Gallstones – an Overview | Gastroenterology


What are gallstones?

Your gallbladder is a small organ just below the liver in the right abdomen. It is a bag that stores greenish-yellow liquid bile that aids digestion. Gallstones form when too much cholesterol in the bile.

Causes of gallstones

According to Harvard Health Publications, 80 per cent of gallstones are made with cholesterol. The remaining 20%   of gallstones are made up of calcium salts and bilirubin.

Although there are some theories, it is not known exactly what causes gallstones to form.

  • Your cholesterol will have more cholesterol: Yellow cholesterol stones are caused by having too much cholesterol in your bile. These hard stones can develop if your liver makes more cholesterol than bile dissolves.
  • More bilirubin in your bile: Bilirubin is a chemical made when the liver destroys old red blood cells. Some conditions, such as liver damage and certain blood disorders, cause your liver to make more bilirubin than it should. Pigmented gallstones form when the gallbladder cannot break down excess bilirubin. These rough stones are often dark brown or black in colour.
  • Concentrated bile due to complete gallbladder: Your gallbladder needs to empty your gallbladder to stay healthy and function properly. If you can’t empty your bile material, the bile becomes too concentrated, causing stones to form.

Symptoms of gallstones

Gallstones can cause pain in the right abdomen. When you eat a high-fat diet, such as fried foods, you start to have gallbladder pain from time to time. This Pain does not usually last more than a few hours.

You may also experience:

  • Nausea
  • Vomiting
  • Dark urine
  • Clay-coloured stools
  • Stomach pain
  • Burping
  • Diarrhea
  • Indigestion

These symptoms are also known as biliary colic.

Asymptomatic gallstones

Gallstones are painless. Instead, the pain occurs when the gallbladder blocks the movement of bile from the gallbladder.

According to the American College of Gastroenterology, 80 per cent of people have “silent gallstones.” This means that they do not experience pain or have any symptoms. In these cases, your doctor can detect gallstones using X-rays or during abdominal surgery.

Chronic risk and problems of gallstones

Acute cholecystitis

When the gallbladder blocks the duct from which bile moves from the gallbladder, it can cause inflammation and infection in the gallbladder. This is called acute cholecystitis. This is a medical emergency. The risk of acute cholecystitis from symptomatic gallstones is 1 to 3 per cent.

Symptoms associated with acute cholecystitis:

  1. Severe pain in the upper abdomen or right back
  2. Fever
  3. Cold
  4. Loss of appetite
  5. Nausea and vomiting

See a doctor immediately if these symptoms persist for more than 1 to 2 hours or if you have a fever.

Other issues

Untreated gallstones can cause problems like:

  1. Jaundice, yellowing of the skin or eyes
  2. Cholecystitis, gallbladder infection
  3. Cholangitis, an infection of the bile ducts
  4. Sepsis, blood infection
  5. Inflammation of the pancreas
  6. Gallbladder cancer

How gallstones are diagnosed?

Your doctor will perform a physical exam that will check your eyes and skin for visible colour changes. The yellow colour can be a sign of jaundice, which is the result of a high level of bilirubin in your body.

The test may include the use of diagnostic tests that help your doctor see inside your body. These tests include:

  • Ultrasound: Ultrasound produces pictures of your abdomen. The imaging method you prefer to diagnose if you have gallbladder disease. It also shows abnormalities associated with acute cholecystitis.
  • Abdominal CT scan: This imaging test will take pictures of your liver and abdominal area.
  • Gallbladder Radionuclide Scan: This important scan takes about an hour to complete. A specialist sends radioactive material into your veins. On examination, it reveals evidence that indicates infection or obstruction of the bile ducts by stones.
  • Blood tests: Your doctor may order blood tests to measure the amount of bilirubin in your blood. The tests can also help determine how well your liver is working.
  • Endoscopic retrograde cholangiopancreatography (ERCP): ERCP is a procedure that uses a camera and X-rays to look for problems in the bile and pancreatic vessels. This will help your doctor look for gallstones trapped in your bile duct.

How are gallstones treated?

Most of the time, you do not need treatment if the gallstones are not painful. Sometimes you can even cross gallstones without even realizing it. If you are in pain, your doctor may recommend surgery. In rare cases, medications can be used.

If you are at high risk for surgical complications, a drainage tube can be placed through the skin into the gallbladder. You can postpone your surgery until your risk is reduced by treating your other medical conditions.

Some of the nutrients you can take include vitamin C, iron, and lecithin. Vitamin C and lecithin have been shown to reduce the risk of gallstones. Talk to your doctor about the proper dosage of these ingredients.

Some people recommend a gallbladder flush, which involves fasting and then taking olive oil and lemon juice to break through gallstones. There is no evidence that it works and the gallstones get trapped in the bile duct.


Your doctor may need a laparoscopic removal of the gallbladder. It is a simple surgery that requires general anaesthesia. The surgeon usually makes 3 or 4 incisions in the abdomen. They then insert a small, lighted device into one of the incisions and carefully remove the gallbladder. You usually go home on the day of the procedure or the next day if you have no problems.

You may experience loose or watery stools after the gallbladder is removed. Gallbladder removal involves the transfer of bile back from the liver to the small intestine. The bile no longer passes through the gallbladder and becomes less concentrated. The outcome is a diuretic impact that causes the runs. To treat this, eat a low-fat eating regimen so you discharge less bile.

Non-surgical treatments

Medications aren’t normally used due to the fact laparoscopic and robotic methods make surgical operation a lot much less risky than withinside the past.

However, if you do not have surgery, you can take Ursodiol (Actigal, Urso) to dissolve gallstones caused by cholesterol. You should take this medicine 2 to 4 times a day. Medicines to remove gallstones can take many years, and gallstones can return if you stop treatment.

Shock wave lithotripsy is another option. A lithotripter is a machine that produces shock waves that pass through a person. These shock waves can break down gallstones.

Foods to avoid

To help improve your condition and reduce the risk of this disease, try these tips:

  • Reduce your fat intake and choose a low-fat diet whenever possible. Avoid fried, greasy, and high-fat foods.
  • Add fibre to your diet to make your bowel movements more visual. Try adding just a pinch of fibre at a time to avoid gas without eating extra fibre.
  • Avoid foods and drinks that cause diarrhea, including caffeinated drinks, high-fat dairy products, and very sweet foods.
  • Eat several small meals a day. Small meals are easy for the body to digest.
  • Drink enough water. They are 6 to 8 glasses per day.

Rapid weight loss can lead to increased gallstones and other health problems.

What can I expect in the long term?

  • If you need surgery to remove your gallbladder or gallbladder stones, the outlook is usually positive. Stone removal In most cases, the stones do not return.
  • If you don’t have surgery, your gallstones may return. This is also true when you are taking medications to dissolve this disease.
  • You do not need treatment if gallbladder symptoms do not appear. However, you may want to make lifestyle changes to avoid making them bigger and causing problems.

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