Gallstones: A Comprehensive Guide to Causes, Symptoms, and Treatment
What Are Gallstones?
Gallstones are hard deposits of digestive fluid called bile that form inside the gallbladder, a small, pear-shaped organ located just below your liver. Gallstones can vary in size, from as small as a grain of sand to as large as a golf ball.
Why They Form:
Gallstones are believed to form due to an imbalance in the substances that make up bile. This may occur if your bile contains unusually high levels of cholesterol, bilirubin, or not enough bile salts.
Recognizing the Symptoms
Many people with gallstones have no symptoms at all. However, when symptoms do occur, they may include:
- Sudden, severe pain: A constant, cramping pain that is sharp or dull, lasting at least 30 minutes. It typically occurs on the right side, under the ribs, or in the middle of the upper abdomen.
- Fever
- Jaundice: A yellowing of the skin and eyes.
- Other symptoms: Nausea, vomiting, and clay-colored stools.
Are You at Risk? Key Risk Factors for Gallstones
You may have a higher risk of developing gallstones if you:
- Are female
- Are over 40 years old
- Are pregnant or taking birth control pills
- Have a family history of gallstones
- Have diabetes
- Are overweight or obese
- Have recently lost weight very quickly, especially on a high-calorie, low-fiber diet
Diagnosis and Treatment Options
Diagnosis:
The primary way to diagnose gallstones is with an ultrasound scan of the abdomen. If the diagnosis is not clear, your doctor may also use other imaging tests like a CT scan or MRI scan.
- Endoscopic Retrograde Cholangiopancreatography (ERCP): A specialized procedure to locate gallstones in the bile ducts.
- Cholescintigraphy: A test to check for abnormal gallbladder contractions or bile duct blockages.
- Blood tests: May be ordered to check for signs of infection or inflammation.
Treatment:
For symptomatic gallstones, the most common treatment is surgery to remove the gallbladder (cholecystectomy).
- Laparoscopic Cholecystectomy: The most common surgical method today, which uses small incisions and a faster recovery time.
- Open Cholecystectomy: An older, less common technique that requires a 4-to-6-inch incision and a longer healing period.
Non-Surgical Alternatives:
In some cases, if a person cannot undergo surgery, non-surgical treatments may be used. These can include:
- ERCP: Can be used to remove stones or help them pass into the bowel.
- Medication: Certain medicines can be used to try and dissolve gallstones. However, this is often a long-term treatment (months to years), and the medications may have limited effectiveness or side effects.