Snow
Snow

Book a free consultation

What are gallstones?

Gallstones are stone-like objects that develop in the gallbladder or bile ducts (the pipe-like system within the liver). Gallstones can range dramatically in size, from tiny grains of sand to golf ball-sized objects. Interestingly, small stones can often cause the most trouble. These are stones that can leave the gallbladder and get stuck. Larger stones tend to remain quietly in the gallbladder. It is important to know that many people who have gallstones are never bothered by them and may not know the stones are even there. In these cases, no treatment is needed.

 

What are gallstones made of?

Gallstones are made up of hardened materials in your body. Typically, there are two types:

  • Cholesterol: Made up of fatty substances in the blood, cholesterol is found throughout the body. These are the most common type of gallstones.
  • Pigment Stones (mainly made of bilirubin): This substance is created when red blood cells break down in the liver. Too much bilirubin can actually leak into the bloodstream and cause the skin and eyes to turn yellow (jaundice).

Gallstones that are made up of cholesterol tend to be greenish in color. It is more common to have gallstones made of cholesterol than other types of stone.

 

Where do gallstones develop?

Gallstones are most commonly found in the gallbladder, as cholesterol stones. Gallstones can also travel from the gallbladder to the common bile duct, which is the largest of the ducts (pipes) in the liver.

Common bile duct stones are much less common than gallstones. Stones that find their way into the common bile duct can create more serious medical situations than just gallstones that remain in the gallbladder. Common bile duct stones can block the common bile duct, resulting in a serious infection called cholangitis. These stones can also cause pancreatitis, a painful condition caused by inflammation of the pancreas. Stones in the common bile duct can be removed without surgery by using a scope. Removal of the gallbladder requires surgery, which is typically done laparoscopically (a minimally invasive surgical procedure).

 

What is the gallbladder?

The gallbladder is a small organ tucked up under the liver, on the right side of your body. It is shaped like a swollen pea pod. The gallbladder’s job is to store and dispense bile—a fluid that helps digest fats in the food you eat. Similarly to a pea pod, the gallbladder is green. This is due to the bile inside the gallbladder. Bile is a mixture of cholesterol, bilirubin, bile salts and lecithin.

The gallbladder is connected to other parts of the digestive system through a series of ducts, or tunnels. These ducts help to carry bile and aid in the entire process of breaking down food. Ultimately, the bile finds its way into the common bile duct, where it passes through a special sphincter (a valve made of muscle), into the small intestine. Once there, the bile can mix directly with food that’s waiting to be digested. The common bile duct then empties bile into the duodenum, the first portion of the very lengthy small intestine.

Not all bile travels directly from the liver into the duodenum. Another portion of bile moves from the liver into the gallbladder through a special duct called the cystic duct. The gallbladder stores bile, which is available to be used for digestion on very short notice. If a fatty meal is eaten, then the gallbladder is signaled to contract and to squeeze some stored bile into the common bile duct where it’s passed into the small intestine to mix with food. All bile ends up in the small intestine, where it helps digest food.

 

What is bile and what is it used for?

Produced in the liver, bile is a combination of cholesterol, bilirubin, bile salts and lecithin. This solution helps break down fat during the digestion process. Bile is either released directly to the small intestine from the hepatic duct (coming straight from the liver) or from the bile ducts after being stored in the gallbladder. The entire system of ducts is called the biliary system. Bile is an important part of digestion and exits the body with your feces.

 

Why do gallstones develop?

Gallstones can develop for several reasons, including:

  • Forming when there is a critical concentration of cholesterol or bilirubin in the bile.
  • Developing if the gallbladder is lazy and does not completely empty itself of bile.
  • Occurring in people with other conditions, like:
    • Cirrhosis of the liver.
    • Blood disorders.
  • During pregnancy.
  • When you rapidly lose weight.

 

What are the symptoms of gallstones?

The symptoms of gallstones can vary based on the size of the gallstone. Most gallstones do not cause any symptoms at all. These gallstones are known as silent stones and require no treatment.When the gallstones cause symptoms, they may include:

  • Pain in the upper mid abdomen or upper right abdomen.
  • Associated pain in the right shoulder.
  • Chest pain.
  • Nausea and vomiting.
  • Repeated similar episodes.
  • Jaundice (a yellow tint to the skin and eyes).

Pain is the main symptom most people experience with gallstones. This pain is steady and can last from around 15 minutes to several hours. The episodes, which can be severe, generally subside after one to three hours or so. People who have these painful attacks, while uncomfortable, are not in any medical jeopardy. Gallstones can cause acute cholecystitis, which is a more serious condition when the gallbladder is actually inflamed. This happens if a stone blocks off the cystic duct, which increases the pressure within the gallbladder. This condition may require antibiotics, hospitalization and even urgent surgery. Stones that pass out of the gallbladder and into the common bile duct can cause a complete blockage of the duct with jaundice, infection and pancreatitis.You may feel pain in several places, including:

  • Upper part of the abdomen, on the right side.
  • Between the shoulder blades.
  • Under the right shoulder.

When people experience pain with gallstones, it is sometimes referred to as a gallbladder attack or biliary colic.There are two special conditions that could mimic gallstone symptoms. First, some gallbladders contain a thick sludge, which has not formed into actual stones. Sometimes sludge is felt to cause symptoms similar to actual gallstone pain. Secondly, there is an uncommon condition called acalculous cholecystitis, when the gallbladder becomes inflamed, but no stones are present. This is generally treated by surgical removal of the gallbladder.

 

How are gallstones diagnosed?

The most commonly used test to detect gallstones is an ultrasound. Ultrasound is a painless and accurate procedure that transmits high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photographic images of the internal structures of the body. While no test is 100%, this is a very accurate test for diagnosing gallstones. There are other radiology tests that are sometimes used, but ultrasound is the main tool for diagnosing gallbladder disease.

In general, ultrasound does not visualize the common bile duct well. Though stones in this duct aren’t as common, they can happen. If they are suspected, the following tests may be done:

  • Endoscopic retrograde cholangiopancreatography (ERCP): This is both a test and a possible treatment for common bile duct stones. When used as a test, an endoscope — a flexible tube with a light and a camera attached — is inserted into the patient's mouth, down the throat, and into the stomach and small intestine. A dye is injected to allow the bile ducts to stand out. If there are gallstones in the bile duct, they can be removed by the endoscope. This scope cannot remove stones contained within the gallbladder.
    flexible tube for ERCP to diagnose and treat gallstones
    Endoscopic retrograde cholangiopancreatography (ERCP) can diagnose and sometimes treat gallstones.
  • Magnetic resonance cholangiopancreatography (MRCP): In MRCP, the bile ducts are examined with magnetic resonance imaging (MRI), a test that uses a large magnet, radio waves, and a computer to produce very clear images of parts of the body. Unlike ERCP, MRCP can only diagnose common bile duct stones. It cannot remove them. However, MRCP’s advantage over ERCP is that it is the safer alternative, so often physicians will opt for MRCP initially.
  • Endoscopic ultrasound (EUS): This procedure combines endoscopy with ultrasound (there’s a probe at the tip of the scope). Like ERCP, this scope is passed through the mouth and advanced to the common bile duct and gallbladder region. It visualizes the common bile duct well. Similar to MRCP, gallstones are identified but not removed during this procedure. If common bile duct stones are demonstrated by EUS (or MRCP), then an ERCP will generally follow to remove them.
    Illustration of how the Endoscopic Ultrasound diagnoses gallstones
    Endoscopic ultrasound passes through the mouth to the common bile duct and gall bladder.

What are gallstones?

Gallstones are stone-like objects that develop in the gallbladder or bile ducts (the pipe-like system within the liver). Gallstones can range dramatically in size, from tiny grains of sand to golf ball-sized objects. Interestingly, small stones can often cause the most trouble. These are stones that can leave the gallbladder and get stuck. Larger stones tend to remain quietly in the gallbladder. It is important to know that many people who have gallstones are never bothered by them and may not know the stones are even there. In these cases, no treatment is needed.

 

What are gallstones made of?

Gallstones are made up of hardened materials in your body. Typically, there are two types:

  • Cholesterol: Made up of fatty substances in the blood, cholesterol is found throughout the body. These are the most common type of gallstones.
  • Pigment Stones (mainly made of bilirubin): This substance is created when red blood cells break down in the liver. Too much bilirubin can actually leak into the bloodstream and cause the skin and eyes to turn yellow (jaundice).

Gallstones that are made up of cholesterol tend to be greenish in color. It is more common to have gallstones made of cholesterol than other types of stone.

 

Where do gallstones develop?

Gallstones are most commonly found in the gallbladder, as cholesterol stones. Gallstones can also travel from the gallbladder to the common bile duct, which is the largest of the ducts (pipes) in the liver.

Common bile duct stones are much less common than gallstones. Stones that find their way into the common bile duct can create more serious medical situations than just gallstones that remain in the gallbladder. Common bile duct stones can block the common bile duct, resulting in a serious infection called cholangitis. These stones can also cause pancreatitis, a painful condition caused by inflammation of the pancreas. Stones in the common bile duct can be removed without surgery by using a scope. Removal of the gallbladder requires surgery, which is typically done laparoscopically (a minimally invasive surgical procedure).

 

What is the gallbladder?

The gallbladder is a small organ tucked up under the liver, on the right side of your body. It is shaped like a swollen pea pod. The gallbladder’s job is to store and dispense bile—a fluid that helps digest fats in the food you eat. Similarly to a pea pod, the gallbladder is green. This is due to the bile inside the gallbladder. Bile is a mixture of cholesterol, bilirubin, bile salts and lecithin.

The gallbladder is connected to other parts of the digestive system through a series of ducts, or tunnels. These ducts help to carry bile and aid in the entire process of breaking down food. Ultimately, the bile finds its way into the common bile duct, where it passes through a special sphincter (a valve made of muscle), into the small intestine. Once there, the bile can mix directly with food that’s waiting to be digested. The common bile duct then empties bile into the duodenum, the first portion of the very lengthy small intestine.

Not all bile travels directly from the liver into the duodenum. Another portion of bile moves from the liver into the gallbladder through a special duct called the cystic duct. The gallbladder stores bile, which is available to be used for digestion on very short notice. If a fatty meal is eaten, then the gallbladder is signaled to contract and to squeeze some stored bile into the common bile duct where it’s passed into the small intestine to mix with food. All bile ends up in the small intestine, where it helps digest food.

 

What is bile and what is it used for?

Produced in the liver, bile is a combination of cholesterol, bilirubin, bile salts and lecithin. This solution helps break down fat during the digestion process. Bile is either released directly to the small intestine from the hepatic duct (coming straight from the liver) or from the bile ducts after being stored in the gallbladder. The entire system of ducts is called the biliary system. Bile is an important part of digestion and exits the body with your feces.

 

Why do gallstones develop?

Gallstones can develop for several reasons, including:

  • Forming when there is a critical concentration of cholesterol or bilirubin in the bile.
  • Developing if the gallbladder is lazy and does not completely empty itself of bile.
  • Occurring in people with other conditions, like:
    • Cirrhosis of the liver.
    • Blood disorders.
  • During pregnancy.
  • When you rapidly lose weight.

 

What are the symptoms of gallstones?

The symptoms of gallstones can vary based on the size of the gallstone. Most gallstones do not cause any symptoms at all. These gallstones are known as silent stones and require no treatment.When the gallstones cause symptoms, they may include:

  • Pain in the upper mid abdomen or upper right abdomen.
  • Associated pain in the right shoulder.
  • Chest pain.
  • Nausea and vomiting.
  • Repeated similar episodes.
  • Jaundice (a yellow tint to the skin and eyes).

Pain is the main symptom most people experience with gallstones. This pain is steady and can last from around 15 minutes to several hours. The episodes, which can be severe, generally subside after one to three hours or so. People who have these painful attacks, while uncomfortable, are not in any medical jeopardy. Gallstones can cause acute cholecystitis, which is a more serious condition when the gallbladder is actually inflamed. This happens if a stone blocks off the cystic duct, which increases the pressure within the gallbladder. This condition may require antibiotics, hospitalization and even urgent surgery. Stones that pass out of the gallbladder and into the common bile duct can cause a complete blockage of the duct with jaundice, infection and pancreatitis.You may feel pain in several places, including:

  • Upper part of the abdomen, on the right side.
  • Between the shoulder blades.
  • Under the right shoulder.

When people experience pain with gallstones, it is sometimes referred to as a gallbladder attack or biliary colic.There are two special conditions that could mimic gallstone symptoms. First, some gallbladders contain a thick sludge, which has not formed into actual stones. Sometimes sludge is felt to cause symptoms similar to actual gallstone pain. Secondly, there is an uncommon condition called acalculous cholecystitis, when the gallbladder becomes inflamed, but no stones are present. This is generally treated by surgical removal of the gallbladder.

 

How are gallstones diagnosed?

The most commonly used test to detect gallstones is an ultrasound. Ultrasound is a painless and accurate procedure that transmits high-frequency sound waves through body tissues. The echoes are recorded and transformed into video or photographic images of the internal structures of the body. While no test is 100%, this is a very accurate test for diagnosing gallstones. There are other radiology tests that are sometimes used, but ultrasound is the main tool for diagnosing gallbladder disease.

In general, ultrasound does not visualize the common bile duct well. Though stones in this duct aren’t as common, they can happen. If they are suspected, the following tests may be done:

  • Endoscopic retrograde cholangiopancreatography (ERCP): This is both a test and a possible treatment for common bile duct stones. When used as a test, an endoscope — a flexible tube with a light and a camera attached — is inserted into the patient's mouth, down the throat, and into the stomach and small intestine. A dye is injected to allow the bile ducts to stand out. If there are gallstones in the bile duct, they can be removed by the endoscope. This scope cannot remove stones contained within the gallbladder.
    flexible tube for ERCP to diagnose and treat gallstones
    Endoscopic retrograde cholangiopancreatography (ERCP) can diagnose and sometimes treat gallstones.
  • Magnetic resonance cholangiopancreatography (MRCP): In MRCP, the bile ducts are examined with magnetic resonance imaging (MRI), a test that uses a large magnet, radio waves, and a computer to produce very clear images of parts of the body. Unlike ERCP, MRCP can only diagnose common bile duct stones. It cannot remove them. However, MRCP’s advantage over ERCP is that it is the safer alternative, so often physicians will opt for MRCP initially.
  • Endoscopic ultrasound (EUS): This procedure combines endoscopy with ultrasound (there’s a probe at the tip of the scope). Like ERCP, this scope is passed through the mouth and advanced to the common bile duct and gallbladder region. It visualizes the common bile duct well. Similar to MRCP, gallstones are identified but not removed during this procedure. If common bile duct stones are demonstrated by EUS (or MRCP), then an ERCP will generally follow to remove them.
    Illustration of how the Endoscopic Ultrasound diagnoses gallstones
    Endoscopic ultrasound passes through the mouth to the common bile duct and gall bladder.

Book a free consultation