin. They are more common among patients who have liver disease, infected bile tubes, or blood disorders, such as sickle-cell anemia.
Gallstones can be any size, from tiny as a grain of sand to large as a golf ball. It may be a single larger stone or combination of many small stones.
Gallstones within the gallbladder often cause no problems. They may cause pain when the gallbladder responds to a fatty meal, if there are many or they are large,. They also may cause problems if they block bile from leaving the gallbladder or move out of the gallbladder and block the bile duct.

Causes and Risk factors of Gallstones:

Gallstones are more common among overweight/obese people, especially women.
Some of the possible causes of gallstone include:

  • Excess cholesterol in the bile
  • Excess bilirubin in the bile
  • Low bile concentration of a substance called bile salts
  • A non-stone-related blockage in the gallbladder that prevents proper emptying

Others at risk include:

  • women who have been pregnant
  • family history
  • people who have recently lost lots of weight
  • intentionally losing weight rapidly and then regaining it may increase men's risk for gallstones later in life
  • women taking oral contraceptives or hormone replacement therapy
  • Taking medications to lower cholesterol levels
  • Having diabetes
  • Eating a diet rich in fat and cholesterol and without enough fiber
  • being sedentary
  • people over 60 years of age

Symptoms of Gallstones:

Most often the gallstones stay in the gallbladder and cause no problems. But sometimes they block the exit from the gallbladder, called the cystic duct resulting in cholecystitis (inflamed gallbladder).
The primary symptom of inflamed gallbladder is pain that comes on suddenly and quickly gets worse which persists for at least 30 minutes, or even for a few hours. This pain can occur in the right side of the body, just below the ribs, between the shoulder blades, or in the right shoulder.
Other symptoms include:

  • Abdominal pain on the right-hand side of the body, just below the ribs
  • back pain between the shoulder blades
  • pain in the right shoulder
  • Fever with chills
  • Vomiting and nausea
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Clay color of stools , dark urine, or both (signs of a bile duct blockage)
  • Pain that occurs after eating a heavy or fatty meal
  • Indigestion, bloating, and gas







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