Anatomy of a Gallstone

Related Media: Cholecystectomy

IMAGE Could you have a gallstone, but not know it? Usually lying dormant for years, they can be extremely painful, even dangerous, if they become symptomatic. John H., an overweight, 55-year-old accountant, woke up one morning not long ago with terrible pains in his upper abdomen and right shoulder. Positive he was having a heart attack, he rushed off to the emergency room. Fortunately, John's problem was far less dramatic. He had gallstones.

Understanding Gallstones

The gallbladder is a small, pear-shaped organ that is part of the digestive system. Located on the right side of the abdomen below your liver, the gallbladder stores and secretes bile, which is made by the liver, into your small intestine when food arrives there from your stomach. Bile, a yellow-brownish fluid, helps digest fats in food. Gallstones form when substances in the bile crystallize, or harden. There are 2 types of gallstones:
  • Cholesterol gallstones—Made mostly of cholesterol, these yellow-green stones comprise about 80% of gallstones.
  • Pigment gallstones—Made mostly of bilirubin and calcium salts, these smaller and darker stones account for the remaining 20% of gallstones.
Gallstones can be as small as a grain of sand, or as large as a golf ball, though smaller gallstones are much more common. In fact, 10%-20% of people in the US typically develop gallstones, though up to 80% of them will not develop symptoms. Symptoms may begin to appear when the stones get too large, or leave the gallbladder and get lodged in a duct.

What Causes Gallstones?

Although there is not an exact cause for gallstones, a number of factors are known to contribute to their formation:
  • Body chemistry—Bile that contains too high a concentration of cholesterol and too low a concentration of bile salts
  • Reduced efficiency—Refers to how well your gallbladder is at contracting and flushing bile into the intestine
  • Proteins —An improper balance of different types of proteins in the liver or bile.
  • Obesity —Excess weight may be linked to a decrease in bile salts and an increase in cholesterol production by the liver. Weight may also affect the efficiency of the gallbladder. This risk is more pronounced in women.
  • Rapid weight loss—Causes an increase in cholesterol in the bile. Rapid weight may also impair gallbladder function.

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