By Groshan Fabiola
Gallstones are a result of a malfunction of the gallbladder.
They appear when the liquid inside the gallbladder hardens and creates
small hard pieces that resemble to stone.
The bile is the liquid inside the gallbladder. It is produced
by the liver and then kept inside the gallbladder until fat digestion
is needed. It will then be pushed by the gallbladder into the common
bile duct and then it will get inside the small intestine where
it will perform its digestive function.
The bile is made out of water, bile salts, cholesterol, fats,
proteins, and bilirubin. All these components give bile its yellowish
color and break up the fats. The reason why gallstones form out
of bile is because sometimes this bile composition can change containing
a lot of cholesterol or a lot of bile salts and bilirubin.
Cholesterol stones have a yellow-greenish color and are made
of cholesterol most of all. 80% of the gallstones are represented
by cholesterol stones.
Another type of gallstones is that made out of pigment (bilirubin)
and is small and dark.
The size of the gallstones is varied. Some stones are tiny but
others can occupy the whole place in the gallbladder. Sometimes
inside the gallbladder doctors find one stone and in other patients
they might find 2 to 10 stones of different sizes and shapes.
The biliary system is made out of the gallbladder and the ducts.
This system is carrying the bile from the liver towards the small
intestine to help in the digestion process.
Gallstones can interfere with the bile�s normal flow and can
block it if they get stuck in any of the small ducts: the hepatic
ducts, the cystic duct and the common bile duct. If the bile gets
locked inside one of these ducts complications like pancreatitis
or gallbladder inflammation can occur. Signs of such a problem are:
jaundice, fever and intense pain that lasts a long time.
Gallstones form due to an increased quantity of cholesterol inside
the bile, due to biliary tract infections and other assumptions
like: hereditary blood disorders and cirrhosis.
Other factors that lead to gallstones formation are: obesity,
ethnicity, age, gender, diabetes and rapid weight loss.
Obesity is considered a factor of risk because it reduces the
amount of bile salts in bile and so cholesterol will be in an increased
amount inside that bile.
Native Americans have a genetic predisposition for developing
gallstones. They seem to secrete more cholesterol inside the bile
than needed. Most of all those aged over 60 are suspected to be
at risk of developing gallstones more frequent than others aged
less then 60.
Women are exposed to this disease more than men. They might develop
gallstones between 20 and 60 years of age. It seems that among the
Pima Indians of Arizona 70% of the women aged under 30 have gallstones
already. Mexican American men and women have a high risk of developing
this affection too.
Those who have diabetes are considered to be exposed to gallstones
because they have high levels of triglycerides which increase the
risk of gallstones.
Is someone looses weight in a short while the fat will be metabolized
by the body during this loss of weight and will determine the liver
to secrete more cholesterol in the bile, resulting the gallstone�s
formation.
Also, pregnant women and those who follow hormone therapy based
on estrogens can develop gallstones. Estrogen has been proven to
increase the level of cholesterol inside the bile and decrease the
gallbladder�s movements.
Gallstones can give symptoms that look like attacks because they
install suddenly. Some of the classic symptoms are: nausea and vomiting,
pain in the right upper abdomen that gets worse as time passes and
pain in the right shoulder and the area between the shoulder blades.
Bloating, belching, gas, jaundice, fever and indigestion are also
present in such an attack.
Sometimes the gallstones give no symptoms and are considered
to be silent stones. They generally do not interfere with the pancreas
or gallbladder and to not require treatment.
Diagnosing gallstones is usually made by accident, especially
the silent ones while performing some tests for other problems.
If the doctor suspects that you feel sick because of gallstones
he will ran an ultrasound test to see if gallstones are present.
These ultrasounds are not harmful and are used even when showing
the baby to the pregnant mother.
Other tests can also be performed like the CT which will show
the complications too. A magnetic resonance cholangiogram can be
used when suspecting that the bile ducts have been blocked by the
gallstone. For showing a malfunction in the contraction of the gallbladder
the cholescintigraphy will be used. This means that a radioactive
material will be injected in the body and it will stimulate the
gallbladder to contract showing any abnormalities in this process.
Sometimes even blood tests will be requested to see signs of possible
infection, obstruction or pancreatitis.
Doctors know that the symptoms of gallstones are similar to those
of appendicitis, pancreatitis, hepatitis, heart attack and ulcers
and will perform tests to eliminate these diseases before diagnosing
gallstones.