Gallstones
Key points
- Gallstones are formed within the gallbladder, an organ that stores bile excreted from the liver.
- Gallstones often have no symptoms and are usually discovered incidentally by a routine x-ray, surgery, or autopsy.
- Symptoms usually start after a stone of sufficient size (larger than 8mm) blocks the cystic duct or the common bile duct.
- Modern advances in surgery have revolutionized the treatment of gallstones.
Alternative names
Cholelithiasis
Definition
Gallstones are formed within the gallbladder, an organ that stores bile excreted from the liver. Bile is a solution of water, salts, lecithin, cholesterol, and other substances. If the concentration of these components changes, they may precipitate from solution and form gallstones.
Gallstones may be as small as a grain of sand, or they may become as large as an inch in diameter, depending on how much time has elapsed from their initial formation.
Causes, incidence, and risk factors
Gallstones often have no symptoms and are usually discovered incidentally by a routine x-ray, surgery, or autopsy.
Gallstones are a common health problem worldwide. They are more common in women, Native Americans, and people over the age of 40.
Other risk factors include ethnic and hereditary factors, obesity, diabetes, liver cirrhosis, long-term intravenous nutrition (total parenteral nutrition), and certain operations for peptic ulcers.
Symptoms
Symptoms usually start after a stone of sufficient size (larger than 8mm) blocks the cystic duct or the common bile duct. The cystic duct drains the gallbladder, and the common bile duct is the main duct draining into the duodenum. Collectively, these ducts form part of the biliary system.
A stone blocking the opening from the gallbladder or cystic duct usually produces symptoms of biliary colic, which is right upper quadrant abdominal pain that feels like cramping. If the stone does not pass into the duodenum, but continues to block the cystic duct, acute cholecystitis results.
If the common bile duct is blocked for a substantial period of time, bacteria may find their way up behind the stone and grow in the stagnant bile, producing symptoms of cholangitis. Cholangitis is a serious condition and usually requires hospitalization. Continued blockage of normal bile flow may produce jaundice.
Stones blocking the lower end of the common bile duct where it enters the duodenum may obstruct secretion from the pancreas, producing pancreatitis. This condition can also be serious and may require hospitalization.
In general, pay attention to the following symptoms:
- Abdominal pain in the right upper quadrant or in the middle of the upper abdomen, which:
o May be recurrent
o May be sharp, cramping, or dull
o May radiate to the back or below the right shoulder blade
o May be made worse by fatty or greasy foods
o Occurs within minutes of a meal
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.