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Severe and sudden pain in the
upper right abdomen and possibly
extending to the upper back.
-
Fever and shivering.
-
Severe nausea and vomiting.
-
Jaundice (yellowing of the skin
or eyes)
-
Clay colored stools or dark
urine.
The gallbladder is
a small pear-shaped saclike organ in
the upper right part of the abdomen.
It is located under the liver,
just below the front rib cage on the
right side. The gallbladder is part
of the biliary system,
which includes the liver and the
pancreas. The
biliary system, among
other functions, transports bile and
digestive enzymes.
Bile is a fluid made by the liver to
help in the digestion of fats.
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It contains several different
substances, including cholesterol and
bilirubin, a waste product of
normal breakdown of blood cells
in the liver.
-
Bile is stored in the
gallbladder until needed.
-
When we eat a high-fat,
high-cholesterol meal, the
gallbladder contracts and
injects bile into the small
intestine via a small tube
called the common
bile duct. The bile then assists
in the digestive process.
There are two types of gallstones:
1) cholesterol stones and 2) pigment
stones.
-
Patients with cholesterol
stones are
more common in the United
States; cholesterol stones make
up a majority of all gallstones
(in the U.S., about 80%). They
form when there is too much
cholesterol in the bile.
-
Pigment stones form
when there is excess bilirubin
in the bile.
Gallstones can be any size, from
tiny as a grain of sand to large as
a golf ball.
-
Although it is common to have
many smaller stones, a single
larger stone or any combination
of sizes is possible.
-
If stones are very small, they
may form a sludge or slurry.
-
Whether gallstones cause
symptoms depends partly on their
size and their number, although
no combination of number and
size can predict whether
symptoms will occur or the
severity of the symptoms.
Gallstones within the gallbladder
often cause no problems. If there
are many or they are large, they may
cause pain when the gallbladder
responds to a fatty meal. They also
may cause problems if they block
bile from leaving the gallbladder or
move out of the gallbladder and
block the bile duct.
-
If their movement leads to
blockage of any of the ducts
connecting the gallbladder,
liver, or pancreas with the
intestine, serious complications
may result.
-
Blockage of a bile duct can
cause bile or digestive enzymes
to be trapped in the duct.
-
This can cause inflammation and
ultimately severe pain,
infection, and organ damage.
-
If these conditions go
untreated, they can even cause
death.
Up to 20% of adults in the United
States may have gallstones, yet only
1%-3% develop symptoms.
-
Hispanics, Native Americans, and
Caucasians of Northern European
descent are most likely to be at
risk for gallstones. African
Americans are at lower risk.
-
Gallstones are most common among overweight,
middle-aged women, but the
elderly and men are more likely
to experience more serious
complications from gallstones.
-
Women who have been pregnant are
more likely to develop
gallstones. The same is true for
women taking birth
control pills
or on hormone/estrogen therapy
as this can mimic pregnancy in
terms of hormone levels.
What Causes Gallstones?
Gallstones occur when bile forms
solid particles (stones) in the
gallbladder.
-
The stones form when the amount
of cholesterol or bilirubin in
the bile is high.
-
Other substances in the bile may
promote the formation of stones.
-
Pigment stones form most often
in people with liver
disease or
blood disease, who have high
levels of bilirubin.
-
Poor muscle tone may keep the
gallbladder from emptying
completely. The presence of
residual bile may promote the
formation of gallstones.
Risk factors for the formation of
cholesterol gallstones include the
following:
-
female gender,
-
being overweight,
-
rapid weight
loss on
a "crash" or starvation diet,
or
-
taking certain medications such
as birth
control pills
or cholesterol lowering drugs.
Gallstones are the most common cause
of gallbladder disease.
-
As the stones mix with liquid
bile, they can block the outflow
of bile from the gallbladder.
They can also block the outflow
of digestive enzymes from the
pancreas.
-
If the blockage persists, these
organs can become inflamed.
Inflammation of the gallbladder
is called cholecystitis. Inflammation
of the pancreas is
called pancreatitis.
-
Contraction of the blocked
gallbladder causes increased
pressure, swelling, and, at
times, infection of the
gallbladder.
When the gallbladder or gallbladder
ducts become inflamed or infected as
the result of stones, the pancreas
frequently becomes inflamed too.
-
This inflammation can cause
destruction of the pancreas,
resulting in pancreatitis and
severe abdominal
pain.
-
Untreated gallstone disease can
become life-threatening,
particularly if the gallbladder
becomes infected or if the
pancreas becomes severely
inflamed.
