Liver Disease

Gallstones

What are gallstones?

Gallstones form when bile stored in the gallbladder hardens into stone-like material. Too much cholesterol, bile salts, or bilirubin (bile pigment) can cause gallstones.

When gallstones are present in the gallbladder itself, it is called cholelithiasis. When gallstones are present in the bile ducts, it is called choledocholithias. Gallstones that obstruct bile ducts can lead to severe or life-threatening infection of the bile ducts, pancreas, or liver. Bile ducts can also be obstructed by cancer or trauma.

About Gallstones

There are two types of gallstones: cholesterol stones and pigment stones. Eighty percent of gallstones are cholesterol stones. Size of gallstones varies from a grain of salt to golf-ball size. A person can develop a single stone or several hundred.

What are the symptoms of gallstones?

At first, most gallstones do not cause symptoms. However, when gallstones become larger, or when they begin obstructing bile ducts, symptoms or "attacks" begin to occur. Attacks of gallstones usually occur after a fatty meal and at night. The following are the most common symptoms of gallstones. However, each individual may experience symptoms differently. Symptoms may include:

pain that comes and goes in the abdomen
nausea
vomiting
fever
chills
jaundice
abdominal bloating
intolerance of fatty foods
belching or gas
indigestion

The symptoms of gallstones may resemble other conditions or medical problems. Consult a physician for diagnosis.

Who is affected by gallstones?

Gallstones are more common in women and Native Americans. The following are suggested risk factors for gallstones:

old age
obesity
western diet
genetic predisposition
Mexican-American descent
quick weight loss or fasting
pregnancy
women on hormone therapy
use of birth control pills

How are gallstones diagnosed?

Symptom-less gallstones sometimes are discovered by accident, during another diagnosis. However, when pain persists, your physician may want to do a complete medical history and medical examination, in addition to the following diagnostic procedures for gallstones:

ultrasound - a diagnostic technique which uses high-frequency sound waves to create an image of the internal organs cholecystography
- x-ray that shows the flow of contrast fluid through the intestines into the gallbladder blood tests

computerized tomography (CT scans) - a diagnostic technique in which a computer and x-rays are used to create cross-sectional images of the body
endoscopic retrograde cholangiopancreatography (ERCP) - this procedure involves inserting an endoscope (viewing tube) through the stomach and into the small intestine. A special dye injected during this procedures shows the ducts in the biliary system.

sphincterotomy - opening the muscle sphincter, a ring of muscle around a natural opening that acts like a valve, wide enough so stones can pass into the intestine

Treatment for gallstones:

If the gallstones cause no symptoms, treatment usually is not necessary. However, if pain persists, your physician will determine treatment based on:

your overall health and medical history
extent of the disease
your tolerance of specific medicines, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Treatment for gallstones in the gallbladder may include:

gallbladder removal (cholecystectomy) - once removed, the bile flows directly from the liver to the small intestine. Side effects of this may include diarrhea, because no bile is stored in the gallbladder.

Treatment for gallstones in the bile ducts may include:

surgical removal of stones (ERCP) - a procedure in which an endoscope is inserted through the stomach into the small intestine.

This page was last updated on: February 6, 2008.

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