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Gallstones

Gallstones

Gallstones is a condition in which one or more stones collect in the gallbladder. Gallstones can infect and damage your gallbladder, liver and pancreas. Knowing the risk factors, the symptoms, and the treatments will help you cope with this health issue.

The gallbladder is an organ located under the liver. It stores a fat-digesting substance called bile. When gallstones form, they can lodge in the gallbladder’s ducts that carry bile to the small intestine. Bile trapped in these ducts can cause inflammation in the gallbladder, the ducts, or the liver. If any of these ducts remain blocked for a significant period of time, severe–possibly fatal–damage can occur in the gallbladder, liver, or pancreas.

In North America, gallstones are typically composed of cholesterol, although a significant number are also made up of pigment. Scientists believe cholesterol stones form when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty as it should for some other reason.

The cause of pigment stones is uncertain. They tend to develop in people who have cirrhosis, biliary tract infections, and hereditary blood disorder, such as sickle cell anemia, in which too much bilirubin is formed.

Who are most at risk for gallstones?

  • women
  • people over age 60
  • Native Americans
  • Mexican Americans
  • overweight men and women
  • people who fast or lose a lot of weight quickly
  • pregnant women, women on hormone therapy, and women who use birth control pills  

Symptoms

Symptoms of gallstones are often called a gallstone “attack” because they occur suddenly. Often, they follow fatty meals, and they may occur during the night. A typical attack can cause:

  • pain in the upper right abdomen or between the shoulder blades
  • intolerance of fatty foods (indigestion, gas, pain, bloating, belching)
  • pain under the right shoulder
  • nausea or vomiting


People who have the above and any of following symptoms should see a doctor right away:

  • sweating
  • chills
  • low-grade fever
  • yellowish color of the skin or whites of the eyes
  • clay-colored stool


Accurate diagnosis is important; gallstone symptoms are similar to those of heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, and hepatitis. To diagnose gallstones, medical professionals use a variety of tests, including blood tests, ultrasound, cholecystography, and x-rays of the gall bladder.  

Care Tips

  • For minor discomfort, you may use non-prescription drugs, such as acetaminophen. 
  • Generally, there is no restriction on activity for the long term treatment of gallstones, aside from resting during attacks of gallbladder colic. 
  • During an attack, sip water occasionally, but do not eat.
  • At other times, eat a low-fat diet.  Fatty meals may bring on mild attacks.
  • If you are overweight, begin a weight reduction program.


Of course, as with all caregiving recommendations, consult a health care professional to make sure these care tips are appropriate to treat your condition.

Professional Treatment Options

Surgery to remove the gallbladder is the most common way to treat symptomatic gallstones. Each year more than 500,000 Americans have gallbladder surgery, called cholecystectomy.  Fortunately, the gallbladder is an organ that people can live without. Losing it does not even require a change in diet.

There are also nonsurgical approaches to treat gallstones. These are used only in special situations–such as a patient with a serious medical condition prohibiting surgery–and only for cholesterol stones. Stones usually recur after nonsurgical treatment. Treatments include:

  • oral dissolution therapy, in which stones are dissolved with drugs made from bile acid;
  • contact dissolution therapy, which involves injecting a drug directly into the gallbladder to dissolve stones;
  • extracorporeal shockwave lithotripsy, which sends shock waves to break up stones into tiny pieces. 

Many people with gallstones have no symptoms. These patients are said to be asymptomatic, and these stones are called “silent stones.” They do not interfere in gallbladder, liver, or pancreas function and do not need treatment.

For more information about gallstones and related topics, contact:

The National Digestive Diseases Information Clearninghouse
2 Information Way
Bethesda, MD 20892-3570
Email them here.

Editorial contributors to this article included the Jewish Home’s Long Term Home Health Care Program and the National Institutes on Health, Digestive Diseases Information Clearinghouse.