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Gallstones

  • What are Gallstones?

    Gallstones are small, stone-like materials found in the gall bladder. The gall bladder is a small sac that contains bile, which is the digestive fluid produced by the liver to break down fat.

    Gallstones are made of hardened bile. Bile is comprised of cholesterol, water, fat, bile salts and bilirubin (red blood cells waste product). Bile that contains high levels of cholesterol, bilirubin or bile salts becomes less aqueous and hardens into stones.

    Gallstones can form one large gallstone in the size of a golf ball, form several little stones or a combination of both. There are 2 types of gallstones:

    • Cholesterol stones, which are the most common type
    • Pigment stones, which are formed when there is a high level of bilirubin in the system

    You may have a mixture of both cholesterol and pigment stones.

  • Gallstones are caused by an imbalance in the bile components.

    Cholesterol gallstones are caused by increased levels of cholesterol and bilirubin in the bile, as well as reduced levels of bile salts.

    Pigment stones tend to occur in people who suffer from liver cirrhosis (scarring), infection of the biliary tract and genetic blood disorders.

    Other reasons might trigger the formation of gallstones, such as:

    • Cholesterol-reducing drugs, which lower the cholesterol levels in the blood but lead to increased cholesterol production in the bile
    • Diabetes
    • Excess oestrogen levels
    • Fasting
    • Gender – women aged 20 – 60 years are more prone to gallstones formation than men
    • Ageing – over 60 years
    • Obesity, which can lead to high levels of cholesterol in the bile
    • Rapid weight loss
    • The presence of gallstones alone is believed to cause the formation of more gallstones
  • Symptoms of gallstones depend on the size, severity and location of the gallstones. They include:

    • Abdominal bloating
    • Burping
    • Clay-coloured stools
    • Fever and chills
    • Indigestion
    • Jaundice (yellowish skin and eyes)
    • Nausea and vomiting
    • Sharp pain in the upper abdomen

    Symptoms of gallstones usually occur after having a fatty meal and at night, although symptoms do not always show. These are known as silent stones, which do not affect gall bladder, liver or pancreatic functions.

  • Treatment of gallstones depends on age and general health and will be recommended by the doctor. Gallstones can be left untreated or removed using the following methods:

    • Cholecystectomy, which is the surgical removal of the gall bladder
    • Medication to dissolve small gallstones
    • Sphincterotomy, which involves cutting the sphincter (the muscle between the common bile duct and the small intestine) to allow better access to the common bile duct (the tube that carries bile from the liver to the gall bladder and intestines)
    • Cholecystitis – acute or chronic swelling of the gall bladder
    • Cell death – gangrene in the gall bladder
    • Cholangitis – infection of the common bile duct
    • Pancreatitis – swelling of the pancreas
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