The development of solid deposits in the bile ducts or gallbladder is referred to as cholelithiasis, sometimes known as gallstones. Its main job is to store and concentrate bile, a digestive fluid made by the liver, in the gallbladder, a tiny, pear-shaped organ underneath the liver.
In most cases, the pigment bilirubin is produced when red blood cells break down, or cholesterol makes up gallstones. From microscopic grains to huge stones that might clog the bile ducts, they can be of various sizes. Millions of people worldwide suffer from cholelithiasis, which is more common in women, obese persons, and people over 40.
Numerous risk factors contribute to the formation of gallstones, albeit the precise reason is not fully understood. These elements comprise:
- Gallstones can develop as a result of too much cholesterol in the bile, which occurs when the liver creates more cholesterol than the bile can break down.
- Unbalanced bilirubin levels can result from a number of illnesses, including liver cirrhosis, blood problems, or infections, and can result in the development of gallstones that are pigmented.
- Gallbladder motility problems: If the gallbladder does not empty completely or does not empty regularly, the bile stays stagnant and there is a greater chance of developing stones.
- Obesity and rapid weight loss: Losing weight quickly or being overweight might affect the bile’s chemical composition, which can lead to gallstone formation.
- Gallstones run in families, therefore having one enhances a person’s chance of getting them.
Most cholelithiasis sufferers are asymptomatic and may never show any signs or symptoms. Gallbladder attacks or complications like inflammation (cholecystitis), infection (choledocholithiasis), or pancreatitis (inflammation of the pancreas) can occur when gallstones block the bile ducts, though.
Biliary colic, another name for a gallbladder attack, can cause severe, sudden pain in the upper abdomen or right side, back pain in the area between the shoulder blades, nausea, vomiting, and bloating.
Evaluation of the patient’s medical history, a physical exam, and imaging tests such as an MRI, CT scan, or ultrasound are frequently used in the diagnosis of cholelithiasis. Depending on how severe the symptoms and problems are, different treatments are available. Modifying one’s lifestyle to reduce fat intake, manage weight, and engage in regular exercise may be advised in mild cases. In more severe situations, surgery may be required, such as a laparoscopic cholecystectomy (removal of the gallbladder).
Causes of Gallstone
- Gallstone production may result from excessive cholesterol in bile. When bile contains more cholesterol than it can break down, gallstones may develop. Although the precise cause of the imbalance between cholesterol and bile salts is not entirely understood, there are some risk factors that can contribute, including a poor diet, obesity, and some hereditary factors.
- Unbalanced bilirubin production: The disintegration of red blood cells produces bilirubin, a yellow pigment. Bilirubin can aid in the development of pigment gallstones if there is an excessive synthesis of it or if the liver has trouble metabolizing it. The usual balance of bilirubin can be upset and the risk of gallstone development is increased by ailments such as liver cirrhosis, blood problems, and specific infections.
- Bile is released from the gallbladder when it contracts in reaction to food, which helps in digestion. Gallbladder motility problems. Bile can stagnate and create stones if the gallbladder does not drain completely or contracts correctly. Some drugs, hormonal imbalances (such as estrogen dominance), and specific medical diseases can all have an impact on gallbladder motility.
- Gallstone development is significantly influenced by obesity and quick weight loss. In addition to slowing gallbladder movement, extra weight can raise bile cholesterol levels. Rapid weight reduction, whether brought on by dieting, bariatric surgery, or other procedures, can also cause gallstones to form because it upsets the ratio of different components in bile.
- The development of gallstones is influenced by genetic and familial factors. You may be more likely to get gallstones if someone in your family has already had them.
- Other elements Diabetes, specific medications (such as hormone replacement therapy or cholesterol-lowering drugs), rapid weight loss from low-calorie diets, a sedentary lifestyle, and specific medical conditions that affect bile flow, such as primary biliary cholangitis, are additional conditions and factors that can raise the risk of gallstone formation.
Effects of Gallstone
- Gallstone attacks can cause sudden, severe discomfort in the upper abdomen or right side when the bile ducts are blocked by gallstones. Gallbladder attacks or biliary colic are episodes that frequently follow a meal, especially one that contains a lot of fat. The discomfort may radiate to the back or shoulder blades and last for a short while to last for several hours. Attacks on the gallbladder can be excruciatingly painful and call for medical treatment.
- Cholecystitis (gallbladder inflammation): Bile trapped in the gallbladder can result in inflammation if a gallstone blocks the cystic duct. Chronic stomach discomfort, fever, nausea, vomiting, and tenderness around the gallbladder are all possible symptoms of cholecystitis. It is regarded as a medical emergency and typically necessitates hospitalization and antibiotic therapy.
- Gallstones can occasionally leave the gallbladder and get stuck in the bile ducts, causing an obstruction (choledocholithiasis). The bile can get obstructed as a result, causing symptoms including jaundice (yellowing of the skin and eyes), black urine, pale feces, abdominal pain, fever, and chills. Intervention for choledocholithiasis may be necessary to remove the stones, either surgically or endoscopically.
- Infection (cholangitis): Cholangitis is an infection that can develop if the bile ducts are obstructed for a long time. The signs of this disorder can be life-threatening and include severe stomach discomfort, fever, jaundice, and other symptoms. Since cholangitis is a medical emergency, it needs to be treated right away with antibiotics and by a doctor.
- Gallstones from the gallbladder may occasionally migrate and obstruct the pancreatic duct, resulting in pancreatitis, an inflammation of the pancreas. Severe abdominal pain, nausea, vomiting, and perhaps even life-threatening consequences can result from this disorder, known as pancreatitis. Hospitalization may be necessary for pancreatitis and medical treatment is required.
- The regular flow of bile, which is necessary for breaking down lipids, can be obstructed by gallstones, among other digestive problems. Cholelithiasis sufferers may consequently encounter symptoms like diarrhea, bloating, indigestion, and an intolerance to fatty foods.
Symptoms of Gallstone
- discomfort in the upper right side of the abdomen, behind the ribs, is the most frequent location for abdominal discomfort, which is the most typical gallstone symptom. It is possible for the discomfort to be modest to severe, intermittent, or constant. It could be characterized as a dull aching, a cramping feeling, or a sudden, stabbing pain. Back or shoulder blade pain could be a symptom.
- Bilateral colic (also known as gallbladder attacks): Bilateral colic is a condition that causes abrupt, severe pain in the upper abdomen. After a meal, especially one that was fatty or oily, the discomfort usually starts. A few minutes to several hours may pass between the assault and the attack’s natural onset of relief. Gallbladder attacks can occur frequently or for a short while.
- Vomiting and spells of nausea are common in people with gallstones, and they may do so before, during, or after a gallbladder attack. The severe pain may cause nausea and vomiting, or the body may react to gallbladder failure by producing these symptoms.
- Bloating and indigestion: Gallstones can obstruct the bile’s natural flow, causing indigestion, bloating, and pain after eating especially high-fat meals. A sense of heaviness or abdominal distension may occur in certain people.
- Gallstones can impact how well fats are digested and absorbed, which can change how often you go to the toilet. Others might have stools that are clay-colored or pale, while some people may have frequent loose stools or diarrhea.
- Jaundice: Gallstones that get stuck in the bile duct can restrict the flow of bile and result in the condition known as jaundice. Jaundice, a yellowing of the skin and eyes, can result from this. Itching, pale feces, and dark urine are common symptoms of jaundice.
Natural Remedies for Gallstone
1. Dietary adjustments
- Low-fat diet: Since high-fat foods can cause gallbladder attacks, eating a low-fat diet may help the gallbladder work less hard. Put an emphasis on eating entire grains, lean proteins, fruits, vegetables, and healthy fats in moderation.
- Foods high in fiber: Consuming enough fiber may help to promote healthy digestion and lower the risk of gallstone development. Include foods high in soluble fiber in your diet, such as fruits, vegetables, legumes, and whole grains.
2. Keep hydrated: Drinking enough water can maintain bile flow and stop concentrated bile from forming, which can lead to the development of gallstones. Aim for eight glasses of water or more each day.
3. Herbal treatments
- Milk thistle: It is thought that milk thistle may support liver function and has hepatoprotective effects. It has been used traditionally to support gallbladder health and is accessible as a supplement.
- Artichoke: Artichoke extract is supposed to improve gallbladder emptying and stimulate bile production. It could be obtained as a supplement or used in the diet.
4. Physical activity: Keeping a healthy weight can help to lower the risk of gallstone formation associated with obesity. Regular exercise and physical activity can also help to maintain a healthy weight. Exercise aerobically at a moderate level while also including strength training.
5. Weight management: Reducing the risk of gallstone formation may be accomplished by maintaining a healthy weight and avoiding abrupt weight reduction or yo-yo dieting. Put your attention on healthy eating habits and regular exercise as effective ways to lose weight.
Treatment options for Gallstone
1. A “wait-and-see” strategy may be used by your healthcare professional if you have gallstones but are not showing any symptoms. Regular monitoring through check-ups and imaging tests may be advised for asymptomatic gallstones since they frequently do not need immediate treatment.
2. Medication: Although medications are frequently ineffective at removing gallstones, they may be prescribed to treat symptoms or head-off consequences. In some circumstances, ursodeoxycholic acid (UDCA) is used to dissolve cholesterol gallstones; however, this treatment is more successful for small stones and may take a long time to take effect.
3. Surgical procedures:
- Cholecystectomy: This procedure, which involves the surgical removal of the gallbladder, is the most popular and effective way to treat gallstone symptoms. While open cholecystectomy necessitates a larger incision, laparoscopic cholecystectomy is a minimally invasive surgery performed through minor incisions. People who experience repeated gallbladder attacks, cholecystitis, or other issues are frequently advised to have a cholecystectomy.
- Endoscopic techniques: In some circumstances, gallstones in the bile ducts can be removed using endoscopic procedures like percutaneous transhepatic cholangioscopy (PTCS) or endoscopic retrograde cholangiopancreatography (ERCP). In these operations, the stones are located, removed, or broken down using a flexible tube equipped with a camera.
4. Extracorporeal shock wave lithotripsy (ESWL): ESWL employs shock waves to break gallstones into tiny pieces, allowing them to move more easily via the bile ducts. It is a non-invasive therapy. It is typically only used for people who are unable to have surgery or endoscopic procedures.
*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.
Author Information
Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician, and Rajeshwar Rao, Pharm D.