A Brief Guide to Gallstones: Types, Causes, Symptoms, Risks, Diagnosis and Treatment

Published on August 23 , 2017 | 5 Minutes to Read

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The gallbladder is a pear-shaped organ located above the liver that stores bile. The bile components may crystallize, resulting in the formation of hardened deposits that reside as gallstones inside the bladder. A gallstone size may vary from as small as a grain of sand to as large as an apricot. In addition, a person can develop one or multiple gallstones and still be unaware about it until a medical examination reveals the problem. Certain symptoms, however, point towards the presence of gallstones. To provide an overview of the problem, in this blog post, we discuss the causes, risks, symptoms, diagnosis and treatment options available for Gallstones. Let’s begin.

Types

Gallstones are of two types – cholesterol stones and bilirubin stones. A recent report published by Harvard Health Publications suggests that 80 percent of gallstones occur due to excess cholesterol in the bile whereas 20 percent cases can be attributed to calcium salts and bilirubin. A detailed description of each type of gallstone is as follows:

Cholesterol Stones

The bile juice dissolves or breaks down the cholesterol secretions of the liver. Gallstones may also develop if the liver produces excessive cholesterol than what can be dissolved by the bile juice.

Bilirubin Stones

Medical conditions such as Cirrhosis of the Liver and certain blood disorders trigger excessive bilirubin production that the gallbladder is unable to break down, leading to the formation of gallstones.

Concentrated Bile

The gallbladder needs to flush out the excess bile to ensure normal functioning. Sometimes the gallbladder fails to drain the bile components leading to its excess concentration and formation of gallstones.

Risk Factors

Many of the risk factors carry a direct relation with diet. The following risk factors may lead to gallbladder stones:

Obesity

Obesity can be an indication of high cholesterol intake that may lead to gallstone formation.

Contraceptives or Pregnancy

Intake of oral contraceptives, hormonal therapy or pregnancy in women triggers the female hormone estrogen, that increases the cholesterol levels leading to gallstones.

Diabetes

People suffering from diabetes have an excess of triglycerides, which is a type of blood fat capable of causing gallstones.

Cholesterol-Lowering Medication

Medications that lower body cholesterol may trigger cholesterol production in bile and cause gallstones.

Symptoms

• Gallstones are painless, but can result in excess discomfort and pain if they block the bile duct from the gallbladder. A few more symptoms can also arise, such as:
• Sudden and intensifying in the upper right part of abdomen
• Pain in the central abdomen below the breastbone
• Back pain between shoulder blades
• Pain in right shoulder
• Nausea or vomiting
• Clay-colored stools

In addition, gallstone pain can start after the meals and may persist from 15 minutes to 24 hours that can restrict normal breathing.

Diagnosis

A doctor may begin the diagnosis with a physical exam by looking for yellowish tints in the eye area indicating the presence of excess bilirubin that may be the cause of bilirubin stones. Some of the other methods of diagnosing gallstones include:

Magnetic Resonance Cholangiopancreatography (MRCP)

The test utilizes a combination of a magnetic field and pulses of radio-wave energy to get a comprehensive picture of the gallbladder that may be helpful in highlighting gallstones.

Cholescintigraphy (HIDA scan)

The test evaluates the functioning and health of the gallbladder.

Endoscopic Ultrasound

The test provides an image of the abdomen and gall bladder to check the presence of gallstones.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

The doctor injects a dye down the small intestine to check the gallstones that may be stuck in the bile ducts.

Treatment

Most cases of gallstones require treatment once they start exhibiting symptoms. Common treatment methods include:

Medications

Oral medications prescribed by a doctor can help in dissolving the gallstones; however, the process may take months to years and in some cases might even not work. Moreover, oral medications are helpful in relieving small gallstones and often ineffective for large stones.

Surgery

A Surgeon may recommend surgery for symptomatic gallstones or for neoplasms. The surgical process, known as Laparoscopic Cholecystectomy involves the removal of the gall bladder to remove the stones. During the surgery, a surgeon makes several incisions in the belly to insert surgical instruments and laparoscope to carefully dissect away the gallbladder under general anesthesia. After the surgery, the bile juice directly flows from the liver to the small intestine without needing the gallbladder to store the digestive juices. Moreover, gallbladder removal doesn’t affect the digestive capabilities, and the patient can go home the same day after surgery and resume work in a couple of weeks or so.

The Way Forward

Stage 1 gallstones are generally painless, therefore often go unnoticed. A person starts experiencing gallstone pain in stage 2, which worsens after meals and during night. Once the gallstone causes a blockage in the duct responsible for the flow of bile, severe pain known as “Biliary Colic“ occurs which is a medical emergency. If a person experiences frequent pain in the abdomen, especially in the quadrant below the breastbone, often accompanied by fevers and chills, they need to seek immediate medical treatment. If you or any person you know is suffering from gallstones and need expert advice, our surgeons at Perth Surgical & Bariatrics are there to help. We are a laparoscopy surgery clinic in Perth, and our surgeons carry an extensive experience in treating gallstones surgically.