- Gallstones are pieces of hard, solid matter that form over time in the gallbladder of some people.
- The gallbladder sits under the liver and stores bile (a key digestive “juice”).
- Gallstones form when the parts of bile — such as cholesterol and bilirubin — form crystals, much as sugar may collect in the bottom of a syrup jar.
- A person can have a single gallstone or hundreds, and these can differ in size from very small (like a grain of sand) to more than one inch (like a golf ball).
- Sometimes the gallbladder has only crystals and stones too small to see with the naked eye. This is called biliary sludge.
- Almost one million Americans are found to have gallstones (gallstone disease) each year.
- There are many ways to treat gallstones, with the most common being to remove the gallbladder.
- Many people with gallstones have no symptoms.
- Often, gallstones are found when a test is done to look at some other problem. So-called silent gallstones are likely to remain silent, and usually no treatment is needed.
- The Gallbladder
- The gallbladder is a sac about the size and shape of a pear that lies under the liver in the upper right-hand part of your abdomen.
- It is joined to the liver and the intestine by a series of small tubes, or ducts.
- The main job of the gallbladder is to store bile, which is made and secreted continuously by the liver, until the bile is needed to aid in digestion.
- After a meal, the gallbladder contracts and bile flows into the intestine.
- When digestion of the meal is over, the gallbladder relaxes and once again starts to store bile.
- Bile is a yellow-brown liquid made from bile salts, cholesterol, bilirubin and lecithin.
- The liver makes about three cups of bile each day.
- Some parts of the bile, such as bile salts and lecithin, act like detergents to break up fat so that it can be easily digested.
- Others, like bilirubin, are waste products. Bilirubin is a dark-brown substance that gives a brown color to bile and stool.
The most typical symptoms of gallstones
(gallstone disease) are:
- Intermittent pain in the upper abdomen, usually on the right side or centrally.
- The pain may be severe.
- The pain may last for as little as 15 minutes or as long as several hours.
- The pain may also be felt between the shoulder blades or in the right shoulder.
- Sometimes patients also have vomiting or sweating.
- The pain often starts after eating, but may awaken patients from sleep.
- Attacks of gallstone pain may be separated by weeks, months or even years.
It is not fully known why some people get gallstones and others don’t. There are certain things, though, that are known to raise the chances of getting gallstones:
Pigment (bilirubin) gallstones
- A greater amount of cholesterol or bilirubin in bile.
- Hormones or medications that result in decreased emptying of the gallbladder.
- Not having an active lifestyle.
- Being female.
- Being over 40 years old.
- Liver disease.
- Family history of gallstones.
are found most often in:
- Patients with severe liver disease.
- Patients with some blood diseases, such as sickle cell anemia and leukemia.
are more common and found most often in:
- Women over 20 years of age.
- Pregnant women.
- Men over 60 years of age.
- Overweight men and women.
- People on “crash diets” who lose a lot of weight quickly.
- People who use certain medications, such as birth control pills and cholesterol-lowering agents.
- Native Americans and Hispanics of Mexican origin.