Gallstones: What You Should Know

What Are Gallstones?

They aren’t really stones. They're pieces of solid material that form in the gallbladder, a small organ located under the liver.

You might not even know you have them until they block a bile duct, causing pain that you need to get treated right away.

Types

The two main kinds are:

Cholesterol stones. These are usually yellow-green in color. They're the most common kind, accounting for 80% of gallstones.
Pigment stones. These stones are smaller and darker. They're made up of bilirubin, which comes from bile, a fluid your liver makes and your gallbladder stores.

What Causes Gallstones?

There may be several reasons, including:

Your genes
Your weight
Problems with your gallbladder
Diet

Bile can be part of the problem. Your body needs bile, but if it has too much cholesterol in it, that makes gallstones more likely.

It can also happen if your gallbladder can’t empty properly.

Pigment stones are more common in people with certain medical conditions, such as cirrhosis (a liver disease) or blood diseases such as sickle cell anemia.

Am I at Risk?

You're more likely to get gallstones if:

You're obese. This is one of the biggest risk factors. Obesity can raise your cholesterol level and also make it harder for the gallbladder to empty completely.

You take birth control pills, hormone replacement therapy for menopause symptoms, or are pregnant. The extra estrogen is the problem. It can increase cholesterol and make it harder for the gallbladder to empty.

You have diabetes. People with this condition tend to have higher levels of triglycerides (a type of blood fat), which is a risk factor for gallstones.

You take medicine to lower your cholesterol. Some of these drugs boost the amount of cholesterol in bile, which may increase your chances of getting cholesterol stones.

You lost weight too quickly. Your liver makes extra cholesterol, which may lead to gallstones.

You’re fasting. Your gallbladder may not squeeze as much.

Gallstones are also more likely if they run in your family, and they're likelier among women, older people, and some ethnic groups, including Native Americans and Mexican-Americans.

What Are the Symptoms?

You might not notice anything, or even know you have gallstones, unless your doctor tells you. But if you do get symptoms, they usually include:

Pain in your upper belly and upper back that can last for several hours
Nausea
Vomiting
Other digestive problems, including bloating, indigestion and heartburn, and gas

How Do Doctors Diagnose Them?

If your doctor thinks you may have gallstones, he'll give you a physical exam. You may also get:

Blood tests to check for signs of infection or obstruction, and to rule out other conditions.

Ultrasound. This quick procedure is done in your doctor’s office, and it makes images of the inside of your body.

CT scan. Specialized X-rays allow your doctor to see inside your body, including your gallbladder.

Magnetic resonance cholangiopancreatography (MRCP). This test uses a magnetic field and pulses of radio-wave energy to make pictures of the inside of your body, including the liver and the gallbladder.

Cholescintigraphy (HIDA scan). This test can check on whether the gallbladder squeezes correctly. Doctors inject a harmless radioactive material, which makes its way to the organ. The technician can then watch its movement.

Endoscopic ultrasound. This test combines ultrasound and endoscopy to look for gallstones.

Endoscopic retrograde cholangiopancreatography (ERCP). The doctor inserts an endoscope through your mouth down to the small intestine and injects a dye to allow the bile ducts to be seen. He can often then remove any gallstones that have moved into the ducts.

What’s the Treatment?

Many people with gallstones get surgery to take out the gallbladder. There are two different kinds of operations.

Laparoscopic cholecystectomy. This is the more common procedure. The surgeon passes instruments, a light, and a camera through several small cuts in the belly. He views the inside of the body on a video monitor. Afterward, you spend the night in the hospital.

Open cholecystectomy. The surgeon makes bigger cuts in the belly to remove the gallbladder. You stay in the hospital for a few days after the operation.

If gallstones are in your bile ducts, the doctor may use ERCP to find and remove them before or during gallbladder surgery.

Can You Treat Gallstones Without Surgery?

If you have a medical condition and your doctor feels you shouldn't have an operation, he may prescribe the medications chenodiol (Chenix), ursodiol (Actigall), or both. These drugs work by dissolving cholesterol stones. Mild diarrhea can be a side effect.

The downside of using either medication is that you may have to take it for years to completely dissolve the stones, which may come back after you stop taking the drug.

Picture of the Gallbladder

Human Anatomy

By Matthew Hoffman, MD

Picture of Liver with Gallbladder — © 2014 WebMD, LLC. All rights reserved.

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Front View of the Gallbladder

The gallbladder is a small pouch that sits just under the liver. The gallbladder stores bile produced by the liver. After meals, the gallbladder is empty and flat, like a deflated balloon. Before a meal, the gallbladder may be full of bile and about the size of a small pear.

In response to signals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts. Bile helps digest fats, but the gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion yet there may be a small risk of diarrhea and fat malabsorption.

Get more information from WebMD videos on gallbladder basics.

Gallbladder Conditions

Gallstones (cholelithiasis): For unclear reasons, substances in bile can crystallize in the gallbladder, forming gallstones. Common and usually harmless, gallstones can sometimes cause pain, nausea, or inflammation.
Cholecystitis: Inflammation of the gallbladder, often due to a gallstone in the gallbladder. Cholecystitis causes severe pain and fever, and can require surgery when inflammation continues or recurs.
Gallbladder cancer: Although rare, cancer can affect the gallbladder. It is difficult to diagnose and usually found at late stages when symptoms appear. Symptoms may resemble those of gallstones.
Gallstone pancreatitis: An impacted gallstone blocks the ducts that drain the pancreas. Inflammation of the pancreas results, a serious condition.

Gallbladder Tests

Abdominal ultrasound: a noninvasive test in which a probe on the skin bounces high-frequency sound waves off structures in the belly. Ultrasound is an excellent test for gallstones and to check the gallbladder wall.
HIDA scan (cholescintigraphy): In this nuclear medicine test, radioactive dye is injected intravenously and is secreted into the bile. Cholecystitis is likely if the scan shows bile doesn’t make it from the liver into the gallbladder.
Endoscopic retrograde cholangiopancreatography (ERCP): Using a flexible tube inserted through the mouth, through the stomach, and into the small intestine, a doctor can see through the tube and inject dye into the bile system ducts. Tiny surgical tools can be used to treat some gallstone conditions during ERCP.
Magnetic resonance cholangiopancreatography (MRCP): An MRI scanner provides high-resolution images of the bile ducts, pancreas, and gallbladder. MRCP images help guide further tests and treatments.
Endoscopic ultrasound: A tiny ultrasound probe on the end of a flexible tube is inserted through the mouth to the intestines. Endoscopic ultrasound can help detect choledocholithiasis and gallstone pancreatitis.
Abdominal X-ray: Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect gallstones.

Gallbladder Treatments

Gallbladder surgery (cholecystectomy): A surgeon removes the gallbladder, using either laparoscopy (several small cuts) or laparotomy (traditional “open” surgery with a larger incision).
Antibiotics: Infection may be present during cholecystitis. Though antibiotics don’t typically cure cholecystitis, they can prevent an infection from spreading.
Chemotherapy and radiation therapy: After surgery for gallbladder cancer, chemotherapy and radiation may be used to help prevent cancer from returning.
Ursodeoxycholic acid: In people with problems from gallstones who are not good candidates for surgery, this oral medicine is an option. Ursodeoxycholic acid may help dissolve small cholesterol gallstones and reduce symptoms. Another oral solution is called Chenix.
Extracorporeal shock-wave lithotripsy: High-energy shockwaves are projected from a machine through the abdominal wall, breaking up gallstones. Lithotripsy works best if only a few small gallstones are present.
Contact solvent dissolution: A needle is inserted through the skin into the gallbladder, and chemicals are injected that dissolve gallstones. This technique is rarely used.

more informations; -

Gallbladder:

Function,

Problems &

Healthy Diet

By Jessie Szalay, Live Science Contributor | May 5, 2016 01:15pm ET

The gallbladder, shown in red, lies beneath the liver within the torso.
Credit: Sebastian Kaulitzki | Dreamstime

The gallbladder is an organ that is part of the human biliary system, which is involved with the production, storage and transportation of bile. Bile is a yellowish-brown fluid produced by the liver and used to break up and digest fatty foods in the small intestine.

The gallbladder is not absolutely necessary for human survival, as bile can reach the small intestine in other ways, according to Britain’s National Health Service. Some problems associated with the gallbladder are gallstones, gallbladder attack and gallbladder disease. Gallbladder pain is usually caused by biliary colic, gallstones, cholecystitis, pancreatitis and cholangitis, according to MedicineNet.

Gallstones

Gallstones are solidified particles of substances in the bile. They are made of a “combination of bile salts, cholesterol and bilirubin,” said Jordan Knowlton, an advanced registered nurse practitioner at the University of Florida Health Shands Hospital. Gallstones can be as small as a grain of sand or as large as a golf ball, according to

“Gallstones can be painful, and cause obstruction,” Knowlton said. “Depending on where the obstruction is, [it] causes a variety of problems: gallbladder obstruction (cholecystitis), biliary tree obstruction (jaundice) and pancreatic duct obstruction (pancreatitis).” Gallstones can block the gallbladder ducts so that bile cannot reach the small intestine as effectively, which may prevent the gallbladder from doing its job and can lead to other gallbladder diseases.

Knowlton explained that while most gallstones pass on their own, some require a minor procedure or even surgery. “Diagnosis can be made by labs, ultrasound, or Hida scan,” she said.

According to the Mayo Clinic, factors that contribute to the risk of gallstones include obesity, high-fat or high-cholesterol diets, diabetes and taking medicines with estrogen. Women, people over 60, Native Americans and Mexican-Americans are also at a higher level of risk.

Gallbladder attack

Gallstones can cause sudden pain that is called a gallbladder attack, according to the National Institutes of Health (NIH). Gallbladder attacks are usually the result of the gallstone blocking the bile ducts, thereby increasing pressure in the gallbladder. They usually occur soon after eating, especially heavy meals. According to the NIH, they can last from one to several hours or, according to the Mayo Clinic, as little as several minutes. The University of Maryland Medical Center lists the following as symptoms of a gallbladder attack: nausea, vomiting, loss of appetite and pain primarily in the upper right side of the abdomen. Pain may be acute or dull, and may be accompanied by jaundice.

The University of California San Francisco Department of Surgery pointed out that the symptoms of a gallbladder attack may be similar to those of a heart attack and other conditions, so it isIMPORTANT

to consult a doctor for a correct diagnosis.

Gallbladder disease

There are several types of gallbladder disease:

Cholecystitis

is the most common type of gallbladder disease, and often what medical professionals associate with the phrase. Knowlton described it as “inflammation of the gallbladder.” It is caused by gallstones obstructing the ducts to the small intestine. In addition to upper right abdominal pain, Knowlton said, cholecystitis carries with it a variety of symptoms, “including fever, positive Murphy’s sign [pain when the abdominal area is examined], nausea and vomiting.” She said, “treatment depends on the severity of the symptoms ... this can often be managed by rest and antibiotics, but for severe cases, surgery is the definitive treatment.”

According to the NIH, after several attacks of pain, chronic cholecystitis may occur. This involves the gallbladder shrinking and losing its function.

“Those prone to gallbladder disease usually fall into the “5 F's”: fair, fat, 40, female, and flatulent!” said Knowlton.

Choledocholithiasis

is the “presence of at least one gallstone in the common bile duct,” according to Penn Medicine. It can block the flow of bile and cause the gallbladder to become inflamed or distended.

Acalculous gallbladder disease

occurs without the presence of gallstones, according to the University of Maryland Medical Center. It happens when the gallbladder muscles or valve are not working correctly, and is often found in patients who are suffering from other serious disorders.

Cholangitis

is inflammation in the common bile duct. According to the Medical University of South Carolina’s Digestive Disease Center, the most common cause is gallstones becoming lodged in the bile duct, though the condition can also be caused by bacterial infections, blockages caused by medical procedures, and tumors.

Gallbladder cancer

is relatively rare, according to the Mayo Clinic. It can be difficult to diagnose because its symptoms are similar to other gallbladder ailments (nausea, vomiting, jaundice, fever).

Gallbladder polyps

are lesions or growths in the gallbladder that are usually harmless and carry no symptoms, according to Healthline. The University of Southern California Center for Pancreatic and Biliary Diseases, however, warns that they can occasionally be a risk factor for gallbladder cancer.

Gangrene

results from inadequate blood flow and can develop in the gallbladder if acute cholecystitis is left untreated. The NIH lists the following symptoms: confusion, fever, gas in tissues under the skin, feeling ill, low blood pressure and persistent pain.

Abscesses

occur when the gallbladder becomes inflamed with pus. Like gangrene, it can occur as a complication of acute cholecystitis, according to The New York Times.

Gallbladder surgery and removal

According to the Mayo Clinic, when dealing with gallstones, doctors often recommend removing the gallbladder through surgery. If the problem does not involve gallstones, antibiotics are often the first treatment. But if the problem persists, the gallbladder will often be surgically removed.

The most common and least invasive method of gallbladder removal is laparoscopic surgery. The NIH explained that in this procedure, the surgeon makes three or four small holes in the belly, inserts a laparoscope — a long tube with a camera — and then removes the gallbladder with tiny surgical tools.

If laparoscopic surgery cannot be performed, the doctor may remove the gallbladder through open abdominal surgery, according to the NIH.

Both forms of surgery are done under general anesthesia.

Diet for a healthy gallbladder

Maintaining a healthy diet and weight go a long way in keeping the gallbladder healthy. “You should eat a well-balanced diet with fruits, veggies, lean meats and fiber,” advised Knowlton. According to New Health Guide, foods that are particularly good for the gallbladder are:

Fresh, fiber-rich fruits and vegetables:

Some great ones are avocados, cranberries, berries, grapes, cucumbers and beets. Broccoli, bell peppers and oranges are high in fiber and vitamin C, which if lacking can contribute to gallstones. Pectin-rich fruits — such as apples, strawberries and citrus — can also help, according to RawPeople.com. Radishes are a terrific option because they increase bile flow, but those already suffering from gallbladder problems shouldn’t eat too many of them.

Lean meat, fish and poultry:

The least fatty cuts are loins or "rounds," according to New Health Guide. Any type of fish, pork, lamb and skinless chicken are also good choices.

Whole grains:

These include oats, bran cereal and brown rice. Try breads and cereals that contain whole, various grains and high amounts of fiber.

Low-fat dairy: Pay attention to the fat content in any type of dairy food.

Caffeinated coffee and alcohol:

Studies have actually shown that moderate amounts (typically two drinks per day) of alcohol or caffeine from coffee may reduce the risk of gallstones. Caffeine from sources other than coffee, such as tea and soda, has not been shown to have a beneficial effect.

Plenty of water:

RawPeople.com advises this one, pointing out that hydration is essential for maintaining the proper amount of water in the bile.

Nuts: The jury is still out on nuts. According to Everyday Health, some studies have shown that eating peanuts or tree nuts such as almonds and walnuts can help prevent gallstones, but it isIMPORTANT

not to eat too many because nuts are high in fat.

Keeping away from certain foods can help, too. “Avoid fatty, fried foods, and limit alcohol!” cautioned Knowlton. According to New Health Guide, some other foods to steer clear of are:

Sweeteners, sugar, and refined carbohydrates:

This includes high-fructose corn syrup and refined sugars, like those found in cookies, soda and snack foods.

Frozen or canned fruits and vegetables:

They may have additives that make it harder for the gallbladder to do its work.

White flour foods:

This includes white bread, pasta and many desserts.

Processed snacks:

Potato chips, cookies, pies — almost any packaged snack are bad for your body.

High-fat foods:

Fried food, fatty cuts of meat, whole-milk dairy products and foods that are highly processed should be avoided.

Very low-calorie diets:

This generally means eating less than 1,000 calories a day. These diets can increase gallstone formation.

Does the Gallbladder Have a Necessary Function?

by John D. Morris, Ph.D.

Resources › Life Sciences Resources › Human Body

Recently a growing pain in my side forced me into the Urgent Care facility at the hospital. Several tests ensued, including an ultra-sound look at my gallbladder. Here in this small potato-sized organ could be seen a solid gallstone, about the size of a jalapeño pepper. I was told it had completely blocked the exit duct and had to be removed. Not just the offending stone, but the entire gallbladder. Both doctor and nurse assured me, "It doesn't matter, it's a useless organ."

Well, I'm not particularly up on human anatomy, and in fact knew little about the gallbladder, but I have investigated similar arguments made for the appendix. Evolutionists have for decades claimed the appendix is a "vestigial organ," a useless evolutionary leftover from our animal ancestry. In fact, just one hundred years ago nearly 200 organs and structures in the human body were thought to be vestigial, a claim even used as "proof" of evolution in place.

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But now we know of uses for each one. There are no "vestigial organs." The appendix is recognized to play an IMPORTANT role in the immune system, particularly in childhood. We can survive without it, but clearly it is a useful, functioning organ, and we are better off to keep it. There are times when it can get blocked or infected, and must be removed, but if healthy, it's best left in place.

Other organs or features once thought to be "useless" include wisdom teeth, tonsils, the thymus gland, the "tail bone," the little toe . . . would a person be better off without these? Of course not! Does their presence prove evolution? Hardly.

The gallbladder serves as a bridge between the liver (which produces bile necessary for the digestion of fats) and the small intestine, where the digestion occurs. The gallbladder stores the bile and parcels it out as needed. If the bladder is removed, it doesn't impair the production of needed bile, only its concentration and timed release into the small intestine. Dilute bile merely oozes in continually. A person can function quite adequately without the gallbladder under normal conditions, but it's better to keep it. Mine was infected and damaged and is now gone, and I haven't missed it . . . but I wonder.

The wise Creator God designed our bodies to cope under a variety of circumstances. Ever since sin entered the perfect creation and all systems began to deteriorate, sometimes things don't perform optimally. Thankfully there are back-up systems for many organs, like the gallbladder. The Creator intended us to survive in this fallen world, and here we see the evidence.

Whenever we hear words like "that's a useless organ," we should recognize them as a product of evolutionary thinking. Often such claims are merely repeats of foundless evolutionary tales heard since elementary school.