Gallstones

The gallbladder is a sack under the liver that stores bile the liver creates. Some people form stones inside the gallbladder. Stones in the gallbladder are a common problem in the US. About 20-30% of the population has gallstones.

Why Do Gallstones Form?

Most stones are made of cholesterol, calcium salts or bilirubin. Having too much cholesterol in your bile can lead to the formation of stones that develop if your liver makes more cholesterol than your bile can dissolve. Bilirubin is produced when your liver destroys old red blood cells. Conditions such as blood disorders or liver damage can cause your liver to produce more bilirubin than it should. Pigmented gallstones form when your gallbladder can’t break down the excess bilirubin. These hard stones are often dark brown or black.

Risk Factors for Gallstones

Lifestyle factors: obesity, high cholesterol diet, rapid weight loss

Uncontrollable factors: being female, Native-American or Mexican-American descent, age over 60, family history

Medical factors: pregnancy, cirrhosis, certain medications, blood disorders, diabetes

Symptoms

Some people with gallstones don't have any symptoms. Other people can have pain in the right upper or middle abdomen that extends to the back, nausea, vomiting, burping, diarrhea, or indigestion.

When gallstones are blocking the gallbladder or bile ducts, people can have other symptoms such as fever, chills, jaundice (yellowing of the skin or eyes), appetite loss or clay-colored stools.

How are Gallstones Diagnosed?

There are many studies that can help diagnose gallstones. Your doctor may order an ultrasound, CAT (computerized axial tomography) scan, HIDA (hepatobiliary iminodiacetic acid) scan, MRCP (magnetic resonance cholangiopancreatography) or blood work. Different studies are better for different problems and your doctor can help order the correct test.

How are Gallstones Treated?

When patients have symptoms from gallstones, this is commonly treated with surgical removal of the gallbladder (cholecystectomy). If there is an infection or blockage from gallstones, this can be an emergency. Sometimes patients need a separate procedure called an ERCP (endoscopic retrograde cholangiopancreatography) to remove stones from the bile ducts before gallbladder removal surgery. Medication does not usually take care of problems caused by gallstones.