The gallbladder is a small-sized organ located in the right upper quadrant of the abdomen, below the liver. Its main function is to store bile juice that assists digestion. Gallbladder stones is a medical condition wherein hardened deposits of cholesterol and bilirubin develop and sometimes get lodged in the gallbladder or bile ducts. The size of these stones may vary from the size of a golf ball to a grain of rice. Many stones may develop simultaneously. These stones can leave the gallbladder and get stuck along the way.
This is when a person may feel the first instance of abdominal pain and discomfort. Interestingly, large-sized gallbladder stones usually stay in the gallbladder and do not cause any discomfort. Depending on the size and discomfort caused, these stones can be removed surgically or via symptomatic care.
What are the types of gallbladder stones?
Depending on its composition, there are mainly two variants of gallbladder stones.
- Cholesterol gallstones
These are the most common types. They account for almost 80% of all gallbladder stones. These stones are generally greenish-yellow in colour, constitute cholesterol and lipid-protein, and contain other components.
- Pigmented gallstones
These are generally smaller in size and black or brown. These stones are formed due to the excess amount of bilirubin in the bile. Bilirubin is the byproduct of destroyed and fragmented red blood cells. This yellow coloured substance passes through the liver into the gallbladder and is then excreted.
What are the symptoms of gallbladder stones?
Usually, gallbladder stones do not exhibit any symptoms. However, if these stones lodge in the bile duct, it might lead to :
- Sudden and rapidly growing pain in the upper right part of your abdomen
- Sudden and rapidly increasing pain in the centre of your abdomen, just below your breastbone
- Back pain between your shoulder blades
- Pain in your right shoulder
- Nausea or vomiting
When do you need to visit the doctor?
Gallbladder stones may not show any signs or symptoms always. However, immediate medical help is required if constant, searing abdominal pain, nausea, and fever develop. Make a note of the symptoms and medical history. Gallbladder stones pain may last for several hours to a few minutes. If severe symptoms and inflammation like these mentioned below occur, it is advisable to seek professional help immediately.
- Abdominal pain that lasts for several hours
- Fever or body chills
- Yellowish skin and eyes. This symptom may indicate jaundice.
- Dark-coloured urine and light-colored stool
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What are the causes of gallbladder stones?
Researchers have not yet found the exact reason why gallbladder stones occur. These stones might be caused by:
- Excess cholesterol in the bile: The body requires bile for digestion. It also dissolves cholesterol excreted by the liver. If the liver excretes more cholesterol than required, the excess cholesterol may crystallize and eventually form gallbladder stones.
- Excess bilirubin in the blood: Conditions like liver cirrhosis, biliary tract infections, and certain blood disorders can cause your liver to produce bilirubin in excess. This excess bilirubin can lead to the formation of gallbladder stones.
- Incomplete emptying of the gallbladder: If it does not empty itself, there might be an accumulation of bile, causing gallbladder stones.
What are the risk factors linked to gallbladder stones?
Several factors might put a person at risk of developing gallbladder stones. A few of them are:
- Hereditary: If an immediate member of the patient’s family has a history of gallbladder stones, the chances of occurrence are higher.
- Lifestyle: Some common reasons for developing gallbladder stones are obesity, rapid weight loss within a short period, and diabetes mellitus.
- Medical: Suffering from liver cirrhosis, estrogen, blood disorders like sickle cell anaemia or leukaemia, and pregnancy are all risk factors associated with gallbladder stones.
What are the complications of gallbladder stones?
Several complications may occur due to the formation of gallbladder stones. The most common ones are:
- Acute cholangitis: This condition refers to the infection of bile ducts due to blockage. Infected bile ducts may spread bacteria in the bloodstream, developing a severe health condition called sepsis.
- Acute cholecystitis: When a gallbladder stone gets logged in the gallbladder’s neck causing intense pain and discomfort, it may lead to Acute Cholecystitis. In extreme cases, the gallbladder might get ruptured or burst.
- Blockage of the pancreatic duct: The pancreatic duct facilitates the movement of pancreatic juices that aids digestion. With gallbladder stones blockage, inflammation in the pancreas may occur which causes intense excruciating abdominal pain
- Cancer in the gallbladder: Gallbladder stones might cause gallbladder cancer in an extremely rare cases. History of gallbladder stones might increase the risk of cancer, though it is very rare.
What are the diagnostic procedures for gallbladder stones?
The doctor might perform the following diagnostic tests:
- A blood test to check for infections
- Abdominal ultrasound to check for gallbladder stones
- CT scan is a specialized scan that enables the doctors to check for gallbladder stones.
- Magnetic Resonance Cholangiopancreatography (MRCP) uses radio waves and magnetic pulses to check the liver and gallbladder functioning.
- Cholescintigraphy (HIDA scan) involves the use of radioactive material. This scan allows the doctors to check whether the gallbladder contracts properly or not.
- Endoscopic Retrograde Cholangiopancreatography (ERCP) involves the insertion of a small tube, which will be passed through the endoscope to the biliary tree. A contrast dye would be injected through a small tube into the ducts, after which X-rays will be taken.
- Endoscopic ultrasound is the combination of ultrasound and endoscopy conducted to check for gallbladder stones.
What are the treatment procedures for gallbladder stones?
Today, there are numerous treatments for gallbladder stones. The doctor might likely remove the gallbladder through surgical processes.. The removal of the gallbladder does not hinder the digestion process. The following are some of the surgical procedures used.
- Laparoscopic cholecystectomy is the most common surgical process. It takes around 24 hours for the patient to get discharged after completing the procedure and about 2 to 3 days to recover fully.
- Open cholecystectomy is a slightly longer procedure that involves removing the gallbladder through larger incisions in the belly. Undergoing this procedure might take a few days for the patient to get discharged and about 7 to 10 days for a full recovery.
Medications to dissolve gallstones: Medicines may help dissolve gallstones without surgery. However, in this way, it may take months or years of treatment to dissolve the gallstones. In addition, there are chances of the formation of gallstones again if treatment is stopped.
Medications for gallstones are not used commonly and are reserved for those who cannot undergo a surgery. Ursodiol and chenodiol may be used to dissolve cholesterol stones. They can cause mild diarrhea.
Shock wave therapy is another non-surgical technique, that uses high-frequency sound waves to break/fragment the stones. Afterwards, bile salt is administered to dissolve small ston pieces. This therapy is used rarely.
Doctors may also try to remove gallstones during an ERCP test. During this procedure, the physician inserts an instrument through the endoscope to attempt removing the stone.
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Can gallstones be prevented?
Since lifestyle is a significant contributor to gallbladder stones, a few preventive measures can be practised to lower the risk.
- Consumption of fiber-rich food. Fiber acts as a prebiotic that helps maintain the gut microbiota. It also helps facilitate proper digestion and overall health.
- Maintaining a healthy weight decreases the chances of excess cholesterol in the bloodstream. Also, it also reduces the chances of being obese.
- A balanced diet helps facilitate better digestion, thus, reducing the chances of gallstones.
- Slow and controlled weight loss reduces the risk of gallstones.
- Women with high risk of gallstones should check with the doctor whether they should avoid the use of hormonal birth control.
Gallbladder stones are usually harmless and dissolve on their own. But, they may pose to be life-threatening if these stones block any duct or cause an infection. Hence, it is worthwhile to take preventive measures. Avoid processed food; instead, consume more fresh fruits, vegetables, legumes, grains, and nuts. Maintaining a healthy lifestyle reduces the chance of acquiring many diseases.
Frequently Asked Questions (FAQs)
- Is it normal to have stones in the gallbladder?
Although a vast majority have gallbladder stones , symptoms or signs may not always occur. If, however, symptoms occur, seek medical help immediately.
- How much time is required to recover from passing a gallstone?
However, if one has undergone surgery, it might take up to a week of hospitalization, depending on the severity. Further, to resume daily work, it might take up to four to six weeks.
- Does drinking water help with gallstones?
Yes, it does. Drinking adequate amounts of water helps the gallbladder and prevents the build-up of bile. This, in turn, prevents the formation of gallbladder stones.
- Will the removal of the gallbladder hinder my digestion?
It is possible to live normally without the gallbladder. When your gallbladder is removed, bile flows directly from your liver into the small intestine, and this may sometimes cause diarrhoea. As bile does not accumulate in the gallbladder, the quantities of digestive fluid can’t be stored up and used to break down a meal, especially a fatty meal. But, this condition is not considered serious and can be corrected by simply limiting fat in the diet.
- Will my gallbladder stones come back after they have been non-surgically regmoved?
There is a high probability that the gallbladder stones might recur. It is advisable to consume a healthy diet, exercise regularly, and increase water intake if one has suffered from gallbladder stones. Surgical intervention, however, makes sure that it does not recur in the future.