Gallstones

What are Gallstones?

Gallstone Disease is a very common hepatobiliary and pancreatic disease. Most people do not know about its presence and have no signs nor symptoms, until they discovered it by doing health check. However, if patients experience symptoms of Gallstone Disease, they need to be hospitalized and undergo surgery as gallstones can lead to various complications.

Formation of Gallstones

Crystallization is a natural physical phenomenon, which implies that the concentration of the liquid reaches a saturated state, crystals will be formed. And when the concentration continues to be at a high level, the crystals will continue to accumulate and grow.

Gallstones can be divided into two categories based on their composition:

• Cholesterol stones: People with genetically high cholesterol are prone to cholesterol stones, amounted for around 80% of all cases.
• Pigment stones: high levels of bile acid and high bilirubin can easily lead to pigment stones, some of them are associated with infections such as bacterial or parasitic infections.

Risk Factors for Gallstone Disease?

Gallstone Disease is very common, about 1/10 of adults have gallstones. Although gallstones are rare in children, the incidence rate will increase with age. Women will reach the peak of disease after 50 years old and men after 60 years old. Below are the common risk factors for Gallstone Disease,

Age and gender
The incidence rate of Gallstone Disease increases with age, and people aged above 40 has a higher risk in having gallstone disease. It is also more common in female than male in every age group.

Genetic factor
A study has shown that if a family member has Gallstone Disease, his close relatives have around 10% higher chance of getting Gallstone Disease. The study of twin brothers shows that about 25% of Gallstone Disease are due to genetic factors.

Pregnancy
The composition of bile will change during pregnancy, and the number of gallbladder contractions will also be reduced, both of which are more likely to form gallstones. The greater number of pregnancies, the higher the incidence of Gallstone Disease too.

Diabetes/High cholesterol
Diabetics are more likely to have cholesterol stones, which may be related to high levels of fatty acids in the body.

Obesity
Obesity is the main cause of disease, especially among women. Young, grossly overweight women have three times the incidence of Gallstone Disease, and the chance of gallbladder inflammation is higher.

Sudden weight loss/dieting
May cause liver to secrete increased amount cholesterol in bile and it also reduce gallbladder contraction.

Drugs
Oral contraceptives, hormone supplements, cholesterol-lowering drugs, etc. can cause gallstones.

Gallstone Disease Symptoms

Most gallstones are asymptomatic and can remain in the gallbladder until they caused obstruction, bringing severe abdominal pain, fever, vomiting and other symptoms. In fact, many patients find them during body check. Symptoms caused by gallstones can include:

Common Gallstones Symptoms

• Pain in the right upper abdomen, and the pain are severe
• Back pain between the shoulder blades
• Nausea and vomiting
• Fever and chills
• Jaundice (yellow colouring of the skin and cholera)
• Dark brown urine or light-colored stool

Complications of Gallstones

When gallstones cause obstruction, it will cause different complications, such as:

Cholecystitis (inflammation of gallbladder)
Gallstones that block the bile duct will cause inflammation, persistent pain and fever. In severe cases, it may cause concurrent sepsis or even death.

Cholangitis (Inflammation of the bile duct)
When gallstones block the common bile duct, it can cause infection and jaundice, with fever and pain as well.

Acute pancreatitis
When gallstones block the pancreatic duct, it can cause acute or chronic pancreatitis and cause severe and continuous abdominal pain, requiring hospitalization.

Gallbladder cancer
Long-term stimulation of gallbladder mucosa by gallstones may lead to gallbladder cancer.

How do you know you have gallstones? (Diagnosis of Gallstone Disease)

As gallstones can be hidden in the body silently, it is often difficult to detect them immediately and by the time symptoms appear they are already a threat. Therefore, if you have any suspicions or concerns, you should seek early diagnosis from your doctor. The specialist will conduct a detailed examination, together with blood tests and ultrasound, to identify the number, size and location of gallstones.

Specialist Consultation
The specialist will examine the patient’s abdomen and need to rule out acute complications requiring surgery, such as cholecystitis or bile duct inflammation, etc.

Blood Test
The blood test can reveal the extent of inflammation, whether the bile duct is occluded resulting in the increase of bilirubin, and whether the liver function and kidney function are affected to assess the risk of the patient.

Ultrasound Examination
The recommended imaging examination is convenient, non-invasive, and you can see the location and size of the gallstones, and you can see whether the bile ducts are dilated.

Endoscopic Retrograde CholangioPancreatography (ERCP)
For both diagnostic and therapeutic purposes, the specialist will find the duodenal papilla which is the opening to the common bile duct through an endoscope. Using instruments or lithotripsy instruments, the gallstones are passed through the to the intestine and then excreted from the body.

Treatment of Gallstone Disease

If you are diagnosed with Gallstone Disease, our specialist team will provide you with a personalized treatment plan. In general, the treatment of Gallstone Disease is mainly in the form of a surgical procedure in which the gallbladder is removed laparoscopically.

To learn more about minimally invasive treatment for Gallstone Disease, please visit:Gallstone Disease Surgery Last Update: June 2021
Please note that all medical health articles featured on our website have been reviewed by Chiron Medical doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.