Gallbladder Disease (Gallstones)

Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid, called bile, is used to help the body digest fats. Bile is made in the liver, then stored in the gallbladder until the body needs to digest fat. At that time, the gallbladder contracts and pushes the bile into a tube-called the common bile duct-that carries it to the small intestine, where it helps with digestion. Bile contains water, cholesterol, fats, bile salts, proteins, and bilirubin. Bile salts break up fat, and bilirubin gives bile and stool a yellowish color. If the liquid bile contains too much cholesterol, bile salts, or bilirubin, under certain conditions it can harden into stones.

The two types of gallstones are cholesterol stones and pigment stones. Cholesterol stones are usually yellow-green and are made primarily of hardened cholesterol. They account for about 80 percent of gallstones. Pigment stones are small, dark stones made of bilirubin. Gallstones can be as small as a grain of sand or as large as a golf ball. The gallbladder can develop just one large stone, hundreds of tiny stones, or almost any combination.

What are the symptoms of gallstones?

Symptoms of gallstones are often called a gallbladder "attack" because
they occur suddenly. A typical attack can cause the following

• Steady pain in the upper abdomen, which increases rapidly and lasts
  from 30 minutes to several hours
• Pain in the back, between the shoulder blades
• Pain under the right shoulder
• Nausea or vomiting

Gallstone attacks often follow fatty meals, and they may occur during the night.
Other gallstone symptoms include the following

• Abdominal bloating
• Frequent intolerance of fatty foods
• Belching
• Gas
• Indigestion

People who also have the above and any of following symptoms should see
a doctor right away

• Chills
• Low-grade fever
• Yellowish color of the skin or whites of the eyes
• Clay-colored stools

Many people with gallstones have no symptoms. They do not interfere with gallbladder, liver,
or pancreas function, and do not need treatment.

Who is at risk for gallstones?

• Women
• People older than 60
• Native Americans
• Mexican Americans
• Overweight men and women
• People who fast or lose a lot of weight quickly
• Women who are pregnant, taking hormone-replacement therapy,
  or using birth-control pills