Gallstones

What are gallstones?

A common occurrence among the U.S. population, gallstones are hard deposits that form in the gallbladder, a small organ located on the right side of the abdomen. The gallbladder holds bile, a digestive fluid that is released into the small intestine.

Gallstones range in size, from something as small as a grain of sand to something as large as a golf ball. In addition, while some people develop only one gallstone, others may develop several at a time. This may result blockage, causing inflammation or infection of the gallbladder (cholecystitis).

There are two types of gallstones that can form in the gallbladder:

  • Cholesterol gallstones: These gallstones appear yellow in color and are composed mainly of un-dissolved cholesterol. They are also the most common type of gallstone.
  • Pigment gallstones: Resulting from bile that contains too much bilirubin, this type of gallstone may appear black or brown in color.

What causes gallstones?

While it is not clear exactly what causes gallstones, it is theorized that they may be due to:

  • Bile containing too much bilirubin, a chemical the liver produces to break down red blood cells
  • Bile containing too much cholesterol, which forms crystals and eventual stones
  • The gallbladder not emptying correctly or often enough, leaving concentrated bile to form gallstones

Factors that may increase the risk of forming gallstones include:

  • American Indian or Mexican American heritage
  • Being female or older than 60
  • Taking certain cholesterol-lowering medications
  • Diabetes
  • Eating a diet high in fat or cholesterol or low in fiber
  • Family history of gallstones
  • Obesity or being overweight
  • Pregnancy
  • Sudden and rapid weight loss
  • Taking hormone therapy drugs such as estrogen

What are the symptoms of gallstones?

Though gallstones themselves cause no symptoms, they may become lodged in a duct and cause a blockage, resulting in symptoms such as:

  • Back pain between the shoulder blades
  • Pain in the right shoulder
  • Sudden and increasing pain in the center or upper right portion of the abdomen

Diagnosing gallstones

There are several tests your doctor may recommend to aid in diagnosis, including:

What are the treatment options for gallstones?

Surgery

For those affected by gallstones, surgery to remove the gallbladder, known as a cholecystectomy, is normally recommended. This procedure can be performed in one of two ways:

  • Laparoscopic cholecystectomy: A minimally invasive procedure in which three to four small incisions are made, allowing thin tubes with tiny cameras (laparoscopes) and specialized tools to be inserted to visualize the inside of the abdomen and effectively remove the gallbladder.
  • Open cholecystectomy: A two- to three-inch incision is made in the upper right section of the abdomen and the gallbladder is removed.

Medication

While medication may be taken to help gallstones dissolve on their own, it may take months or years for the gallstones to fully dissolve. Because of this, medication is not a typical modality of treatment for this condition.

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