Gallstones: Causes, Symptoms, Diagnosis, and Treatment

Gallstones are hardened digestive juices that form in the gallbladder. Gallstone has a size ranging from as small as a grain of sand to the size of a golf ball. Some people develop only one gallstone, while others develop more simultaneously. Check out the causes, symptoms, diagnosis, to complete treatment below.

What is gallstones?

Gallstones are deposits of bile in the form of pieces of solid material that form in the gall bladder. These stones develop due to cholesterol and bile pigment which sometimes form hard particles.

Furthermore, the gallbladder or gallbladder is an organ in the body that looks similar to a pear. In it there are about 50 ml of bile to help the digestive process.

Bile is a liquid produced by the liver and consists of several substances, including cholesterol, bilirubin, and bile salts.

There are two important functions of bile, including:

  • Bile contains bile acids, which are very important for the digestion and absorption of fat and fat-soluble vitamins in the small intestine.
  • To eliminate waste products (such as bilirubin), which is the result of body secretions into the stool.

Causes of Gallstones

It is not known exactly what causes gallstones to form, but several factors increase the formation of this condition, including:

1. Too Much Cholesterol In Bile

Normally, our bile has compounds that can digest cholesterol released by the liver (liver). But if the liver secretes too much cholesterol, rather than the ability of bile to digest it, then most of this cholesterol will settle and crystallize to form gallstones.

2. Too Much Bilirubin in Bile

Bilirubin is a chemical compound that is released when the liver destroys red blood cells. Some conditions, such as liver damage and certain blood disorders, cause the liver to produce more bilirubin than it should. While the remaining excess bilirubin can later form a rocky sediment to form.

3. Emptying of the gallbladder

When digesting fat or other body secretion material, the gallbladder will contract to release the liquid until it runs out. If the emptying of the bile does not run out or it still leaves residue, the remaining bile can also cause gallstone.

Risk Factors that Increase the Occurrence of Gallstones

After knowing the cause of gallstones, another important thing to know is what factors can increase the risk. By knowing the conditions that are causing it, you can avoid this disease.

Here are some factors that increase risk, including:

1. Heredity

If someone in your family has gallstones, you may be at high risk of experiencing the same condition.

2. Obesity

This is one of the biggest risk factors for gallstone. Obesity can cause an increase in cholesterol.

3. Pregnant Women or Taking Birth Control Pills

Estrogen can increase cholesterol and reduce gallbladder motility. Women who are pregnant or who take birth control pills have higher estrogen levels and are more likely to experience this condition

4. Race

Certain ethnic groups, including Native Americans and Mexican-Americans, are more likely to get gallstones.

5. Gender and Age

This disease is more common in women and elderly people.

6. Taking cholesterol medication

Some cholesterol-lowering drugs increase the amount of cholesterol in bile, a condition that can increase the potential for cholesterol stones.

7. Diabetes

People with diabetes tend to have higher glyceride levels (a type of blood fat), which is a risk factor for this condition

8. Drastic Weight Loss

If a person loses weight too fast, the liver will secrete extra cholesterol which can cause gallstones.


The following are the types of gallstones that can form in the gallbladder, including:

1. Cholesterol stones

Usually gallstones are yellow and green, around 80 percent of this type of disease is cholesterol stones.

2. Stone Pigments

Gallstone is smaller, darker in color, and is formed from bilirubin.

Symptoms of Gallstones

Gallstones often do not cause symptoms. Someone usually knows to have this disease when being examined for other diseases. Therefore, it helps you know the symptoms early on.

The following are the symptoms of stones that can be recognized, including:

  • Sudden and rapidly increasing pain in the right upper abdomen.
  • Sudden and more intense pain in the middle of the abdomen, just below the sternum.
  • Back pain between shoulder blades.
  • Pain in the right shoulder.
  • Nausea or vomiting.
  • Pain can last several minutes to several hours.

When is the Right Time to See a Doctor?

Seek immediate treatment if you develop signs and symptoms of serious complications, such as:

  • Abdominal pain is so severe that you cannot sit still or find a comfortable position.
  • The skin and whites of the eyes turn yellow.
  • High fever with chills.

Complications of Gallstones

Complications can include:

  • Inflammation of the gallbladder

Gallstone lodged in the gallbladder can cause inflammation of the gallbladder (cholecystitis). This condition can cause severe pain and fever.

  • Bile Duct Blockage

Stones can clog the ducts where bile flows from the gallbladder or liver into the small intestine. This condition can cause severe pain, jaundice, and bile duct infections.

  • Blockage of the Pancreatic Duct

Pancreatic duct is a channel that flows from the pancreas and is connected to the bile duct just before it enters the duodenum. Pancreatic juices are liquids that aid digestion, flowing through the pancreatic ducts.

Gallstone can cause blockages in the pancreatic duct causing inflammation of the pancreas (pancreatitis). Pancreatitis causes severe and constant abdominal pain and usually requires hospitalization.

  • Gallbladder Cancer

People with a history of the disease have an increased risk of gallbladder cancer. Even so, cases of gallbladder cancer are very rare, so that even though the risk of cancer increases, the possibility of gallbladder cancer is still very small.

Gallstone Diagnosis

If the doctor suspects that you have the disease, the doctor will do a physical examination and may carry out various other tests, including the following tests:

1. Blood Test

Blood tests can be given to check for signs of infection and obstruction or to rule out other conditions.

2. Ultrasonography

This procedure produces images from various parts of the body and can be used to identify gallstones.

3. CT scan

This test uses special X-rays to make a cross-section of images of organs and body tissues.

4. Magnetic Resonance Cholangiopancreatography (MRCP)

This test uses magnetic fields and radio wave energy to obtain images of structures in the body, including the liver, gallbladder, and pancreatic ducts.

5. Endoscopic Retrograde Cholangiopancreatography (ERCP)

The doctor inserts an endoscope through the patient’s mouth into the small intestine and injects a dye to allow the bile ducts to be seen.

Treatment of Gallstones

In general, treatment for this disease is based on symptoms and diagnosis results. Even so, many people with gallstones without symptoms don’t need treatment

Treatment options that can be tried include:

  • Drugs

If you have a certain medical condition or your doctor recommends that you do not have to undergo gallstone surgery, your doctor may prescribe medications such as ursodiol (Actigall) and chenodiol (Chenix). This medicine works to dissolve cholesterol stones. Mild diarrhea can be a side effect of both of these drugs.

The disadvantage of using this medicine is that you may have to take it for years to completely shed gallstones. In addition, this condition can recur once you stop taking the medicine.

  • Operation

Many people with this condition undergo surgery to remove the gallbladder. There are two types of surgery, including:

1. Laparoscopic cholecystectomy

During this procedure, the instrument, light, and camera are inserted through several small incisions in the abdomen. The surgeon will see the inside of the body through a laparoscope that is projected through a monitor, then the gallbladder is removed. This procedure usually does not require hospitalization, you can go home the same day.

2. Open cholecystectomy

The surgeon makes a larger abdominal incision to remove the gallbladder. You will stay in the hospital for several days after the operation.

Prevention of gallstones

Some factors that increase the risk of developing this condition, such as age, gender, and race, cannot be changed.

However, if you follow a vegetarian diet there is a possibility it can reduce the risk of developing gallstones. Those who adopt a vegetarian lifestyle are significantly less affected by this disease compared to people who often eat meat.

Some experts say a low-fat diet and a high-fiber diet (fruits and vegetables) can help protect against disease development. In addition, controlling body weight can also help prevent gallstone formation.


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