What Are Gallstones and How to Treat Them

Know all about causes, symptoms and treatment of gallstones

Gallstones are stones that are formed in the gallbladder, which is a collection receptacle for bile. Bile is produced by special cells in the liver and is then channeled through tiny ducts in the liver to the gallbladder. As the bile comes into the gallbladder, the water separates from the bile and the bile becomes concentrated in the gallbladder.

Later, some time after a meal, the muscle that forms the wall of the gallbladder forces the concentrated bile into the intestines. The concentrated bile works better at food digestion than the bile with the water in it and therefore it is kept in the gallbladder. Bile is usually yellow to a brownish in color and it is the bile that gives the color to your bowel movements.

Gallstones usually form in the gallbladder, but they can form anywhere where the bile travels. Gallstones, which form in the gallbladder, might also be small enough to exit the gallbladder with the bile. Other places where gallstones can form include the cystic ducts and the hepatic ducts, where the bile is produced.

What causes gallstones?

There are several theories of what causes gallstones, but they occur mostly in women, and it is believed that the majority of people with gallstone problems are genetically predisposed to gallstones. In most of these cases, gallstones are inherited from someone related who also has gallstones. Other possible causes of gallstones are:

1. Cholesterol gallstones are the most common gallstones in people who reside in the United States and Europe. These gallstones are primarily formed by cholesterol buildup in the gallbladder. The way these types of gallstones are formed is that cholesterol must be dissolved in the bile before it can be transported through the intestines and digested.

The problem is that cholesterol is fat and fat does not dissolve in water and therefore they form stones. Other ways that cholesterol gallstones are formed is that there is a rapid cholesterol growth in the gallbladder and the cholesterol accumulates into stones.

2. Pigment gallstones are the second most common cause of gallstones. Pigment gallstones are usually caused by old hemoglobin that can accumulate in the gallbladder. Hemoglobin is the part of the blood that delivers the oxygen to all your tissues and organs.

The pigment gallstones are created by the old red blood cells, which transform into a chemical called bilirubin. Bilirubin is secreted through the liver. There are several different types of pigment gallstones, which are listed below.

a. Black pigment gallstones are formed when there is too much bilirubin in the gallbladder and the bilirubin mixes with other substances in the bile, such as calcium.

b. Brown pigment gallstones are formed when there is not enough concentrated bile in the gallbladder. This can happen when the duct that leads the bile into the gallbladder becomes obstructed or when the altered bilirubin is mixed with other substances, such as bacteria, calcium, cholesterol or lecithin.

3. Ceftriaxone is an antibiotic that can, on rare occasions, cause gallstones. Ceftriaxone is an antibiotic that removes the bile from the gallbladder and allows all kinds of foreign substances such as cholesterol and bilirubin to be left alone. As all these substances mix with the antibiotic, they form a gallstone that is calcium carbonate.

How do you know if you are at risk for gallstones?

There are several risk factors for gallstones. If the above paragraphs got you nervous about having cholesterol gallstones because you have high cholesterol, you need not worry. There is no relationship with cholesterol in the blood and cholesterol in the gallbladder. Some of the risk factors that you need to be aware of are:

1. Gender is one of the greatest risk factors. Gallstones affect women more than men, but men can also get gallstones.

2. Age can be another risk factor. The risk of having gallstones increases with age.

3. Obesity is another major cause of gallstones. If you are overweight, you are more likely to have more fat within your body, increasing the chance of cholesterol accumulating in your gallbladder.

4. Pregnancy can increase the risk of cholesterol gallstones because during pregnancy bile can contain more cholesterol and the gallbladder does not contract normally as it does when a woman is not pregnant.

5. If you take birth-control pills or hormone therapy, you can also increase the risk of having gallstones because hormones and birth-control pills can simulate the same conditions as during pregnancy.

6. Rapid weight loss can increase the risk of cholesterol gallstones, but once the weight is lost, the cholesterol decreases in the bile and the stones disappear.

7. Crohn’s disease can be a large risk factor for cholesterol gallstones, because this condition prevents the bile to be made properly and is not able to dissolve cholesterol enough and the stones form.

8. Sickle Cell Anemia, thalassemia or cirrhosis of the liver can be risk factors for pigment gallstones. As mentioned above, black pigment gallstones are caused when there is an excessive load of bilirubin in the liver. This is common with people with anemic blood disorders such as sickle cell anemia. Cirrhosis of the liver can also cause gallstones because there is a reduced production of bile from a malfunctioning liver.

What are symptoms of gallstones?

In general, gallstones do not have any symptoms, but in some individuals gallstones may be large and can cause pain as they jam ducts.

Can gallstones cause serious complications?

Yes, they can. There are many things that can go wrong if gallstones go unchecked. In many cases when gallstones become a serious enough problem, they may lead to the removal of the gallbladder because gangrene can set in the gallbladder. Other complications are:

1. Cholecystitis is a condition that is brought on by inflammation of the gallbladder and is mainly caused by ducts being obstructed by gallstones. Initially, the inflammation of the gallbladder is sterile, should there be no bacteria present.

However, over time bacteria that travel through the intestine can infect the gallbladder and cause more serious problems, such as the gallbladder going necrotic and gangrene setting in. The typical sign of cholecystitis is abdominal pain. This condition can be treated with a series of antibiotics.

2. Colongitis is caused when the intrahepatic ducts inside the liver become inflamed. This usually happens when gallstones get jammed in some of the ducts in the liver and the bile becomes infected. People with this condition usually get very sick with high fever and an elevated white blood cell count.

3. Jaundice is usually associated with liver ailments, but it can happen with gallstones as well. Basically, jaundice is a result of an excessive amount of bilirubin in the body, giving the skin a yellowish color. Jaundice occurs when the bile ducts in the liver are obstructed for a long time.

Why are the ducts obstructed? In some cases it can be diseases and inflammation of the liver, but the usual suspect are gallstones. The stones get big enough and can obstruct the ducts in the liver, allowing for jaundice to begin.

4. Pancreatitis is mainly caused by gallstones and alcoholism. Pancreatitis is an inflammation of the pancreas and the reason why gallstones can cause pancreatitis is because the pancreas surround the common bile duct, which empties the gallbladder into the intestine. If the common bile duct is obstructed by a gallstone, it can block the pancreas from secreting pancreatic juices, causing this condition. Fortunately, gallstones rarely cause severe pancreatitis.

5. Cancer of the gallbladder can also be caused by gallstones. However, there is one caveat. It is still not clear what comes first. Some schools of physicians believe that gallstones precede the onset of gallbladder cancer, whereas others believe that the gallstones can cause the actual cancer. There are still many studies that need to be made to get a final result.

Can gallstones be diagnosed?

Yes, they can be diagnosed. Technically there are two ways that physicians can diagnose gallstones. The first way gallstones are diagnosed is when a patient comes into the doctor’s office complaining of abdominal pains then a doctor can suspect gallstones of being the culprit.

The second way gallstones are diagnosed is when a patient gets diagnosed for another medical condition in the abdomen and the stones are discovered. There are a couple of techniques that physicians use to diagnose gallstones:

1. Ultrasound of the abdominal region of the body is the most common way that gallstones can be diagnosed. The way the ultrasound works is that a special device is swept across your abdomen, emitting high frequency sound waves that produce an image of all your abdominal organs. This can easily detect gallstones.

2. Endoscopic ultrasonography is also an ultrasonic procedure that is done with the use of an endoscope that the patient swallows after ingesting a special fluid that makes the digestive organs more visible. For this procedure, a patient needs to be sedated intravenously.

3. Liver and pancreatic blood tests can be required if the physician believes that you have an inflammation of either the liver or pancreas.

Can gallstones be treated?

Gallstones can be treated, but treatment should only be rendered if the gallstones cause problems. In most people, gallstones are silent and are not large enough to obstruct any of the major ducts, therefore in a person older than 65 years of age who have a diagnosis of gallstones, treatment might not even be necessary.

For problematic gallstones, there are several different methods of treatment.

1. Colesystectomy is an extreme treatment option. This is the procedure of surgically removing the gallbladder. This is a common procedure when gallstones are present in the gallbladder and the surgery itself has a low rate of complications.

The one complication is that bile might leak from the bile ducts into the abdomen. The surgery is usually done by a single incision in the abdomen and the gallbladder is removed. The patient is usually put under general anesthesia for this procedure.

2. Extraction of the gallstones is done when the gallstones are in the bile ducts in either the liver or going into the intestines.

3. Oral dissolution therapy is a method to treat cholesterol gallstones. This therapy involves ingesting a fluid that is a bile acid that naturally occurs in the bile. This allows for the bile to more effectively dissolve the gallstones.

There are many ways to treat gallstones. However, if you suspect of having gallstones or know that you have gallstones, you should first consult your doctor before undergoing any procedure. In most cases you may not even need any treatment, but in some cases, where gallstones can cause severe problems the above-mentioned treatments or other treatments that your doctor might know about might be necessary.