Gallstones

gallstones diagram, gallstone disease

The gallbladder is a small organ on the right side of your abdomen that sits just behind your liver. The gallbladder’s main function is house bile that is released into your small intestine to aid with digestion. If you’ve ever known someone to have a “gallbladder attack,” that means they’re most likely suffering from gallstones.

Read on to learn more about gallstones and how Charleston GI can help!

WHAT ARE GALLSTONES?

Gallstones are hard, pebble-like deposits that form in your gallbladder. These deposits vary in size, are made up of either cholesterol or bilirubin, and stop up your bile ducts. When these deposits cause a blockage, it can result in sudden, severe pain, and you should seek medical attention if you’re experiencing gallbladder pain.

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CAUSE

The cause of gallstones can vary from patient to patient, but there are two main types:

  • Stones made of cholesterol: Cholesterol gallstones are the most common type of gallstones. Typically, the chemicals in your bile work to dissolve cholesterol, but if more cholesterol enters your gallbladder than the bile can dissolve, stones can form. This type is only detectable by sonogram and does not show up on CT scans.
  • Stones made of bilirubin: Gallstones made up of bilirubin are known as pigment stones. Bilirubin is a chemical that is produced by the breakdown of red blood cells. Pigment stones can be a result of your liver producing too much bilirubin, causing deposits to form in the gallbladder.

RISK FACTORS 

Gallstones are more commonly found in those who are:

  • Female
  • Native American
  • Hispanic descent
  • Over 40
  • Overweight

Other factors that may increase an individual’s risk of gallstones include: 

  • A family history of gallstones
  • A sedentary lifestyle
  • A high-fat or high-cholesterol diet
  • Diabetes
  • Liver diseases
  • Rapid weight loss
  • Low-fiber diet
  • Medications containing estrogen, such as birth control pills or hormone therapies
  • Pregnancy
  • Celiac disease
  • Lactose intolerance
  • Long-term intravenous feeding

SYMPTOMS

For some people, gallstones may not cause any symptoms. In others, a “gallbladder attack” may last anywhere from several minutes to a few hours. If you suspect you may have gallstones, you may notice any of the following symptoms:

  • Sudden onset of intensifying pain in the upper, right side or center of your abdomen.
  • Pain in your back, between your shoulder blades
  • Right shoulder pain
  • Nausea or vomiting
  • Fever
  • Jaundice (Yellowing of skin and whites of eyes)

WHEN TO SEE A DOCTOR

We suggest making an appointment with your doctor if your signs or symptoms become worrisome. Seek medical attention immediately if you begin to experience more serious symptoms, such as:

  • Intense, uncomfortable abdominal pain
  • Jaundice
  • High fever

DIAGNOSTIC TEST 

To diagnose your gallstones, your doctor may use one of the diagnostic tests below. Your doctor will decide which test is right for you based on your condition.

  • Endoscopic ultrasound (EUS): This type of ultrasound can evaluate your digestive tract and identify small stones in your gallbladder and bile duct. For the procedure, your doctor will use a thin, flexible endoscope that will pass through your mouth and into your digestive tract. The ultrasound device transmits waves to capture precise images of your digestive tract and its surrounding tissue, including the gallbladder, to determine any presence of gallstones. 
  • Abdominal ultrasound: Abdominal ultrasounds involve using an ultrasound device called a transducer and obtains images of your digestive tract by moving the transducer back and forth across your abdomen. The transducer transmits images to a computer to provide your doctor with an understanding of what’s going on in your digestive tract. An abdominal ultrasound is a common diagnostic test for gallstones, but further testing may be recommended.
  • Blood tests: Blood tests can help your doctor diagnose infection, pancreatitis, jaundice, inflammation, or other issues that may be caused by gallstones.
  • Other Imaging Tests: There are some other imaging tests including magnetic resonance cholangiopancreatography (MRCP), a type of MRI, and endoscopic retrograde cholangiopancreatography (ERCP), a more invasive option where you doctor can diagnose and remove gallstones during the procedure. 

TREATMENT

Treatment for gallstones can include:

  • Surgery to remove gallbladder: The procedures include an open cholecystectomy or more commonly a laparoscopic cholecystectomy.
  • ERCP: An endoscopic retrograde cholangiopancreatography can be used to both find and treat gallstones by removing them during the procedure.
  • Medication to help dissolve gallstones.

PREVENTION

While gallstones can’t always be prevented, you can help lower your risk. There are a few things you can do to help, including:

  • Avoiding rapid weight loss: Losing weight too quickly can increase your risk of gallstones. Losing a maximum of one to two pounds a week is a healthy weight loss goal. 
  • Not skipping meals: Stick to regular meal times every day, as fasting or skipping meals can increase your risk of gallstones.
  • Eating more high-fiber foods: We know that fiber keeps things moving, so enjoy high-fiber foods like fruit, vegetables, and whole grains to lower your risk.
  • Maintaining a healthy weight: Being obese or overweight can increase your risk. Eat a healthy diet and continue a regular exercise schedule to help you maintain a healthy weight and decrease your risk of gallstones.

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GALLSTONE DIET

Eating a healthy diet full of nutrients is a great way to lower your risk of gallstones. Diets rich in processed foods, refined sugars, and saturated fat may lead to a greater risk of gallbladder problems.

FOODS TO AVOID WITH GALLSTONES

Cholesterol has been shown to have an effect on the formation of gallstones, so our gastroenterologists advise steering clear of the following foods for your gallbladder’s health:

  • Sausages
  • Fatty cuts of meat
  • Butter, ghee, and lard
  • Creams or hard cheeses
  • Cakes and biscuits
  • Coconut oil or palm oil
  • Alcohol
  • Refined sugars, such as fructose
  • Foods high in added sugars, such as baked goods and sweets
  • Fast food
  • High-fat foods (saturated fat)
  • Trans fats, like fried foods
  • Low-fiber diet

FOODS TO HELP RELIEVE GALLSTONES

Our doctors recommend maintaining a healthy, nutrient-rich, balanced diet to help lower your risk of gallstones. Increase your intake of the following foods to help continue lowering your risk of gallstones:

  • Fruits
  • Vegetables
  • Beans and peas
  • Whole grains, like oats, brown rice, and whole wheat bread
  • Nuts, such as cashews and peanuts
  • Healthy fats, like olive oil and avocados
  • Fish  

FREQUENTLY ASKED QUESTIONS

How serious is having gallstones?

A blockage caused by gallstone can cause serious complications, including pancreatitis, infection, bile duct inflammation, and gallbladder inflammation. Untreated gallstones can increase your risk of gallbladder cancer.

What are some complications of gallstones?

Gallstones blocking the bile duct can result in infection or inflammation of the pancreas, gallbladder, and/or the tube that is responsible for transporting bile to from the liver to the gallbladder and intestines.

How common are gallstones?

Gallstones affect around 10% of adults and 20% of adults over the age of 65%. Of those diagnosed with gallstones, only about 20% require treatment.

How does having gallstones (cholelithiasis) affect me?

Your gallbladder is a part of a system of organs that pass bile between one another. These organs are connected by bile ducts, which are responsible for allowing the bile to travel from your liver to your gallbladder to your small intestine. Your bile ducts also help support your pancreas in the delivery of its own digestive juices.

If your bile duct is congested by a gallstone, it can cause a back-up of bile into the other organs. The backed-up bile can cause intense pain, pressure, inflammation, and in some cases, infection.

What diseases and conditions can gallstones lead to?

Untreated gallstones can potentially result in several different complications:

  • Gallbladder disease: Gallstones can become stuck in the bile ducts, and the backed-up bile can cause inflammation of the gallbladder. Not addressing gallstones can cause damage to your gallbladder, resulting in impaired gallbladder function and scar tissue. The blocked bile and inflammation increases the risk of infection.
  • Liver disease: Gallstones can cause the backed-up bile to end up in your liver. This causes inflammation of the liver, increasing your risk of infection and cirrhosis. A poor functioning liver can cause the entire biliary system to break down.
  • Gallstone pancreatitis: A gallstone can also block the pancreatic bile duct which leads to inflammation of your pancreas. This inflammation and infection can cause pain and has potential to cause long-term damage if the inflammation becomes chronic. 
  • Cholangitis: Cholangitis is the infection of the tube that carries bile from one organ to another. A scarred, inflamed bile duct becomes narrow, further restricting the flow of bile between organs. It’s important to get the gallstone removed to avoid long-term problems related to the blockage.
  • Jaundice: A clogged up bile duct can cause bile to leak into your bloodstream. It’s the bile’s job to carry toxins that your liver has filtered, so with a blockage, those toxins will end up in your blood streams. Bilirubin is yellow in color, which is what causes the whites of your eyes to become yellow when jaundiced. 
  • Malabsorption: When your bile is not properly traveling to your small intestines, this can lead to digestive difficulties and an inability to absorb nutrients. Bile breaks down fats and helps your small intestine absorb fat-soluble vitamins that are important for your digestive health.

What is the main cause of gallstones?

Most gallstones found are primarily made up of excess cholesterol, so the cause of many gallstones are contributed to having too much cholesterol in your blood. There are many different causes for high cholesterol, including obesity and diabetes. If your blood has a high amount of cholesterol in it, that means your bile has a high cholesterol content as well. If your bile contains a high amount of cholesterol, it won’t be able to sufficiently dissolve it. 

Who gets gallstones?

Anyone is at risk for gallstones, including children. Gallstones are most commonly found in adults over 40 because of how slow gallstones grow. Female hormones increase the risk of gallstones, making women more at risk than men. 

Other risk factors to consider:

  • Individuals of Native American or Mexican descent.
  • Those who have been diagnosed with metabolic syndrome.

Why are women at higher risk of getting gallstones?

Estrogen can increase cholesterol levels in the blood, and progesterone is known to slow down gallbladder contractions. Both of these hormones fluctuate throughout a female’s cycle and play an important role in reproduction. Females who use oral contraceptives or hormone therapy are also at risk. Being overweight can also increase estrogen and increase cholesterol blood levels, increasing the risk of gallstones.

What are the first signs of having gallstones?

Gallstones only become noticeable when one gets lodged, resulting in a bile blockage. Most people suffering from gallstones experience abdominal pain, most commonly in the right, upper section of the abdomen. Most experience these “episodes” following a rich or large meal, which is when your gallbladder contracts and sends out bile for digestion.

If you feel this pain only on occasion, you may have a partial blockage. This warning sign is pressure building up when your gallbladder contracts to send bile to the small intestine.

What does gallstone pain feel like?

Most people will feel abdominal pain in the upper, right section of their abdomen, under the ribcage. You may also feel pain in the center of your abdomen below the breastbone or in your right shoulder. It can be a dull ache or an intensifying pain that comes in waves.

What else causes cholelithiasis?

Some of the other factors that contribute to gallstones include:

  • Excess bilirubin: Gallstones made up of excess bilirubin are known as pigment stones. Bilirubin is produced by your liver when it’s breaking down red blood cells. Your liver may produce excess bilirubin due to a medical disorder like infections, liver disease, or blood disorders.
  • Gallbladder stasis: This happens when bile is left behind after a gallbladder contraction attempts to move the bile out of the gallbladder. Bile that isn’t moved out of the liver can create a sludge-like substance that crystallizes at the bottom of your gallbladder.

Can gallstones go away without surgery?

There is a chance for your gallstone to pass through the bile duct, into your intestines, then out of your body through your poop. Some medications can be used to dissolve the stones, but they are typically slow to work. If you’re actively experiencing symptoms, this may not be a great option. 

What is the recovery time for gallstone surgery?

A laparoscopic cholecystectomy has a quick recovery, and you’ll typically be home within 24 hours of the procedure. Most patients are fully recovered in about two weeks. An open cholecystectomy is more invasive and requires a hospital stay of about three to five days following the surgery. With an open cholecystectomy, you’ll need to recover for about six to eight weeks. Your digestive system will take about two to eight weeks to adjust.

What happens when you don’t have a gallbladder anymore?

The good news is your digestive system can function without your gallbladder. The gallbladder acts as a holding place for your bile and delivers it to your small intestine for digestion. Your doctor will redirect your bile ducts straight to your small intestine to aid with digestion. 

What can I eat after gallstone surgery?

You’ll want to take it easy following gallbladder removal, as it will take a few weeks for your body to adjust. You may experience some indigestion or diarrhea while your body gets used to functioning without the gallbladder. Your doctor will instruct you on what to eat and what to avoid. You’ll be back to yourself in no time!

What is the prognosis if I have gallstones (cholelithiasis)?

If you’ve been diagnosed with gallstones, but don’t have any symptoms, you’ll likely remain asymptomatic. If you’re experiencing symptoms with your gallstones, the most common treatment is cholecystectomy, or gallbladder removal. Most patients recover well and easily adjust to digesting without a gallbladder, with little to not issues. 

When should I seek medical attention for gallstones?

If you’re experiencing severe pain, seek medical attention. A “gallbladder attack” can last anywhere from 20 minutes to several hours, with pain in the upper, right section of your abdomen. If your pain is accompanied by nausea and vomiting, emergency medical attention may be necessary.

Can gallstones go away on their own?

There is a chance for your gallstones to resolve themselves. It is more common like you will need treatment. If you’re not experiencing any symptoms, maintain a healthy diet and exercise regimen to lower your risk of them becoming more serious.

When should you go to the ER for gallbladder?

If you’ve been experiencing severe abdominal pain, nausea, or vomiting for more than two hours or also have a fever, seek emergency medical care.

Do gallstones cause gas?

With gallstones, you may also experience flatulence, feeling too full, nausea, regurgitation, or vomiting. 

Can walking get rid of gallstones?

Studies show that a regular exercise routine can help lower your risk of gallbladder issues. While exercising can help reduce your risk or manage your symptoms, there’s no evidence that walking or other forms of exercise can remove the stones.

How long can gallstones go untreated?

Gallstones grow very slowly and can take 10 to 20 years to grow large enough for you to notice. As long as you’re not experiencing symptoms, they can be left untreated. Talk to your doctor if you notice any symptoms of gallstones.

Can drinking water remove gallstones?

Drinking water can help your gallstones. Drinking enough water is safe and a non-invasive option for helping shrink your the stones. Talk to your doctor about your water intake and how it can affect your gallbladder.

Does apple cider vinegar help get rid of gallstones?

Apple cider vinegar has been shown to be a helpful supplement for blood sugar management, but there isn’t evidence to support its use for treating gallstones. 

Can stress cause gallbladder attacks?

Eating in a hurry or eating when stressed or angry may lead to bile duct spasms, which can lead to digestive problems and liver-gallbladder issues.

Is lemon water good for gallstones?

The pectin in lemon can be helpful for stopping bile acids from being reabsorbed in the gut. This can prevent gallstones from forming. In addition, lemon juice encourages the gallbladder to contract and efficiently move bile and small gallstones out of the organ.

What drinks aggravate it?

Sugary drinks and alcohol can negatively affect your gallbladder’s function. When you’re thirsty, choose water for its many benefits and ability to help detoxify your gallbladder.

Are there other medical names for gallstones?

Other terms for gallstones and gallstone-related pain includes:

  • Cholelithiasis
  • Gallbladder attack
  • Biliary colic
  • Gallstone attack
  • Biliary calculus: gallstones chenodeoxycholic acids (CDCA)
  • Ursodeoxycholic acid (UDCA, ursodiol)

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