Saanichton, BC

Dr. Miguel A. Lipka

Gallstones

This is categorized under:

A gallstone is a crystalline mass formed within the gallbladder by accretion of bile components. These stones are formed in the gallbladder, but may pass distally into other parts of the biliary tract such as the cystic duct, common bile duct, pancreatic duct, or the ampulla of Vater.

Many people do not experience any symptoms and are said to have "silent gallstones." Often the gallstones are found when a test is performed to evaluate some other problem. Treatment is only recommended if a person actually experiences symptoms of the condition.

A severe and steady pain in the upper abdomen or right side is the most common symptom of gallstones. The pain, which also may affect the shoulder blades or right shoulder, lasts anywhere from several minutes to hours. In addition, you may experience sweating or vomiting.

In its more advanced and severe stages, gallstones can cause prolonged pain and infection of the gallbladder (acute cholecystitis). Presence of gallstones in other parts of the biliary tract can cause obstruction of the bile ducts, which can lead to serious conditions such as ascending cholangitis or pancreatitis. Stones that have passed into the bile duct usually result in pain, fever and jaundice, which is yellow discoloration of the eyes and skin. Gallstones in the advanced stages can be life-threatening, and are therefore considered to be medical emergencies.

Gallstone risk factors include:

  • Being overweight
  • Age near or above 40
  • Female
  • Pre-menopausal

The condition is more prevalent in caucasians than in people of other races. A lack of melatonin could significantly contribute to gallbladder stones. Researchers believe that gallstones may be caused by a combination of factors, including inherited body chemistry, body weight, gallbladder motility (movement), and perhaps diet. The absence of such risk factors does not however preclude the formation of gallstones.

No clear relationship has been proven between diet and gallstone formation; however, low-fiber, high-cholesterol diets and diets high in starchy foods have been suggested as contributing to gallstone formation.

Other nutritional factors that may increase risk of gallstones include:

  • Rapid weight loss
  • Constipation
  • Eating fewer meals per day
  • Eating less fish
  • Low intakes of the nutrients folate, magnesium, calcium, and vitamin C.

Wine and whole grain bread may decrease the risk of gallstones.

Gallstones can sometimes be dissolved by oral ursodeoxycholic acid, but it may be required that the patient takes this medication for up to two years. Gallstones may recur however, once the drug is stopped.

Other treatments include:

  • Endoscopic retrograde sphincterotomy (ERS) -- cutting of the sphincter or muscle that lies at the juncture of the intestine with both the bile and pancreatic ducts
  • Lithotripsy -- extracorporeal shock wave lithotripsy that breaks up gallstones
  • Cholecystectomy surgery -- gallbladder removal