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by Savitsky D

Gallstones

(Biliary Colic; Calculus of Gallbladder; Cholangitis; Cholelithiasis; Cholecystitis; Cholecystolithiasis; Choledocholithiasis)

Definition

Gallstones are pieces of stone-like material that collect in the gallbladder. This is a small organ under the liver that stores a digestive fluid called bile. Gallstones may be as small as a grain of sand or as large as a golf ball. A person may have one large stone, many tiny stones, or both.
Gallstones
IMAGE
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Causes

Gallstones happen when bilirubin or cholesterol crystalize into stones. This may be due to:
  • Too much cholesterol in the bile
  • Too much bilirubin in the bile
  • Not enough bile salts
  • Problems that make it hard for the gallbladder to empty, such as a blockage

Risk Factors

This problem is more common in women. It is also more common in people who are Native American or Scandinavian.
Other things that may raise the risk are:
  • Having other family members who had gallstones
  • Obesity
  • Rapid weight loss or frequent changes in weight
  • History of intestinal problems
  • Being on IV nutrition
  • A high fat diet
  • Lack of physical activity
  • Smoking
  • Taking certain medicines, such as estrogen, cholesterol-lowering drugs, and thiazide diuretics
  • Problems with the liver, such as cirrhosis
  • Crohn disease

Symptoms

Most people do not have symptoms. Those who do may have pain in the upper right side of the belly. It may last 30 minutes to several hours. Other problems may be:
  • Sudden pain after heavy meals
  • Nausea and vomiting
  • Bloating
  • Burping
  • Gas
  • Fever or chills
  • Yellowing of the skin or the whites of the eyes
  • Clay-colored stool

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.
Blood tests will be done to look for signs of infection or inflammation. Urine tests may be also be done.
Images will be taken to look for gallstones. This can be done with:

Treatment

Gallstones that do not cause symptoms do not need to be treated. Options for people who do have symptoms are:
  • Medicine, such as:
    • Pain relievers
    • Bile salt tablets to dissolve the gallstones
  • Shock wave lithotripsy to break up the gallstones
  • ERCP—uses endoscopy and x-rays to locate and remove gallstones
  • Surgery to remove the gallbladder—cholecystectomy

Prevention

This risk of this problem may be lowered by:

RESOURCES

American Liver Foundation
https://www.liverfoundation.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES

Canadian Liver Foundation
https://www.liver.ca
Health Canada
https://www.canada.ca

References

Demehri FR, Alam HB. Evidence-Based Management of Common Gallstone-Related Emergencies. J Intensive Care Med. 2016 Jan;31(1):3-13.
Gallstones. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gallstones. Accessed February 9, 2021.
Gallstones. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/gallstones. Accessed February 9, 2021.
Gallstones. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones. Accessed February 9, 2021.

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