Math Is Fun Forum

Jai Ganesh

Administrator

Registered: 2005-06-28

Posts: 53,380

Gallstones

Gallstones

Gist

Gallstones are hardened deposits of digestive fluid (cholesterol or bilirubin) that form in the gallbladder. While often asymptomatic, they can cause sudden, severe right upper abdominal pain (biliary colic), nausea, vomiting, and fever if they block bile ducts. Risk factors include being female, age 40+, obesity, and rapid weight loss. Treatment usually involves surgical gallbladder removal (cholecystectomy).

Gallstones form when bile becomes unbalanced, typically from too much cholesterol or bilirubin, or too few bile salts, causing solid crystals to form that harden into stones, often due to the gallbladder not emptying properly. Key causes and risk factors include diets high in fat/cholesterol, obesity, rapid weight loss, certain medications, diabetes, pregnancy, genetics, and liver/blood disorders that increase bilirubin.

Summary

Your gallbladder is a pear-shaped organ under your liver. It stores bile, a fluid made by your liver to digest fat. As your stomach and intestines digest food, your gallbladder releases bile through a tube called the common bile duct. The duct connects your gallbladder and liver to your small intestine.

Your gallbladder is most likely to give you trouble if something blocks the flow of bile through the bile ducts. That is usually a gallstone. Gallstones form when substances in bile harden. Gallstone attacks usually happen after you eat. Signs of a gallstone attack may include nausea, vomiting, or pain in the abdomen, back, or just under the right arm.

Gallstones are most common among older adults, women, overweight people, Native Americans and Mexican Americans.

Gallstones are often found during imaging tests for other health conditions. If you do not have symptoms, you usually do not need treatment. The most common treatment is removal of the gallbladder. Fortunately, you can live without a gallbladder. Bile has other ways to reach your small intestine.

Details

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that's released into your small intestine.

Gallstones are hardened deposits of bile that can form in your gallbladder. Bile is a digestive fluid produced in your liver and stored in your gallbladder. When you eat, your gallbladder contracts and empties bile into your small intestine (duodenum).

Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time.

People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don't cause any signs and symptoms typically don't need treatment.

Symptoms

Gallstones may cause no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, the resulting signs and symptoms may include:

* Sudden and rapidly intensifying pain in the upper right portion of your abdomen
* Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
* Back pain between your shoulder blades
* Pain in your right shoulder
* Nausea or vomiting

Gallstone pain may last several minutes to a few hours.

When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you.

Seek immediate care if you develop signs and symptoms of a serious gallstone complication, such as:

* Abdominal pain so intense that you can't sit still or find a comfortable position
* Yellowing of your skin and the whites of your eyes (jaundice)
* High fever with chills

Causes

It's not clear what causes gallstones to form. Doctors think gallstones may result when:

* Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.
* Your bile contains too much bilirubin. Bilirubin is a chemical that's produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation.
* Your gallbladder doesn't empty correctly. If your gallbladder doesn't empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones.

Types of gallstones

Types of gallstones that can form in the gallbladder include:

* Cholesterol gallstones. The most common type of gallstone, called a cholesterol gallstone, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but may contain other components.
* Pigment gallstones. These dark brown or black stones form when your bile contains too much bilirubin.

Risk factors
Factors that may increase your risk of gallstones include:

* Being female
* Being age 40 or older
* Being a Native American
* Being a Hispanic of Mexican origin
* Being overweight or obese
* Being sedentary
* Being pregnant
* Eating a high-fat diet
* Eating a high-cholesterol diet
* Eating a low-fiber diet
* Having a family history of gallstones
* Having diabetes
* Having certain blood disorders, such as sickle cell anemia or leukemia
* Losing weight very quickly
* Taking medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
* Having liver disease

Complications

Complications of gallstones may include:

* Inflammation of the gallbladder. A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.

* Blockage of the common bile duct. Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Severe pain, jaundice and bile duct infection can result.

* Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from the pancreas and connects to the common bile duct just before entering the duodenum. Pancreatic juices, which aid in digestion, flow through the pancreatic duct.

A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.

* Gallbladder cancer. People with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very small.

Prevention

You can reduce your risk of gallstones if you:

* Don't skip meals. Try to stick to your usual mealtimes each day. Skipping meals or fasting can increase the risk of gallstones.
* Lose weight slowly. If you need to lose weight, go slow. Rapid weight loss can increase the risk of gallstones. Aim to lose 1 or 2 pounds (about 0.5 to 1 kilogram) a week.
* Eat more high-fiber foods. Include more fiber-rich foods in your diet, such as fruits, vegetables and whole grains.
* Maintain a healthy weight. Obesity and being overweight increase the risk of gallstones. Work to achieve a healthy weight by reducing the number of calories you eat and increasing the amount of physical activity you get. Once you achieve a healthy weight, work to maintain that weight by continuing your healthy diet and continuing to exercise.

Additional Information

Gallstones (cholelithiasis) are hardened pieces of bile that form in your gallbladder or bile ducts. They’re common, especially in females. Gallstones don’t always cause problems, but they can if they get stuck in your biliary tract and block your bile flow. If your gallstones cause you symptoms, you’ll need treatment to remove them — typically, surgery.

Overview

Gallstones are hardened pieces of bile sediment that can form in your gallbladder.

What are gallstones?

Gallstones are hardened, concentrated pieces of bile that form in your gallbladder or bile ducts. “Gall” means bile, so gallstones are bile stones. Your gallbladder is your bile bladder. It holds and stores bile for later use. Your liver makes bile, and your bile ducts carry it to the different organs in your biliary tract.

Healthcare providers sometimes use the term “cholelithiasis” to describe the condition of having gallstones. “Chole” also means bile, and “lithiasis” means stones forming. Gallstones form when bile sediment collects and crystallizes. Often, the sediment is an excess of one of the main ingredients in bile.

How serious are gallstones?

Gallstones (cholelithiasis) won’t necessarily cause any problems for you. A lot of people have them and never know it. But gallstones can become dangerous if they start to travel through your biliary tract and get stuck somewhere. They can clog up your biliary tract, causing pain and serious complications.

The problem with gallstones is that they grow — slowly, but surely — as bile continues to wash over them and leave another layer of sediment. What begins as a grain of sand can grow big enough to stop the flow of bile, especially if it gets into a narrow space, like a bile duct or the neck of your gallbladder.

How common are gallstones (cholelithiasis)?

At least 10% of U.S. adults have gallstones, and up to 75% of them are female. But only 20% of those diagnosed will ever have symptoms or need treatment for gallstones.

What are gallstones symptoms?

Gallstones generally don’t cause symptoms unless they get stuck and create a blockage. This blockage causes symptoms, most commonly upper abdominal pain and nausea. These may come and go, or they may come and stay. You might develop other symptoms if the blockage is severe or lasts a long time, like:

* Sweating.
* Fever.
* Fast heart rate.
* Abdominal swelling and tenderness.
* Yellow tint to your skin and eyes.
* Dark-colored pee and light-colored poop.

What is gallstone pain like?

Typical gallstone pain is sudden and severe and may make you sick to your stomach. This is called a gallstone attack or gallbladder attack. You might feel it most severely after eating, when your gallbladder contracts, creating more pressure in your biliary system. It might wake you from sleep.

Gallstone pain that builds to a peak and then slowly fades is called biliary colic. It comes in episodes that may last minutes to hours. The episode ends when and if the stone moves or the pressure eases. People describe the pain as intense, sharp, stabbing, cramping or squeezing. You might be unable to sit still.

Where is gallstone pain located?

Your biliary system is located in the upper right quadrant of your abdomen, which is under your right ribcage. Most people feel gallstone pain in this region. But sometimes, it can radiate to other areas. Some people feel it in their right arm or shoulder or in their back between their shoulder blades.

Some people feel gallstone pain in the middle of their abdomen or chest. This can be confusing because the feeling might resemble other conditions. Some people mistake gallstone pain for heartburn or indigestion. Others might feel like they’re having a heart attack, which is a different emergency.

Are gallstones symptoms different in a female?

No, but females may be more likely to experience referred pain — pain that you feel in a different place from where it started. So, they may be more likely to experience gallstone pain in their arm, shoulder, chest or back.

Females are also more prone to chronic pain, and they may be more likely to dismiss pain that comes and goes, like biliary colic does. It’s important to see a healthcare provider about any severe or recurring pain, even if it goes away. Once you’ve had a gallstone attack, you’re likely to have another.

What triggers gallstone pain?

Gallstone pain means that a gallstone has gotten stuck in your biliary tract and caused a blockage. If it’s a major blockage, you might feel it right away. If it’s only a partial blockage, you might not notice until your gallbladder contracts, creating more pressure in your system. Eating triggers this contraction.

A rich, heavy or fatty meal will trigger a bigger gallbladder contraction. That’s because your small intestine detects the fat content in your meal and tells your gallbladder how much bile it will need to help break it down. Your gallbladder responds by squeezing the needed bile out into your bile ducts.

What are the important warning signs of gallstones?

Biliary colic is the only warning sign of gallstones that you’ll get. It happens when a gallstone causes a temporary blockage, then manages to move out of the way and let bile flow through again. Even though the pain eventually goes away, it’s important to recognize these episodes as the warning that they are.

Once a gallstone has caused a blockage in your biliary tract, it’s likely to keep happening. The same one may be hanging around the same tight spot and continuing to grow. Or you may have more gallstones waiting in the wings. One day, a gallstone might get stuck and stay stuck. This would be an emergency.

---

It appears to me that if one wants to make progress in mathematics, one should study the masters and not the pupils. - Niels Henrik Abel.

Nothing is better than reading and gaining more and more knowledge - Stephen William Hawking.