Gallstones can lurk inside your gallbladder. Many people have
gallstones and never know it. Gallstones are hard deposits in your gallbladder,
a small organ that stores bile, which is a digestive fluid made in the liver.
Gallstones may consist of cholesterol, salt, or bilirubin, which is discarded
red blood cells. Gallstones range in size. They can be as small as a grain of
sand or as large as an apricot.
The components in bile can crystallize and harden in your
gallbladder, leading to gallstones. According to Harvard
Health Publications, 80 percent of gallstones are made of cholesterol. The
other 20 percent of gallstones are made of calcium salts and bilirubin. These
are known as pigment stones.
Gallstones may develop when there is too much cholesterol in the
bile secreted by your liver. Bile usually dissolves or breaks down cholesterol.
However, if your liver makes more cholesterol than your bile can dissolve, hard
stones may develop.
Bilirubin is a chemical produced when your liver destroys old red
blood cells. Some conditions, such as cirrhosis of the liver and certain blood
disorders, cause your liver to produce more bilirubin than it should. Stones
form when your gallbladder cannot break down the excess bilirubin. These hard
substances are also called pigmented stones.
Your gallbladder needs to empty bile to be healthy and function
properly. If it fails to empty its bile content, the bile becomes overly
concentrated, which causes stones to form.
Is at Risk for Gallstones?
While your body produces cholesterol naturally, you can also take
in excess cholesterol through your diet. Many risk factors for gallstones are related
to diet. These include:
- being overweight or obese
- eating a diet that’s high in fat or cholesterol
- rapid weight loss within a short period of time
- eating diet that’s high in fiber
- having diabetes mellitus
Other risk factors include:
- being female
- being of American Indian or Mexican-American
- being pregnant
- having a family history of gallstones
- being age 60 or older
- having cirrhosis of the liver
- taking certain medications for lowering
- taking medications that have a high estrogen
Don’t stop taking any medicines unless you have discussed it with
Are the Symptoms of Gallstones?
You may not experience any symptoms if you have gallstones. According
to the American
College of Gastroenterology (ACG), 80 percent of people who have gallstones
don’t have any pain at all. These are called “silent” gallstones. Your doctor
may find these stones in your gallbladder from X-rays or performing surgery on
Some people do have gallstone symptoms. The most common symptom
of gallstones is pain in the right upper quadrant of your abdomen. The pain
often radiates to your back or right shoulder or shoulder blade.
Other symptoms include:
- a yellowish tint in your skin or eyes, which can
- nausea or vomiting
- clay-colored stools
What Are the Stages of Gallbladder Disease?
Extreme gallstone pain is known as a “gallbladder attack.” This
extreme pain lasts more than one to two hours. Gallstones themselves don’t
cause this pain. It occurs when the gallstones block the movement of bile from
the gallbladder. This doesn’t usually happen overnight. Instead, there are
three stages that lead to the attack.
- In stage 1, gallstones form in the gallbladder. Usually,
there’s no pain in this stage.
- In stage 2, you start to experience gallbladder
pain from time to time. You may notice this when you eat foods that are high in
fat, such as fried foods. The pain doesn’t usually extend past a few hours.
Other symptoms can include stomach pain, burping, diarrhea, nausea, and
- In stage 3, a gallstone blocks the duct where
bile moves from the gallbladder, a gallbladder attack occurs. This stage is a
medical emergency. Symptoms can include intense stomach or back pain, fever,
chills, or appetite loss.
According to the American College of
Gastroenterology (ACG), the risk of silent gallstones causing a gallbladder
attack is 1 percent annually. For every 100 people that have silent gallstones,
10 of those people will have an attack within a decade.
Are Gallstones Diagnosed?
Your doctor will perform a physical examination that includes
checking your eyes and skin for visible changes in color. A yellowish tint in
your skin or eyes may be signs of jaundice. Too much bilirubin in your body
The examination may involve using diagnostic testing to see
inside your body. These tests include:
Ultrasound tests produce images of your abdomen. This is the
preferred imaging method to initially confirm that you have gallstone disease.
Abdominal CT Scan
This is an imaging test that takes pictures of your liver and
Gallbladder Radionuclide Scan
This is a very important scan that takes about one hour to
complete. A specialist injects a radioactive substance into your veins. The substance
travels through your blood to the liver and gallbladder. It highlights any
infection or blockages in these organs.
Your doctor may order blood tests that measure the amount of
bilirubin in your blood. The tests also help determine how well your liver is
Are Gallstones Treated?
Your doctor may use any of several treatment options to remove
stones or improve your condition.
Surgery is often the first option if you have significant symptoms.
Your doctor may need to perform a laparoscopic gallbladder
removal, which is a common surgery. General anesthesia is usually required for
gallbladder removal. The surgeon will usually make three or four incisions on
your abdomen. Your surgeon will insert a small, lighted device into one of the incisions
and carefully remove your gallbladder.
You usually go home on the day of the procedure if you have no
Drugs that dissolve gallstones caused by cholesterol are an
option if you cannot undergo surgery. These medications may take several years
to eliminate the gallstones.
Lifestyle Changes After Gallbladder Removal
Much like an appendix, a gallbladder isn’t necessary for a person
to live a full and healthy life. However, you may have loose or watery stools
after gallbladder removal.
This diarrhea occurs because removing a gallbladder involves
rerouting the bile from the liver to the small intestine. Bile no longer goes
through the gallbladder after surgery and it becomes less concentrated. The
result is a laxative effect that causes diarrhea. If you eat a diet lower in
fats, less bile will be released. Examples of dietary steps you can take
- Reduce your intake of fats. Choose low-fat foods
whenever possible. Avoid high-fat, greasy, and fried foods.
- Add fiber to your diet. Extra fiber can make your
bowel movements less liquid. Try to add only a serving of fiber at a time to
prevent gas that can occur from eating excess fiber.
- Avoid foods and drinks known to cause diarrhea,
such as caffeine, high-fat dairy products, and very sweet foods.
- Eat several small meals per day instead of large
meals. Smaller meals are easier for the body to digest.
I Prevent Gallstones?
You can’t prevent gallstones, but you can reduce your risk with
lifestyle strategies. Eat a balanced diet. Don’t skip meals. Drink sufficient
amounts of water each day to keep your body hydrated. If you plan to lose
weight, do it slowly. Aim to lose no more than two pounds per week. Rapid
weight loss may increase your risk of gallstones and other health problems.
Can I Expect in the Long Term?
Surgery to remove your gallbladder or any stones in your
gallbladder is often successful. In most cases, stones don’t return. However,
if you don’t have surgery, the gallstones can return. This is true even when
you’ve taken medicines to dissolve the gallstones.