Getting to the Bottom of Gallstones

The gallbladder is a small pear-shaped organ that plays an important role in food digestion. It stores bile produced by the liver and provides it to the small intestine where it breaks down fat. It generally goes unnoticed until a patient experiences symptoms of a disorder, such as gallstones. Gallstones are like grains of sand or small rocks that develop in the gallbladder as a result of bile becoming chemically unbalanced. When a gallstone is large it may get caught in the passageways, or ducts, of the gallbladder, pancreas or liver, resulting in extreme pain.

The Two Types

Gallstones generally fall into one of two categories. Pigment gallstones develop when bile contains too much bilirubin, a naturally-occurring chemical normally removed by the liver. They generally develop in people with liver conditions such as cirrhosis or sickle cell anemia. But cholesterol gallstones comprise 80 percent of all gallstones and consist mostly of undisolved cholesterol.

Diets high in fats and cholesterol are a main contributor to gallstone development. However, cholesterol levels in your bile do not always correspond to cholesterol levels in your blood, especially since cholesterol-lowering drugs do not prevent gallstones even though they lower blood cholesterol levels. Crash diets that include too little fat, skipping meals, too few calories, rapid weight loss or going long periods without eating, prohibit the gallbladder from emptying often enough or completely, increasing the risk of gallstone development.

In addition to diet, other risk factors for developing gallstones include gender, body weight, age and ethnicity. Women are more likely to develop gallstones because estrogen causes more cholesterol to be excreted in bile. Women with high levels of estrogen in their bodies, such as those who are pregnant, taking birth control pills or on hormone therapy, are especially at risk. Overweight individuals may also have higher levels of cholesterol excreted into their bile. People older than 60 and those of Native American and Mexican-American descent are also high-risk groups.

If gallstones develop and cause symptoms, medical intervention is necessary in order to avoid permanent organ damage. “Symptoms of gallstones include abdominal pain, nausea, vomiting and diarrhea especially after a high-fat or spicy meal, known as a gallbladder attack,” says general and vascular surgeon Christopher Lucas, D.O. “Seek medical treatment immediately if you experience these symptoms, especially if accompanied by dark urine, fever, chills and/or yellowing of the skin and whites of the eyes. These signs may indicate an obstructed bile duct, which can result in a potentially fatal gallbladder rupture.”

Getting Treated
The most common treatment for gallstones is surgical removal of the gallbladder. Usually performed laparoscopically on an out-patient basis, this procedure allows most patients to return to normal activities within days. A person with a healthy liver can function normally without a gallbladder. However, lifestyle modifications such as limiting fat intake and increasing dietary fiber may be necessary for normal digestive function. Although surgery is the most common treatment for large gallstones and blocked ducts, non-surgical options to dissolve or break up the stones may be appropriate for persons unable to undergo surgery due to complications such as cardiovascular conditions or liver disease.

If you experience signs or symptoms associated with gallstones or fall into a high-risk group, contact your physician to discuss treatment options and ways to minimize your risk. It is important to seek medical care at the first sign of gallbladder attack or pain to avoid additional complications such as infections, duct obstructions or gallbladder rupture.

For more information, contact Dr. Lucas's office at 931-502-3700.