Most people are familiar with kidney stones, but gallstones are not as universally recognized. Rather than kidney stones, which form in the kidney, gallstones form in the gallbladder, which is an organ that stores the bile that is excreted from the liver. Bile is a combination of water, lecithin, salt, cholesterol and other substances, some of which are toxic. When the concentrations of these various ingredients are altered, they may precipitate and form gallstones.
Gallstones are more common than most people realize, and often go unnoticed by the patient. Sometimes, older gallstones are discovered in routine x-rays or surgeries and are dealt with afterwards. Gallstones are most common in women over the age of forty.
Symptoms are usually not apparent until a stone of significant size (larger than 9 mm) blocks the cystic duct or the common bile duct. These ducts are both parts of the biliary system, and complications with the draining of the gallbladder can cause potentially serious problems.
Therefore, gallstones are usually not the major problem; it is the issues resulting from the formation of gallstones that cause escalating health issues.
When the common bile duct is obstructed for a long period of time, bacteria can find its way around the stone and grow in the stagnant bile, eventually causing symptoms of cholangitis, which is a serious medical condition that usually requires excessive treatment as a hospital in-patient.
Symptoms of gallstones can be either mild or severe, and may be mistaken as symptoms of other diseases and disorders. Abdominal pain in the upper right quadrant of the abdomen is the most common symptom, and it is usually a vague cramping sensation that remains constant. It will become worse after eating a meal, especially if the meal contains fatty or greasy foods.
Light-colored stools, nausea, vomiting, heartburn, gaseousness, indigestion or excessive flatus are all symptoms of the presence of gallstones. The patient might also experience a feeling of fullness in the stomach, even when he or she has not eaten in quite some time. The desire to ingest food will dissipate, and abdominal cramping will escalate until treatment is administered.
In order to positively detect the presence of gallstones, you will have to go to the hospital or an imaging center for tests. Common tests include ultrasounds, CT scans and x-rays of the abdomen; a gall bladder radionuclide scan and an ERCP (endoscopic retrograde cholangiopancreatography).
As recent as ten years ago, the removal of the gall bladder – called a cholecystectomy – was the only treatment for gallstones. Later, medications were developed for dissolving gallstones, but these medications often caused several side effects even more threatening than the gallstones themselves.
Today, the most common treatment for gallstones is called laparoscopic cholecystectomy, which requires a very small incision and a tiny camera to remove the gallbladder. This surgery has a complication rate of less than 1%, and most patients can have the surgery completed in the morning and go home that afternoon.
For patients who wish to forgo surgery in favor of other, less invasive methods can try to dissolve gallstones by taking bile salts. This method may take several years to work, however, during which time new gallstones might begin to develop. There are also a few chemical methods that work in less than 20% of the cases, and none of these are recommended.
Patients will gallstones are only 20% likely to experience symptoms, and more than 99% of patients who have received some form of therapy never have gallstones again.