Gallstones – Symptoms, Causes, Risks and Treatment

Gallstones are hard deposits of solid material, that appear like stones or lumps in the gallbladder – a small, pear-shaped organ located on the right side of the body, directly below the liver. The gallbladder stores bile – a green-yellowish liquid that aids the digestion process. Gallstones may go unnoticed until they block a bile duct, causing immense pain and discomfort. These can vary in size from a grain of sand to a large golf ball, and can also vary in number from person-to-person.

There are two main types of gallstones: 

Cholesterol stones: Too much cholesterol in bile can lead to the formation of green-yellow stones. These are formed when the liver produces too much cholesterol as compared to the dissolving capacity of bile. 

Pigment stones: Pigment stones are dark brown or black, and are formed due to excessive presence of a chemical known as bilirubin. Bilirubin is produced by the liver naturally when it breaks down red blood cells, though conditions such as liver damage or blood disorders can lead to increased production of bilirubin than normal levels. Stones are formed when the gallbladder is unable to break down the excessive bilirubin present in the bile. 

Concentrated Bile: In the ordinary course of functioning, the gallbladder empties the bile to maintain health; however, when it fails to function correctly, the bile accumulates in the gallbladder and becomes excessively concentrated leading to the formation of stones. 

Symptoms of Gallstones

In many cases, gallstones may go unnoticed until they block a bile duct. Gallstones that do not cause any signs do not need to be treated. However, it is easy to understand the symptoms and detect gallstones. Some of the common symptoms of gallstones include:

  • Acute and rapidly intensifying pain in the upper right abdomen
  • Acute and rapidly intensifying pain in the centre of the abdomen
  • Excessive pain in the back, especially between shoulder blades
  • Nausea
  • Vomiting
  • Foul-smelling and dark urine
  • Clay-colour stool
  • Excessive and uncontrollable burping
  • Diarrhoea
  • Indigestion

Gallstone pain can last for some minutes or even a few hours.

 Causes of Gallstones

Gallstones occur when certain chemicals – such as cholesterol, calcium bilirubinate and calcium carbonate – in the gallbladder are out of proportion. A disproportion of chemicals leads to the formation of stones in the gallbladder. Typically stones are formed when there is:

  • Excessive cholesterol
  • Excessive bilirubin
  • Concentrated bile

 Risk Factors

Though the exact reason why a chemical imbalance occurs in some people and not the others is not known. However, certain factors put one at more risk than others, such as:

  • Being female
  • Age 40 or more
  • Race – Native or Mexican American
  • Obesity or overweight
  • Sedentary lifestyle
  • Pregnancy
  • Unhealthy diet comprising high-fat, high-cholesterol, low-fibre, etc.
  • Family history
  • Diabetes
  • Liver disorders
  • Leukemia or other blood disorders
  • Excessive loss of weight
  • Certain medications

 Treatment of Gallstones

If gallstones do not produce any symptoms, they might not need any treatment. Many times gallstones pass on their own without any pain or problem; however, in other cases, gallstones may cause severe symptoms and excessive pain, requiring medical treatment. In most cases with symptoms, surgery is the prime choice for gallstones; and in rare cases medications are used. Moreover, if a person is unfit for surgery, his condition may be treated by first focusing on minimizing risks and then conducting the surgery.

Treatment options for gallstones include:

 Natural treatment and home remedies: Some natural treatment such as lifestyle changes, healthy diet, etc. can help prevent the formation of gallstones and also reduce the intensity of symptoms. Also, some home remedies can work effectively to minimize pain and complications temporarily. Some tips for maintaining gallbladder health include:

  • Maintaining a healthy body weight
  • Eating a nutrient-enriched diet
  • Eating anti-inflammatory diet
  • Engaging in regular exercise
  • Avoiding foods with high-fat, high-cholesterol and low-fibre
  • Avoid rapid weight loss
  • Take recommended supplements for Vitamin C, iron and lecithin

Home remedies such as fasting and then taking olive oil with lemon juice can help flush out gallstone automatically, though this has no proven record.

 Surgery: The most effective and priority treatment for troubling gallstones is a laparoscopic gallbladder removal surgery. The patient is placed under the influence of anaesthesia. Then the surgeon makes 3-4 small incisions in the abdomen to insert a small, thin, flexible tube-like device to remove the gallbladder. After the gallbladder is removed, the bile is rerouted from the liver to the small intestine directly, leading to no chance of bile concentration or stone formation. As a result of the procedure, a person might experience loose or watery stool, which can be easily managed by consuming a diet which is low in fat so that there is a lesser release of bile. The surgery is safe, quick and straightforward with fast recovery period; most patients are discharged the same day from the hospital.

Another minor form of surgery or a non-invasive surgery – is shock wave lithotripsy in which high-energy shock waves are used to break larger stones into small pieces, enabling them to pass on their own in some days.

 Non-surgical treatments: Non-surgical methods such as medications are considered less effective in treating gallstones since it may take years for the medicines to break the stones and also the chances of recurrence of stones are higher when treatment is stopped. Medication is also not preferred as a prime method since the forms of surgery used to treat gallstones are very effective and less risky. 

In all, gallstones can be easily treated if they produce troubling symptoms; however, in cases, where gallstones do not produce any symptoms, treatment may not be necessary since they can pass on their own. However, the best course of treatment is to be undertaken post consultation with a doctor.