Gallstones

Gallstones are hardened deposits that can form in the gallbladder, a small organ beneath the liver that stores bile, which helps digest fats. There are two main types of gallstones:

• Cholesterol gallstones: The most common type, made primarily of hardened cholesterol. They are usually yellow-green in color.
• Pigment gallstones: Smaller and darker, these stones are made of bilirubin, a substance produced from the breakdown of red blood cells.

Symptoms

• Sudden and intense pain in the upper right abdomen or the center of the abdomen, often referred to as a gallbladder attack.
• Pain between the shoulder blades or in the right shoulder.
• Nausea or vomiting.
• Bloating, indigestion, or gas.
• Jaundice (yellowing of the skin and eyes) if a stone blocks the bile duct.

Causes

• Bile contains too much cholesterol: If your liver excretes more cholesterol than bile can dissolve, the excess may crystallize and eventually form stones.
• Bile contains too much bilirubin: Certain conditions, such as liver cirrhosis, biliary tract infections, or blood disorders, can cause the liver to produce excess bilirubin, leading to pigment stones.
• Gallbladder does not empty efficiently: If the gallbladder does not empty completely or often enough, bile may become overly concentrated, contributing to stone formation.

Treatment

• Watchful waiting: If there are no symptoms, treatment may not be necessary.
• Medications: Certain oral medications can dissolve cholesterol gallstones, but this process can take months or years and is not always effective.
• Surgery: If gallstones cause significant pain or complications, surgical removal of the gallbladder (cholecystectomy) is often recommended. This can be done via:
  Laparoscopic cholecystectomy: A minimally invasive surgery using small incisions.
  Open cholecystectomy: A more invasive procedure requiring a larger incision.
• Endoscopic procedures: For stones in the bile duct, endoscopic retrograde cholangiopancreatography (ERCP) can be used to remove stones.