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Gallbladder Stones: Symptoms, Causes, Risks, and Treatment

Medikoe Health Expert

Medikoe Health Expert

  Koramangala, bengaluru, karnataka, india, Bengaluru     Sep 29, 2020

   6 min     

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Overview

Gallbladder stones or gallstones are a common condition of the digestive system. It is also called cholelithiasis. It occurs when the digestive fluid, bile, harden and are deposited in the gallbladder. 

There are about 10 million cases of gallstones in India. The condition is treated only if there are a lot of symptoms. Otherwise, it can be remedied through lifestyle changes.

The Gallbladder

Before we get to discussing gallstones, let us understand a little about our gallbladder. It is a small organ that is situated below the liver in the upper right side of the abdomen. This organ is responsible for storing the greenish-yellow digestive juice called bile. 

The function of the gallbladder is to release bile into the small intestine during digestion. The gallbladder does not produce bile; it just stores it, which is why it is not an essential organ. But, people without gallbladder may be at risk for diarrhoea or fat malabsorption.

What is the cause of Gallstones?

The exact reason for the formation of gallstones has not been found. But the medical community has theorised certain causes behind it. 

Mostly it is attributed to an increased cholesterol level in the bile juice. It has been observed that when the liver produces excess amounts of cholesterol, the bile juice is unable to dissolve it. This leads to the formation of yellow-coloured cholesterol stones in the gallbladder. 

It could also be caused when there are excess amounts of bilirubin in the bile juice. Bilirubin is a substance produced by the liver when it destroys old red blood cells.  If you have some sort of liver damage or blood disorders, the liver may produce more than the required amount of bilirubin. This results in the gallbladder not breaking down the excess bilirubin, resulting in the formation of dark brown or black gallstones.

You may also develop gallstones if the bile content in the gallbladder is concentrated. Such an issue could occur if the gallbladder doesn’t empty the bile into the small intestine from time to time.

Symptoms of Gallstones

One of the first noticeable symptoms of gallstones is a sharp pain in the upper right abdomen. One experiences such a pain when they consume food that is high in fat, like fried items. This pain does not last for long.

Some other symptoms that one may experience includes;

  • Nausea and vomiting
  • Dark coloured urine
  • Clay coloured excreta
  • Indigestion or diarrhoea
  • Stomach pain
  • Burping

The above group of symptoms is also known as biliary colic. 

Asymptomatic Gallstones

Gallstones do not have that many painful symptoms. The pain only occurs when the bile juice that is moving from the gallbladder is blocked by the gallstones.

A study has indicated that 80% of the patients with gallstones do not experience any pain. 

Complications or Long-term Risks

There are a few complications that may arise if the gallstones go untreated.

Acute cholecystitis

This is a condition that occurs when there is inflammation or infection in the gallbladder due to blockage by the stones. This condition is to be treated immediately and is considered a medical emergency. A patient with gallstones has a very low risk of developing this condition.

A person with acute cholecystitis show the following symptoms;

  • Intense pain in the upper stomach or mid-right back
  • Fever and chills
  • Loss of appetite
  • nausea and vomiting

Other Possible Complications

A person with untreated gallstones may develop complications such as:

  • Jaundice, a condition characterised by yellowish tint to the skin and eyes
  • Cholecystitis, or infection of the gallbladder
  • Cholangitis, or infection in the bile duct
  • Sepsis, infection in the blood
  • Inflammation of pancreas
  • Gallbladder cancer

Risk factors for gallstones

There are certain risk factors that could contribute to the development of gallstones. These factors are related to diet, lifestyle, medicines, health conditions, etc. There are some factors that are uncontrollable, too, like family history, age, gender, race, etc.

Listed below are these risk factors.

Lifestyle risk factors    

  • Being overweight or obese
  • Consuming food that is high in fat or cholesterol, or low in fibre    
  • Sudden weight loss in a small time period

Uncontrollable risk factors   

  • being female
  • Born of a Native American or Mexican-American descent
  • having a history of gallstones in the family
  • being 60 years or older

Medical risk factors

  • having cirrhosis
  • having diabetes mellitus
  • being pregnant
  • Consuming  certain medications for lowering cholesterol
  • Taking in medications that are rich in high estrogen content

It is important to remember that, even if medications may increase the risk of developing gallstone, do not stop taking them, unless your doctor recommends it. You may have a discussion with your health professional and find alternatives to reduce the risks.

Diagnosis of Gallbladder Stones

 The first step to diagnosing gallstones is a complete physical examination. If the doctor observes visible yellowish tinge on your skin and eyes, he may ask for further tests. This is because jaundice (the yellowish tinge) occurs due to an increased amount of bilirubin in the body, a symptom of gallstones.

Other tests suggested by the doctor include;

  • Ultrasound: the ultrasound provides you with an image of the inside of your abdomen. Through this image, the doctor can detect gallstones and signs associated with acute cholecystitis.
  • CT Scan of the abdomen: This test provides with the image of the liver and the surrounding abdominal region
  • Gallbladder radionuclide scan: This test involves injecting a radioactive substance into your veins, which travels to the liver and gallbladder through the blood. The substance helps provide evidence that suggests the presence of gallstones. The whole procedure takes an hour to complete.
  • Blood Test: Blood tests may help you understand if there is an increased bilirubin count in the blood, which is a symptom of gallstones.
  • Endoscopic retrograde cholangiopancreatography (ERCP): This is an endoscopic procedure that makes use of tiny cameras, and X-rays to detect issues within the bile and pancreatic duct; helps find gallstones in the bile duct.

Treatment of Gallbladder Stones

Gallstones are only treated if it causes you pain. The body naturally passes out gallstones without you noticing. Surgery is the treatment option that is often recommended if the condition causes you any pain. In this procedure, your gallbladder will be removed laparoscopically. A person without a gallbladder is more likely to have watery stools or diarrhoea, due to the increased bile content flowing into the small intestine that acts as a laxative. This condition can be managed by consuming food that has a low-fat content.

If not surgery, then medications are prescribed; such a situation is quite rare.

Shock wave lithotripsy is also another form of treatment. This procedure involves passing shockwaves through the patient, which helps break down gallstones into smaller pieces, which is then passed normally.

You can avoid the development of gallstones by implementing certain lifestyle changes. 

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Tags:  Digestive health ,Gastroentology,gallstones, gallbladder health, digestive system, liver, increased bile, high bilirubin count

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