What is the gallbladder?
The gallbladder is a small oblong sac located in the abdomen, under the liver, is a component of the digestive system, and acts as a passageway for bile produced by the liver which collects there between meals.
It is about 10 cm long and stores between 40 and 60 ml of bile out of the 500 to 800 ml produced each day by the liver.
When food is ingested, it contracts and releases its content into the common bile duct, then in the duodenum to participate in digestion with a very limited role.
When the gallbladder contracts poorly, the bile tends to stagnate, and stones can form. Most often these stones are not symptomatic, but sometimes, a stone can migrate from the gallbladder into the common bile duct and cause pain in the upper right part of the abdomen opposite the liver: this is what we call hepatic colic.
When the stone gets stuck between the gallbladder and the common bile duct infection can occur, this is called acute cholecystitis.
If the stone gets stuck in the common bile duct, the infection can affect the upstream bile network (and therefore the liver) and cause what is called cholangitis characterized by Charcot’s triad: pain in the liver, fever, and jaundice (yellowing of the skin and conjunctivae).
Gallstones can sit in the gallbladder for years without causing any symptoms. But, sometimes (especially) the smaller gallstones are pushed in the direction of the bile duct. When they get stuck in a bile duct, they can cause a lot of pain. The most common gallbladder symptoms, also referred to as gallstone problems, include the following:
By vigorously squeezing the gallbladder and bile duct, your body tries to push the gallstone further. This causes severe cramps on the right side of the upper abdomen. The cramps come and go. The pain is very intense and is referred to as biliary colic or a gallstone attack.
Another remarkable symptom of gallstone is a pain that gets worse when you try to sit down. The pain may be there for a few minutes and then go away. Sometimes the pain remains present much longer in a row and you may feel nauseous from the pain or even vomiting.
When a trapped stone prevents bile from entering the intestine, your stool becomes light in color (beige, putty color). Because the bile has nowhere to go, engorgement eventually occurs in the liver. As a result, the bile dye can end up in the blood. Your skin and the whites of your eyes may then turn yellow. Your urine will then turn dark.
Inflammation in bile duct or gallbladder (cholangitis or cholecystitis)
A stuck stone can cause your bile ducts and gallbladder to become inflamed. You can then get sick and get a fever.
Inflammation in the pancreas (pancreatitis)
Because the bile duct that leads to the intestine runs partly through the pancreas, sometimes the pancreas can also become inflamed. You can then get constant pain deep in your upper abdomen and in your back, with fever and being seriously ill.
What is the cause of gallstones?
Why people get gallstones, we don’t know for sure. In some families, gallstones seem to be more common.
Gallstones also seem to be more common in women than in men. During pregnancy, the chance of a gallstone is slightly greater.
Doctors think that gallstones may be caused by some bile remaining in the gallbladder. That bile then becomes thicker and harder. And after a while, stones arise.
Bile contains cholesterol. If there is a lot of cholesterol in the bile, you may be more likely to have gallstones.
The risk of gallstones may also be increased by:
- female hormones.
- eating too little because you want to lose weight
How do I know if I have gallstones?
To know for sure if you have gallstones, you must talk to your doctor. They can then prescribe you an ultrasound of the abdomen. On the ultrasound, the doctor can often see if you have gallstones. However, not all gallstones can be seen on an ultrasound. Sometimes an MRI scan is necessary. With this, all types of gallstones can be seen.
How can I prevent gallstones?
- There is no diet to prevent gallstones.
- Eat healthy. Make sure you maintain a healthy weight.
- By losing weight slowly, the chance of gallstones may be smaller.
- Do not lose weight too quickly. If you lose a lot of weight too quickly, you are more likely to have gallstones. A dietitian can help you lose weight in a healthy way.
- It is preferable to practice regular physical exercise: 30 minutes a day, five days a week.
Even when stones are already present, these lifestyle habits help prevent new stones from forming.
Medications for gallstones
In case of pain attacks due to a gallstone, painkillers (NSAIDs) can help. Examples include diclofenac, ibuprofen and naproxen. NSAIDs can cause an upset stomach and affect the effect of some other medications. If you are over 60 years old and already suffer a chronic disease, such as gastrointestinal, heart, vascular or kidney problems, talk to your doctor or pharmacist about whether you can use an NSAID.
Your doctor may also give an injection of diclofenac in the buttock or upper arm in case of acute colic pain.
What to do if you have gallstones?
Most people with gallstones don’t notice that they have gallstones. Sometimes the gallstones are discovered by chance when an echo of the upper abdomen is made for something else. If gallstones do not cause any complaints, no treatment is needed.
If you have a gallstone attack, a gallstone can suddenly come loose and cause some pain. The gallstone will then enter the intestine. The pain will then suddenly go away, and the gallstone will disappear with your poop.
When to contact your doctor for gallstones?
Contact your doctor if:
- You have sharp pain attacks in the upper abdomen
- You cannot sit still from the pain
- The pain symptoms remain
- You have pain and vomiting
- You are in pain and develop a fever