What Are Gallstones Or Cholelithiasis? Causes, Symptoms, Risk Factors, Complications And Treatments

Gallstones or cholelithiasis are referred to as digestive disorders characterised by stones or hardened forms of digestive fluids such as cholesterol or bilirubin formed in the gallbladder. Studies say that gallstones are often asymptomatic as people with the condition are usually diagnosed incidentally.

In such people, the likelihood of developing complications is less (around 1-2 per cent), however, if asymptomatic gallstones start developing symptoms, maybe within 5-20 years, the complications can be life-threatening. [1]

The gallbladder is a small, pear-shaped organ located just under the liver. The organ helps store and release digestive fluid bile that is produced by the small intestine.

In this article, we will discuss details on gallstones. Take a look.

Causes Of Gallstones Or Cholelithiasis

There are three main causes of gallstones or cholelithiasis:

1. Cholesterol stones

Cholesterol stones are formed when there is excess cholesterol secreted by the liver. Bile helps in breaking down and dissolving cholesterol, to form an insoluble complex that is excreted from the body via stool. Due to excess cholesterol, the bile is unable to dissolve the extra cholesterol, which then precipitates as crystals in the gallbladder causing cholesterol gallstones. [2]

2. Excess bilirubin stones

Bilirubin, a yellow-coloured pigment formed during the breakdown of red blood cells, is secreted by the liver to the gallbladder for the bile to dissolve. Sometimes, due to excess secretion of bilirubin, the bile is unable to break them all, causing crystallisation of excess bilirubin and leading to bilirubin gallstone formation. These stones are usually black in colour. [3]

3. Gallbladder hypomotility

When we consume fatty foods, bile is emptied from the gallbladder and is carried to the small intestine to help dissolve or break down fats in the food. Sometimes, due to insufficient consumption of fats, the gallbladder poorly secreted bile, leaving an excess of it into the gallbladder, when then becomes concentrated and form gallstones. These stones are usually brown.

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Symptoms Of Gallstones Or Cholelithiasis

Some of the symptoms of gallstones may include: [4]

• High fever
• Pain in the right upper quadrant.
• Stomach pain soon after eating spicy or greasy food.
• Tenderness below the liver area.
• Persistently increased heartbeat.
• Low blood pressure.
• Vomiting and nausea.
• Jaundice (sometimes)
• Abdominal swelling
• Clay-coloured stools.
• Loss of appetite.
• Sweating

Risk Factors Of Gallstones Or Cholelithiasis

Some of the risk factors for gallstones may include: [5]

• Obesity
• Genetic or history of gallstones in the family.
• Age over 40.
• Pregnancy. Due to an increase in the hormone estrogen.
• Being female
• Metabolic syndrome like diabetes or hypertension.
• People with liver diseases.
• Crohn's disease
• Prolonged fasting
• Certain medications like birth pills
• Rapid weight loss
• Gastric or weight-loss surgeries.

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Complications Of Gallstones Or Cholelithiasis

Prolonged or untreated gallstones can result in complications like:

• Cholecystitis or inflammation of the gallbladder.
• Gallstone pancreatitis or blockage of pancreatic duct by the gallstones.
• Choledocholithiasis or gallstones in the bile duct.
• Cholangitis or inflammation of the bile duct system.

Diagnosis Of Gallstones Or Cholelithiasis

Some of the methods to diagnose gallstones may include:

• Ultrasound: It is considered to be the first-line diagnostic method to get the best images of gallstones. Its specificity is 99 per cent. [6]
• Hepatobiliary iminodiacetic acid (HIDA) scan: To look for problems in the gallbladder.
• CT Scan: It also helps get images of stones in the gallbladder.
• Endoscopic: The test helps when diagnosing gallstones patients with jaundice.

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Treatments Of Gallstones Or Cholelithiasis

Some of the treatment methods for gallstones are:

• Laparoscopic cholecystectomy: This commonly performed surgery is suggested for people with symptomatic gallstones.
• Dietary advice: asymptomatic patients are mainly given dietary advice and other lifestyle suggestion to reduce the risk of gallstones formation.
• Intravenous antibiotics: To prevent the risk of gallbladder infection and good health of the digestive system.
• Medications: It includes medications like ursodiol to dissolve the gallstones. The process may take years. [7]

To Conclude

Gallstones are prevalent in people of developing countries. Consult a medical expert if you have symptoms of the gallstones or start immediate treatment for the condition if it is diagnosed incidentally.