Robert Wood Johnson University Hospital
 

Gallstones

Gallstones

About gallstones

There are two types of gallstones: cholesterol stones and pigment stones. Eighty percent of gallstones are cholesterol stones. The size of gallstones varies from a grain of salt to golf-ball size. A person can develop a single stone or several hundred.

What are gallstones?

Gallstones form when bile stored in the gallbladder hardens into stone-like material. Too much cholesterol, bile salts, or bilirubin (bile pigment) can cause gallstones.

When gallstones are present in the gallbladder itself, it is called cholelithiasis. When gallstones are present in the bile ducts, it is called choledocholithiasis. Gallstones that obstruct bile ducts can lead to a severe or life-threatening infection of the bile ducts, pancreas, or liver. Bile ducts can also be obstructed by cancer or trauma, but this is not related to gallstones.

What causes gallstones?

Cholesterol stones are believed to form when bile contains too much cholesterol, too much bilirubin, not enough bile salts, or when the gallbladder does not empty as it should for some other reason.

Pigment stones tend to develop in people who have cirrhosis, biliary tract infections, and hereditary blood disorders such as sickle cell anemia. The causes of these stones are uncertain.

What are the symptoms of gallstones?

At first, most gallstones do not cause symptoms. However, when gallstones become larger, or when they begin obstructing bile ducts, symptoms or "attacks" begin to occur. Attacks of gallstones usually occur after a fatty meal and at night. The following are the most common symptoms of gallstones. However, each individual may experience symptoms differently. Symptoms may include:

People who experience the following symptoms should consult their doctor immediately:

Some people with gallstones do not present any symptoms. These stones are called "silent stones," as they do not interfere with the function of the gallbladder, liver, or pancreas, and do not require treatment in most cases.

The symptoms of gallstones may resemble other conditions or medical problems, such as heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, or hepatitis. Always consult your health care provider for a diagnosis.

What is a risk factor?

A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things.

Different diseases, including cancers, have different risk factors. Although these risk factors increase a person's risk, they do not necessarily cause the disease.

Some people with one or more risk factors never develop the disease, while others develop disease and have no known risk factors. But, knowing your risk factors to any disease can help to guide you into the appropriate actions, including changing behaviors and being clinically monitored for the disease.

Who is affected by gallstones?

The following are suggested risk factors for gallstones:

How are gallstones diagnosed?

In some cases, asymptomatic gallstones are discovered by accident--during testing for another diagnosis. However, when pain persists or happens again and again, your health care provider may want to conduct a complete medical history and physical examination, in addition to the following diagnostic procedures for gallstones:

Treatment for gallstones

Specific treatment for gallstones will be determined by your health care provider based on:

If the gallstones cause no symptoms, treatment is usually not necessary. However, if pain persists, treatment may include:

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