A gallstone is a solid structure in the gallbladder or the ducts of the biliary system. Gallstones usually arise in the gallbladder and are a common problem. Gall (bile) is a fairly thick, yellow-
Little is known about the cause of the development of gallstones. The composition of the bile and the operation of the gallbladder itself may play a role. Gallstones can arise, for example, when the gallbladder squeezes out insufficiently during the meal. Then, the remaining bile can concentrate. Overweight and rapidly losing weight increase the risk of gallstones. Apart from this, hereditary factors may also play a role.
There are two types of gallstones: cholesterol gallstones and bilirubin pigment stones. Cholesterol gallstones can arise when the bile contains too much cholesterol. Female hormones may play a role here. Bilirubin pigment stones are made up for the most part of bilirubin salts. Gallstones also arise more frequently during pregnancy.
Gallstones come in different sizes, from one millimeter up to more than two centimeters. It’s possible that multiple stones occur simultaneously.
The vast majority of people with gallstones have no trouble. Gallstones located in the gallbladder cause little to no symptoms. Symptoms arise only when a gallstone gets stuck in the bile ducts. This obstructs the flow of bile. The gallbladder will try to remove the barrier and let the gallstone flow through. To do this, the gallbladder contracts violently. This violent contraction of the gallbladder can cause severe pain in the right upper abdomen (biliary colics). This pain can last from one to four hours. The pain often radiates to the back or the right shoulder. The pain is usually triggered or worsened by a (fatty) meal, because bile plays a role in the digestion of fat. Additional symptoms may include nausea, vomiting and jaundice.
A discolored stool may indicate gallstones. Bile will partially end up in the stool and ensures the normal brown color of stool. If the flow of bile is insufficiently, the stool may be decolorized.
The general practitioner can usually diagnose gallstone on the basis of the symptoms. However, further examination is needed to make the diagnosis with certainty. In most cases, ultrasound may be used for this purpose. With an MRI scan, the doctor can detect gallstones in the gallbladder and especially in the bile ducts. Sometimes, the doctor can't find the gallstones with the examinations above, but can still make the diagnosis based on the determination of dilated bile ducts. Gallstones are often found by chance during an ultrasound or CT scan of the abdomen.
Gallstones which cause no symptoms don’t require treatment. For gallstones which do cause problems, the following treatments are available:
The risk of complications of gallstones is low. In almost all patients who have had gallbladder surgery for gallstones, the condition is remedied. Possible complications are inflammation of the biliary tract, inflammation of the gallbladder or acute pancreatitis. Acute pancreatitis is a serious complication, that can occur when a gallstone gets stuck in the major duodenal papilla.