What are gallstones and how do they form. Why do some people develop gallstones while others don t. What are the most common symptoms of gallstones. How are gallstones typically diagnosed and treated. Can gallstones be prevented through lifestyle changes.

Understanding Gallstones: Formation and Types

Gallstones are solid deposits that form in the gallbladder, a small organ located beneath the liver. These stones develop when there’s an imbalance in the chemical composition of bile, a digestive fluid produced by the liver and stored in the gallbladder. While gallstones are more prevalent in adults, they can also affect children, with approximately 2% of pediatric patients being diagnosed with this condition.

There are two primary types of gallstones:

• Pigment gallstones: These are the most common type in children. They form when bile contains excessive amounts of bilirubin, a byproduct of red blood cell breakdown.
• Cholesterol gallstones: More common in adults, these stones develop when bile mixes with cholesterol and hardens.

The size of gallstones can vary significantly, ranging from tiny grains of sand to structures as large as golf balls. Many individuals have gallstones without experiencing any symptoms, a condition known as asymptomatic gallstones.

Risk Factors and Causes of Gallstone Formation

Several factors contribute to the development of gallstones. Understanding these risk factors can help in prevention and early detection:

• Gender: Females are at higher risk than males, especially those who have had children.
• Age: The risk increases for individuals over 40.
• Body weight: Being overweight or obese is a significant risk factor.
• Rapid weight loss: Crash diets or sudden weight loss can increase the likelihood of gallstone formation.
• Medical conditions: Certain blood disorders, liver diseases, and hormonal imbalances can contribute to gallstone development.
• Medications: Some medications, including oral contraceptives, can increase the risk.
• Genetics: Family history can play a role in gallstone susceptibility.

In children, specific factors may lead to gallstone formation:

• Abnormalities in red blood cell production
• Prolonged fasting due to illness
• Use of contraceptives in adolescents
• Pregnancy in teenage girls
• Long-term parenteral nutrition

Recognizing Gallstone Symptoms: When to Seek Medical Attention

While many people with gallstones remain asymptomatic, others may experience a range of symptoms, particularly after consuming fatty or greasy meals. Common symptoms include:

• Sudden, intense pain in the upper right abdomen (biliary colic)
• Nausea and vomiting
• Fever
• Jaundice (yellowing of the skin and eyes)
• Persistent abdominal discomfort

Is immediate medical attention necessary for all gallstone symptoms? Not always, but certain signs warrant urgent care:

• Severe abdominal pain that doesn’t subside
• Jaundice accompanied by fever and chills
• Persistent vomiting and inability to keep food down
• Signs of infection, such as high fever and chills

If these severe symptoms occur, it’s crucial to seek emergency medical care to prevent complications such as cholecystitis (inflammation of the gallbladder) or cholangitis (infection of the bile ducts).

Diagnosing Gallstones: Medical Tests and Procedures

How do healthcare providers diagnose gallstones? The process typically involves a combination of physical examination, medical history review, and diagnostic tests:

• Ultrasound: This non-invasive imaging technique is the most common method for detecting gallstones.
• CT scan: Provides detailed images of the gallbladder and surrounding structures.
• HIDA scan: A nuclear medicine test that evaluates gallbladder function and detects blockages.
• Blood tests: Help assess liver function and detect signs of infection or inflammation.
• Endoscopic retrograde cholangiopancreatography (ERCP): A procedure that combines endoscopy and X-rays to diagnose and sometimes treat gallstone-related problems.

These diagnostic tools enable healthcare providers to determine the presence, size, and location of gallstones, as well as assess any complications that may have arisen.

Treatment Options for Gallstones: From Watchful Waiting to Surgery

The approach to treating gallstones depends on the severity of symptoms and the presence of complications. Treatment options include:

Watchful Waiting

For asymptomatic gallstones, doctors may recommend monitoring the condition without active intervention. This approach is often suitable for individuals with small, uncomplicated gallstones that aren’t causing symptoms.

Medication

In some cases, medications may be prescribed to dissolve small gallstones. However, this treatment is less common and typically reserved for patients who cannot undergo surgery.

Surgical Intervention

The most effective treatment for symptomatic gallstones is surgical removal of the gallbladder, a procedure known as cholecystectomy. There are two main surgical approaches:

• Laparoscopic cholecystectomy: A minimally invasive procedure using small incisions and a camera.
• Open cholecystectomy: Traditional surgery with a larger incision, usually reserved for complicated cases.

Is it possible to live without a gallbladder? Yes, the body can function normally without this organ. After gallbladder removal, the liver continues to produce bile, which flows directly into the small intestine to aid in digestion.

Preventing Gallstones: Lifestyle Modifications and Dietary Changes

While not all gallstones can be prevented, certain lifestyle changes may reduce the risk of their formation:

• Maintain a healthy weight: Gradual weight loss and avoiding rapid weight fluctuations can help.
• Exercise regularly: Physical activity may lower the risk of gallstone formation.
• Eat a balanced diet: Include plenty of fruits, vegetables, and whole grains while limiting fatty foods.
• Stay hydrated: Adequate water intake may help prevent bile from becoming too concentrated.
• Avoid prolonged fasting: Regular meals help stimulate gallbladder contraction and bile flow.

Do dietary supplements play a role in gallstone prevention? Some studies suggest that vitamin C, coffee, and moderate alcohol consumption may have protective effects, but more research is needed to confirm these findings.

Complications of Untreated Gallstones: Understanding the Risks

When left untreated, gallstones can lead to several serious complications:

• Cholecystitis: Inflammation of the gallbladder, which can cause severe pain and fever.
• Choledocholithiasis: Blockage of the common bile duct, potentially leading to jaundice and infection.
• Pancreatitis: Inflammation of the pancreas due to gallstone obstruction of the pancreatic duct.
• Gallbladder cancer: Although rare, chronic gallstone irritation may increase the risk of gallbladder cancer.

How quickly can complications develop? While some complications may develop gradually, others, such as acute cholecystitis or pancreatitis, can occur suddenly and require immediate medical attention.

Living with Gallstones: Management Strategies and Long-term Outlook

For individuals diagnosed with gallstones, managing the condition involves a combination of medical supervision and lifestyle adjustments:

• Regular check-ups: Even for asymptomatic gallstones, periodic monitoring is essential.
• Dietary modifications: Avoiding trigger foods that exacerbate symptoms can help manage discomfort.
• Pain management: Over-the-counter pain relievers may help alleviate mild symptoms.
• Stress reduction: Since stress can trigger gallbladder attacks, relaxation techniques may be beneficial.

What is the long-term outlook for individuals with gallstones? With proper management and timely treatment, the prognosis is generally good. Many people lead normal, healthy lives after gallbladder removal, while others successfully manage asymptomatic gallstones with lifestyle modifications and regular medical supervision.

In conclusion, understanding gallstones—their causes, symptoms, and treatment options—is crucial for early detection and effective management. By recognizing risk factors and implementing preventive measures, individuals can reduce their likelihood of developing this common yet potentially serious condition. For those already diagnosed with gallstones, working closely with healthcare providers and adhering to recommended treatment plans can ensure optimal outcomes and improved quality of life.

Gallstones – Overview – HSE.ie

Gallstones are small stones that form in the gallbladder. They are usually made of cholesterol – a type of fat found in your blood.

Symptoms of gallstones

In most cases, gallstones don’t cause any symptoms and don’t need to be treated.

But a gallstone can become trapped in an opening (duct) inside the gallbladder. This can trigger a sudden, intense pain around your tummy. This pain usually lasts between 1 and 5 hours. It’s known as biliary colic.

Some people with gallstones can also develop complications. These include inflammation of the gallbladder (cholecystitis). This can cause:

• persistent pain
• jaundice
• a fever

When gallstones cause symptoms or complications, it’s known as gallstone disease or cholelithiasis.

Read about the symptoms of gallstones

The gallbladder

The gallbladder is a small, pouch-like organ. It’s found underneath the liver. Its main purpose is to store and concentrate bile.

Bile is a liquid produced by the liver to help digest fats. It’s passed from the liver into the gallbladder through a series of channels. These are known as bile ducts.

Causes of gallstones

Doctors believe that gallstones develop because of a chemical imbalance in the bile inside the gallbladder. In most cases, the levels of cholesterol in the bile become too high. The excess cholesterol then forms into stones.

Gallstones are very common. Around 1 in 10 adults has gallstones. But only a minority of people develop symptoms.

You’re more at risk of developing gallstones if you’re:

• overweight or obese
• female – particularly if you’ve had children
• 40 or over – the risk increases as you get older

Treating gallstones

Treatment is usually only necessary if gallstones are causing:

• symptoms – such as abdominal pain
• complications – such as jaundice or acute pancreatitis

If this is the case, your doctor may recommend keyhole surgery to remove the gallbladder. This procedure is known as a laparoscopic cholecystectomy. It’s relatively simple to perform. There is a low risk of complications.

You can lead a normal life without a gallbladder. Your liver will still produce bile to digest food.

Outlook

You can treat most cases of gallstone disease with surgery. Only very severe cases can be life threatening. This is usually only if you are already in poor health. Deaths from gallstone disease are rare.

Content supplied by the NHS and adapted for Ireland by the HSE

Page last reviewed: 22 December 2020

Next review due: 22 December 2023

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Gallstones (Cholelithiasis) | Boston Children’s Hospital

 What are gallstones?

Gallstones are solid deposits of digestive fluid in the gallbladder, a small organ that sits just below the liver. Although the condition is more common in adults, about 2 percent of children of children are diagnosed with gallstones. Another word for gallstones is cholelithiasis.

Many people have gallstones without realizing it. Sometimes, however, the gallbladder becomes inflamed or a gallstone moves into a duct or passageway, creating a blockage. When this happens, a child may have abdominal pain and nausea, vomiting and/or fever.

How do gallstones form?

Normally, bile drains from the liver into the small intestine where it helps digest food. Between meals, bile is stored in the gallbladder. Sometimes bile hardens and forms gallstones. Gallstones range in size from small like a grain of sand to the size of a golf ball.

There are different types of gallstones:

• Pigment gallstones are the most common type of gallstone in children. They form when bile contains too much bilirubin, a byproduct of the body’s natural breakdown of red blood cells.
• Cholesterol gallstones are the most common form of gallstone in adults. They form when bile mixes with cholesterol and hardens.

 What causes gallstones?

Girls are at higher risk than boys of developing gallstones. Other than gender, a number of factors can cause gallstones to form. The most common causes in children include:

• abnormalities in the production of red blood cells
• prolonged fasting due to illness
• use of contraceptives
• pregnancy
• long-term parenteral nutrition

 What are the symptoms of gallstones

Often, people have gallstones but no symptoms. If gallstones become symptomatic, the gallbladder typically needs to be removed. Symptoms often flare up after meals, especially meals high in fat or grease.

Symptoms include:

• pain in the upper right abdomen
• nausea
• vomiting
• fever

When to seek emergency medical care

If a child with gallstones experiences any of the following symptoms, they need immediate medical care:

• abdominal pain that is so intense, the child can not get comfortable
• jaundice (a yellowish tint in the eyes and skin)
• fever with chills

 How we care for gallstones

The Division of Gastroenterology, Hepatology and Nutrition at Boston Children’s Hospital will assess your child’s symptoms and order appropriate tests to determine the severity of the gallstones. Depending on the test results, we will determine the best course of treatment for your child with a team of physicians.

 If your child has symptomatic gallstones that require surgery, surgeons in our will use a minimally invasive procedure called a laparoscopic cholecystectomy to remove the blocked gallbladder.

Gallbladder Stones: Main Causes, Symptoms and Treatment Options – July 13, 2021

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Where do stones come from?

To understand this, you must first understand what bile is. It is necessary for the digestion of food, it is formed in the liver, and only accumulates in the gallbladder, so that later it pushes bile into the duodenum. The main components are acids, cholesterol, pigments, lecithin, calcium and mucin-glycoprotein gel. When bile stagnates, crystals fall to the bottom of the bladder and stones form. They come in different sizes, from a few millimeters to a chicken egg, single and multiple.

– The main causes of stone formation include hereditary disorders of cholesterol metabolism, overeating, eating foods rich in cholesterol, fasting or irregular meals, overweight, multiple pregnancies, long-term use of contraceptives and, in general, female gender, chronic pancreatitis, cholecystitis, – says Natalya Ignatova, gastroenterologist of the gastroenterological department of the New Hospital.

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How is cholelithiasis manifested?

In most patients, the presence of stones does not cause any symptoms – they are found incidentally during an examination for another reason. However, they can also cause significant inconvenience.

— Pain in the abdomen, more often in the area of ​​the right hypochondrium, may disturb, — says Ignatova. – Pain can be given to the back or to the right shoulder blade, right shoulder, interscapular region. They will be associated with food, they can be bursting, pressing, short-term. In an acute condition – biliary colic – the pain can be very intense, cutting, intolerable. Also, cholelithiasis can be manifested by nausea, vomiting, stool disorders – loosening, discoloration, alternating constipation and loose stools.

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How is gallstone disease treated?

The first thing to know is that you cannot try to dissolve stones on your own. The fact is that the stones differ from each other in composition, and it is possible to truly determine only on the operating table after extraction. One can only assume their chemical composition by concomitant diseases and frequency of occurrence.

There are several options for treating stones. Medicamentous – dissolution of stones with preparations of bile acids – ursodeoxycholic. The effect of such treatment is up to 60%, – says Ekaterina Skvortsova, general practitioner, therapist at the Medsi clinic. — Shock wave cholelithotherapy — has a limited range of applications. And finally, laparoscopic cholecystectomy is an operation.

— Patients are prescribed ursodeoxycholic acid preparations (Ursosan, Ursofalk, Exhol, Urdox, etc.). Taking therapy in courses, it is possible to restore the normal flow of bile, get rid of congestion, which means there will be no reason for the formation of stones in the future, says Natalia Ignatova. – In the presence of rare episodes of pain syndrome, the situational use of antispasmodics (Drotaverine, Ditsetel, Buscopan, etc. ) is acceptable to relieve symptoms.

And the best treatment is, of course, prevention.

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How to prevent gallstone disease?

Basic prevention is the general principles of rational nutrition. Also important is the normalization of body weight, the mode of work and rest.

“It is necessary to exclude long breaks between meals and overeating, drink enough water per day (at least 2 liters per day), limit the consumption of fatty, smoked foods, fast food, carbonated lemonades, alcohol,” says Skvortsova. – Eat foods should be rich in vegetable fiber, calcium, vitamins, vegetable oils, protein – lean meats, fish. You need a fractional 4 meals a day in moderate portions. It is also necessary to timely identify and treat other diseases of organs and systems.

She notes that phytotherapy for the prevention of gallstone disease is really effective, but the selection of the necessary components, frequency, duration of courses should be determined by the doctor. Independent attempts to “cleanse the liver” often lead to exacerbation, gastritis, inflammation of the intestine.

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What to do if the disease has already been found?

In addition to the basic treatment tactics, patients require special nutrition. The approach to nutrition for people suffering from gallstone disease is Pevzner’s diet number 5.

— Eat small meals 5-6 times a day, avoid very hot or cold foods. Limit foods rich in cholesterol, says Ekaterina Skvortsova. – The use of foods rich in vitamins A, B, C, magnesium – reduce the crystallization process. Weekly it is necessary to spend fasting days on cucumbers, kefir. Limit tea, coffee, dark chocolate.

In case of cholelithiasis, it is necessary to adhere to diet No. 5

Infographics: Vitaly Kalistratov / Network of city portals

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What else to read about medicine?

• Treating the pancreas: how to live with pancreatitis
• Liver diseases: diseases that people learn about too late
• Stomach pain: how not to harm yourself by trying to relieve symptoms

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Why can stones form in the gallbladder and its ducts? First of all, this is due to all sorts of violations of metabolic processes. Normally, the gallbladder acts as a natural reservoir for bile produced by the liver. If the patient develops any metabolic disorders, then cholesterol crystals or insoluble salts combine to form more or less large calculi.

The presence of stones in the gallbladder in a patient in many cases leads to the development of cholecystitis. The fact is that solid stones have a mechanical irritating effect on the walls of this hollow organ, provoking its inflammation.

According to statistics, gallstones are a very common problem. Every tenth person of working age suffers from this disease in our country. In women, this pathology, for a number of reasons, occurs many times more often than in the representatives of the stronger sex.

Reasons why you may need surgery for gallstones

In a healthy person, bile does not thicken. Its liquid consistency throughout the entire time prevents the formation of stones. What can have a negative impact on the work of this organ and lead to a change in the physical properties of bile with the subsequent formation of stones of various sizes? First of all, it is:

• excess cholesterol – that is why gallstones without surgery or with the help of surgery are most often removed by patients from countries whose diet is rich in foods high in protein and fat. In addition, obesity and long-term use of oral contraceptives can lead to an increase in cholesterol levels;
• stagnant processes in the body, violations of the outflow of bile. May be the result of constant flatulence, in which the enlarged intestine puts pressure on other internal organs, as well as physical inactivity, pregnancy and some diets that provide for abnormally long intervals between meals;
• infection of the gallbladder with pathogens, followed by the development of an inflammatory process in it. Bacteria and other microbes can enter this organ either ascending, or with the flow of lymph or blood.

Signs of stones in the patient’s gallbladder

This disease can be asymptomatic for many years. With an increase in the number and size of calculi, the patient may experience such alarming symptoms as:

• pains under the ribs on the right side, which are paroxysmal in nature and can be felt as pressing, stitching or boring;
• nausea and vomiting;
• belching and feeling of bitterness in the mouth;
• feces may be colorless;
• flatulence;
• stool disorders;
• feeling unwell, decreased performance;
• Jaundice is often indicative of the presence of gallstones;
• high temperature, etc.

Most often, in patients suffering from this disease, the so-called biliary colic occurs as a reaction to the presence in the diet that are too heavy for digestion – smoked, fatty, etc. – Varieties of food. In addition, it can occur after physical activity or drinking strong drinks. All these factors can lead to spasm of the muscles of this organ. In addition, often colic manifests itself as a response to the deformation of the walls of the gallbladder with large numerous stones or due to stretching of this organ due to the large amount of bile accumulated inside it. Acute, sometimes unbearable pain occurs when the stone moves along the bile ducts, as well as in case of clogging of the bile duct with stones.

Complications of gallstones

If we talk about the size of the stones, then the diameter of the stones can vary from a few millimeters to two or three centimeters. There are cases when one stone, comparable in size to a chicken egg, occupies the entire gallbladder, ruthlessly stretching and deforming its walls. As for the maximum number of gallstones recorded in one patient, there were about 7000 of them.

In the absence of timely treatment – for example, removal of gallstones without surgery or surgery – the patient may develop complications such as:

• obstruction of the biliary tract, which, in turn, may be followed by infection of the bile and its inflammation with the addition of pancreatitis;
• rupture of an organ too distended with stones, followed by peritonitis;
• in case of movement of especially large calculi from the gallbladder into the intestine – its blockage;
• malignancy of organ cells.

Detection and treatment of gallstones in ON CLINIC in Ryazan

Ultrasound of the gallbladder allows you to confirm or refute a preliminary diagnosis. And it will not be difficult to suspect the presence of gallstones in a patient on the basis of an examination and anamnesis by an experienced gastroenterologist – namely, such specialists see patients daily in the corresponding department of ON CLINIC in Ryazan.