Many people can develop gallstones and never know it. Gallstones are hard deposits in your gallbladder, a small organ that stores bile, a digestive fluid made in the liver. Gallstones may consist of cholesterol, salt, or bilirubin, which are discarded red blood cells. Stones can range in size, from tiny sand grains to large ones the size of golf balls.
Gallstones may develop when there is too much cholesterol in the bile secreted by your liver. Bile usually dissolves or breaks down cholesterol. But if your liver makes more cholesterol than your bile can dissolve, hard stones may develop.
Other causes include the following:
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 in order to be healthy and function properly. If it fails to empty its bile content, the bile becomes overly concentrated, which causes stones to form.
You may be at risk if you have one or more of the following risk factors:
- over the age of 40
- Native American or Hispanic descent
- have or had an organ or bone marrow transplant
- cirrhosis of the liver
- on a low-calorie diet that leads to rapid weight loss
You may not experience any symptoms if you have gallstones. Your doctor may find stones in your gallbladder while doing X-rays or surgery in the abdomen. When symptoms are present, you may experience:
- pain that radiates in your upper abdomen (normally on the right side or in the middle)
- a yellowish tint in your skin or eyes (jaundice)
- nausea or vomiting
- clay-colored stools
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 causes jaundice.
The examination may involve using diagnostic testing to see inside your body. These tests include:
Abdominal CT Scan
This is an imaging test that takes pictures of your liver and abdominal region.
Ultrasound tests produce images of your abdomen.
Gallbladder Radionuclide Scan
This very important scan 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 gauge how well your liver is functioning.
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 symptoms. A surgeon may perform a commonly used technique called laparoscopic gallbladder removal.
General anesthesia is required. Three to four incisions are made on your abdomen. The surgeon inserts a small, lighted device into one of the incisions and carefully removes your gallbladder. You usually go home on the day of the procedure if you have no complications.
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.
Surgery to remove your gallbladder or any stones in your gallbladder is often successful. In most cases, stones do not return.
You can’t prevent gallstones, but you can reduce your risk with lifestyle strategies. Eat a balanced diet. Do not 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 a week. Quick weight loss may increase your risk for gallstones and other health problems.
Written by: Brindles Lee Macon and Winnie Yu
Medically reviewed by George Krucik, MD