Gallstones

Causes

Gallbladders store fluid from the liver. The fluid is sent to the small intestine to help break down food. Gallstones may be caused by a problem with fluids from the liver such as:

• Too much cholesterol in the bile
• Too much bilirubin in the bile
• Not enough bile salts
• Problems that make it hard for the gallbladder to empty, such as a blockage

Blockages in the gallbladder can also trap bile and may lead to stones.

Risk Factors

Gallstones are more common in females. Other things that may raise the risk of gallstones are:

• Having other family members who had gallstones
• Obesity
• Quick weight loss or frequent changes in weight
• Certain digestive problems, including:
• Intestinal problems, such as Crohn disease
• Problems with the liver, such as cirrhosis
• Being on IV nutrition
• Lifestyle habits, such as:
• A high fat diet
• Lack of physical activity
• Smoking
• Certain medicines, such as estrogen, drugs to lower cholesterol, and thiazide diuretics

Symptoms

Most people do not have symptoms. Those who do may have pain in the upper right side of the belly. It may last 30 minutes to several hours. Other problems may be:

• Sudden pain after heavy meals
• Nausea and vomiting
• Bloating
• Burping
• Gas
• Fever or chills
• Yellowing of the skin or the whites of the eyes
• Clay-colored stools (poop)

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Blood tests will be done to look for possible causes or rule out other problems. Urine tests may also be done.

Gallstones can be seen with:

• Ultrasound
• Magnetic resonance cholangiopancreatography (MRCP)
• Hepatobiliary scintigraphy (HIDA) scan
• Endoscopic retrograde cholangiopancreatography (ERCP)

Treatment

Gallstones that do not cause symptoms do not need to be treated. Stones that are causing symptoms or blockages may be treated with:

• Medicines to:
  • Ease pain
  • Dissolve the gallstones
• Shock wave lithotripsy—a device sends energy through skin to break up the gallstones
• Endoscopic retrograde cholangiopancreatography (ERCP)—a scope is passed through the mouth and into the stomach; gallstones can be removed
• Surgery to remove the gallbladder—cholecystectomy

Prevention

This risk of gallstones may be lowered by:

• Maintaining a healthy weight
• Regular physical activity
• A diet that is low in fat and rich in fruits, vegetables, and whole grain foods