A Simple Explanation of Gallstones
In most cases, people with gallstones don’t exhibit any symptoms and thus never know they have them. In some cases the stones aren’t treated because the patient has no pain or discomfort. However, when gallstone removal is needed the most common practice is to remove the entire gallbladder. The body doesn’t need the gallbladder, just like it doesn’t need the appendix.
Two types of gallstones can form in the body – these are referred to as either cholesterol or pigmented stones. The type of gallstones that form can be linked to the patient’s country. For example people in America tend to develop cholesterol stones. People from Asian countries tend to develop pigmented gallstones.
The size of gallstones vary from person to person. They can be as small as a grain of sand and as large as a golf ball. The number of gallstones is equally as varied; the human body can produce a few hundred tiny gallstones, several moderate size gallstones, a few large gallstones, or any combination thereof. The only significant difference between large and small gallstones is that large ones tend to stay in one place whereas smaller gallstones are known to move around.
Cholesterol stones are the most prevalent among people from more developed or industrialized countries. Cholesterol stones form because the bile contains too much cholesterol, too much bilirubin (a brownish substance created when liver breaks down old red blood cells), or not enough bile salts, which are detergent-like chemicals that are stored in the gallbladder. Small cholesterol stones can get lodged in the ducts leading into the pancreas and cause pancreatic inflammation (pancreatitis).
The other type of gallstone is pigment stones. These stones develop when the body sheds its old red blood cells either too frequently or too quickly. As a result, the body produces an excess amount of bilirubin, the primary cause of pigment stones. People with sicke-cell anemia or biliary tract infections tend to get pigment stones. Studies show that those with sicke-cell anemia tend to have pigment gallstone problems early in life.
Both cholesterol and pigment stones can become hardened (calcified) over time. Approximately 20% of all gallstones contain enough calcium to make them visible on regular x-rays. Because calcified stones are hardened efforts to dissolve them may not be successful.
In some instances the presence of biliary sludge indicates a predisposition to developing gallstones. Biliary sludge is a thick protein-filled substance found in the gallbladder. It can itself sometimes cause abdominal pain when the sludge blocks the ducts going into the intestine. Biliary sludge can also cause inflammation of the pancreas or gallbladder.
Gallstones can sometimes be treated by having the stones themselves removed (endoscopic surgery) or by being dissolved. The symptoms of gallstones can sometimes be minimized by an adjustment in one’s diet. However, the most common and permanent procedure for removing gallstones is gallbladder removal surgery. As recently as ten years ago this required the surgeon to make a 5″-8″ incision in the abdominal area through which the gallbladder was removed. Presently, most gallbladders are removed laparoscopically, which just requires 4 small incisions through which tiny instruments (a small scope with a camera, a small scope with a cutting tool) are placed. This type of surgery greatly reduces the patient’s hospital stay – many patients return home a few hours after the surgery. Recovery time is also reduced. Approximately 500,000 Americans have their gallbladders removed each year making this surgical procedure one of the most common in the U.S.
