Gallbladder is a small, pear-shaped organ, located at the upper right part of the abdomen below the liver.
The role of the gall bladder is to store the yellow coloured liquid called bile juice that helps in proper digestion.
Whenever there is excessive cholesterol deposit, it gets hardened and forms Gallstones. These are of varying sizes ranging from the size of a grain to the size of a golf ball. Also, there may be multiple gallstones present at the same time.
If a person feels severe symptoms of gallstone, he/she is advised to undergo gall bladder stone removal surgery. Otherwise, if these stones do not cause any problems, there may not require any treatment.
Types of Gall Bladder Stones :
There are basically Two Types of Gallstones :
Cholesterol stones: Usually yellow-green in colour, they are the most common gallstones found. Excessive concentration of bile in gall bladder leads to formation of yellow cholesterol stones.
Pigment stones: Small and darker ones, these stones are formed of bilirubin. Bilirubin comes from bile which is produced by the liver and gets stored in the gallbladder.
Gall bladder Stones Causes :
There is no clear thought on what exactly leads to the development of gallstones. However, there are a few theories, based on which doctors carry forward the treatment.
Presence of Excessive Cholesterol in Bile : Bile present in gallbladder has the ability to dissolve the cholesterol released by our liver. However, if the quantity of cholesterol released is much more than the bile can process, the excess cholesterol crystallizes and turns into hard yellow coloured stones.
Presence of too much of Bilirubin in Bile : Bilirubin is a chemical produced by the liver on break down of the red blood cells. Sometimes, the liver tends to produce excessive bilirubin due to certain medical conditions like biliary tract infections, liver cirrhosis, and few blood disorders. This excess bilirubin leads to the formation of gallstones.
Gallbladder not working Efficiently : There may be conditions when the gallbladder does not empty completely as it should. In that case, bile gets accumulated and concentrated and leads to stone formation.
Gall Bladder Stone Symptoms :
In most cases (75%), gallbladder stones show no signs or symptoms.
Often, gallstones do not show any symptoms, but when it gets stuck in the duct, it can cause blockage. In that case, you can experience one or more of the following symptoms:
Sudden acute pain in the upper right side of the abdomen
Back pain between the shoulder blades
Pain in the right shoulder
Gall Bladder Stone Pain :
Gallbladder pain due to stones is sudden and intensifying. One may experience it in the middle or upper right section of the abdomen, or you one may feel pain in the back at the middle of shoulder blades.
This pain may last for a few minutes or a few hours. It may get less intense or disappear to reappear. This pain is probably caused when a gallstone blocks the passage of bile that gets passed through gallbladder to the small intestine.
How Gall Bladder Stones Diagnosed?
There are several traditional and advanced procedures and tests that help doctors diagnose the condition and degree of the disease.
Physical Examination : The doctor will conduct physical examination by checking your eyes and skin for change in colour as a yellowish tint can indicate signs of jaundice.
Ultrasound : Preferred imaging method to see the presence of gallstones and abnormalities due to acute cholecystitis.
Abdominal CT Scan : An imaging test that provides images of your liver and abdominal area.
Gallbladder Radionuclide Scan : Very effective test. It takes around one hour to complete. During this test, a radioactive substance is injected into your veins that travel to the liver and gallbladder via blood. Results of this test suggest the presence of blockage and infection in the bile ducts from stones.
Blood Tests : Tests the amount of bilirubin and how the liver is functioning.
Endoscopic Retrograde Cholangiopancreatography (ERCP) : During this procedure, a camera and X-rays are used to determine the problems in the bile a pancreatic duct.
How are Gallstones Treated?
Commonly, Gallstones require no treatment unless they cause severe symptoms like pain, and vomiting etc. Surgery is recommended in severe cases.
a.) Surgery :
Laparoscopic Gallbladder Removal : During this procedure, the surgeon will make 3-4 incisions in your abdomen. Through these incisions, a small, lighted device is inserted to carefully remove the gallbladder. The patient isrelieved on the same day of the procedure if no further complication is seen.
b.) Nonsurgical Treatments :
Medication : Due to advanced surgical procedures using laparoscopic and robotic techniques, surgeries are a lot easier and successful these days. Still, if you are not a candidate for surgery due to certain medical complications, doctors may prescribe a few medications that help dissolve these gallstones. But, medications are not commonly recommended as they are not much effective in treating this problem and take years to show results.
c.) Shockwave Lithotripsy :
This is a noninvasive technique where a lithotripter is used. This machine creates shock waves to pass through the patient to break gallstones into smaller pieces. But, the gallstones can recur.
Gall Bladder Stone Diet :
a) Effect of Food on Gallbladder : Being a small, delicate yet important organ, it is important to consume a healthy diet full of nutrients to maintain its health. While some foods help in improving its function, others can initiate and aggravate the gallbladder problems.
b) Foods - Good for Gallbladder : The key to having a healthy gallbladder is to have a well-balanced diet having fruits, and vegetables, which have loads of nutrients, high in calcium, vitamins C, and B and fiber. Also, eating plant-based protein like beans, nuts, lentils, tofu, and tempeh are very good for gallbladder.
It is best to Incorporate Following Foods in Your Diet for a Healthy Gallbladder :
Dark, leafy greens
Fish and shellfish
Foods Not Good for Your Gallbladder :
It is best to avoid the foods which are high in fat and processed foods. Vegetable oils are difficult to break down and cause gallbladder problems.
Refined white foods (bread, pasta, etc.)
Foods high in fat
Gall Bladder Stone Risk Factors :
There is not much information about the exact causes of formation of gallstones. Still, there are some observances about risk factors of formation of gallstones.
Women are observed to have more tendencies to develop this problem. Moreover, pregnant women, women on hormone replacement therapy, and those using hormone birth control are at increased risk of having gallstones.
Besides, there are other risk factors which are common to both genders. These are as follows :
Coronary artery disease
A history of gallbladder problems; self or in family
Rapid weight loss followed by weight gain
A faulty diet that is high in processed foods, carbohydrates and calories but having lowfibre
Taking certain medications for lowering cholesterol
When to see a doctor?
When a gallstone blocks the duct from where gallbladder releases the bile, it can lead to serious problems like inflammation and infection. It is called acute cholecystitis and is a medical emergency.
The Symptoms associated with the condition are as follows :
Intensifying pain in the upper right side of the abdomen or mid-right back
Other conditions that may arise due to untreated gallstones are as follows:
Cholangitis, a bile duct infection
Sepsis, a blood infection
Gall bladder Stones FAQs (Frequently Asked Questions) :
Are Gall bladder stones Serious?
A gallstone may cause a serious condition when a small sized stone blocks the bile duct. The conditions may include Cholecystitis (gallbladder inflammation), Pancreatitis (inflammation of the pancreas), Jaundice and/or Cholangitis (inflammation of the liver).
Can Stone be Removed from Gallbladder?
Medications (including Ursodeoxycholic acid), Lithotripsy (breaking down of gallstones through shock waves and Laser), ERS or Endoscopic Retrograde Sphincterotomy (for relief from obstruction), and Cholecystectomy (surgical removal of the gallbladder) are the methods used for removing gallbladder stones.
What foods to avoid if you have gall bladder stones?
One should avoid food high in cholesterol and fat during the gallstone condition. A diet high in fruits and vegetables, whole grains, low-fat dairy products, and lean meat/ poultry/ fish, which is high in fiber, is good for gallstone condition.
Can you dissolve gall bladder stones?
Medications including ursodiol and chenodiol can dissolve the cholesterol gallstones, but it may take years for them to produce the desired effects.
Can apple juice dissolve gall bladder stones?
Apple juice contains malic acid, which may soften the gallstones. No scientific studies actually support the claim. Consumption of excessive fruit juices can be detrimental to health. Talk to your physician before using any such natural remedy.
Is it possible to remove gall bladder stones without surgery?
The gallstones can be removed without surgery by methods including Lithotripsy and shock wave therapy, medications, and endoscopy treatment.
What is the best treatment for gallbladder stones?
If gallstones occur frequently, surgery is the recommended treatment option, which is the removal of the gallbladder. Medications are used in people who cannot undergo surgery, and it may take years to give results.
Which doctor treats gallbladder stones?
A Gastroenterologist treats gallbladder stones. You may also be referred to a surgeon for Cholecystectomy or surgical removal of the gallbladder.
How can I dissolve gall bladder stones naturally?
While a number of claims have been made that the gallstones can be dissolved through natural remedies including Apple juice, apple cider vinegar, milk thistle, and others, no conclusive evidence has been found towards the effectiveness of these remedies. Only trust your registered and certified doctor for providing you the best and reliable treatment.
Can gallstones come back after the gallbladder is removed?
Gallstones may not be formed in the gallbladder as it is surgically removed, but it still can form in the other structures located within the biliary tract (for instance, the common bile duct). But such incidences are very rare.
Can you remove gallstones without removing the gallbladder?
Medications can dissolve the cholesterol gallstones over a period of a few years. Lithotripsy or extracorporeal shockwave treatment can be used in patients not having enough strength for gallbladder surgery.