About Gallbladder Stones

The gallbladder is a little, pear-shaped organ located just below the liver on the right side of the belly. A digestive fluid called bile is stored in the gallbladder and is expelled into the small intestine. Bile is responsible for transporting waste products from the liver, including bilirubin, which is produced by the body during the breakdown of red blood cells. When the waste products and bilirubin are out of balance, gallbladder stones might form. From the size of a grain of sand to that of a golf ball, gallstones can vary widely in size.

Gallbladder Stones

Gallbladder stones are also called gallstones which are pieces of solid material that develop in the gallbladder, a little organ located beneath the liver, referred to as gallstones. This can develop into a condition called cholecystitis.

To aid with digestion, the gallbladder stores and secretes bile, a liquid produced in the liver. Bile is responsible for transporting waste products like cholesterol from the liver, including bilirubin, which is produced by the body during the breakdown of red blood cells. When cholesterol and bilirubin are out of balance, gallstones might form. A gallstone might be as big as a golf ball or a grain of sand. 

Types of Gallstones

Gallbladder stones can be categorized into two types:

• Pigment Stones: The primary component of these brown or black stones is bilirubin. Those who contract them typically have leukemia or sickle cell anemia, or they have liver problems.
• Cholesterol Stones: Since they are primarily composed of undissolved cholesterol, they are often yellow-green in color. However, they may also contain other substances like bilirubin or bile salts in large quantities. Approximately eighty percent of gallbladder stones are of this type, which is the most prevalent.

Gallbladder Stones Signs & Symptoms

Pain in the gallbladder can happen practically anytime, but it usually happens after eating a high-fat meal, like fried food. Gallbladder stones may cause upper right abdominal or midline stomach pain. 

The following symptoms may worsen if gallbladder stones are not detected:

• Elevated body temperature
• Jaundice, or yellowing of the skin and eye whites
• Sore throat
• Itchiness on the skin
• Diarrhea
• Disorientation
• Cold
• Appetite loss
• Rapid heartbeat
• Abdominal bloating

Gallbladder Stones : Causes

Gallstones form due to chemical imbalances in bile components:

• Excess cholesterol (80% of stones): Bile cannot dissolve surplus cholesterol excreted by the liver, leading to cholesterol crystallization
• High bilirubin levels: Conditions like cirrhosis, blood disorders (e.g., sickle cell anemia), or infections increase bilirubin, forming pigment stones
• Gallbladder stasis: Incomplete emptying concentrates bile, promoting stone formation

Gallbladder Stones Risk Factors

Demographic:

• Gender: Women (especially pregnant, on estrogen therapy, or using oral contraceptives) are twice as likely to develop stones
• Age: Risk increases after 40
• Ethnicity: Native Americans and Mexican Americans have higher susceptibility

Health Conditions:

• Obesity and rapid weight loss (dieting/bariatric surgery)
• Metabolic disorders: Diabetes, high triglycerides, or metabolic syndrome.
• Liver/gut diseases: Cirrhosis, Crohn’s disease, or biliary infections

Lifestyle:

• High-fat/low-fiber diets and sedentary habits
• Prolonged fasting reduces gallbladder motility

Complications

• Biliary colic: Sudden, severe upper-right abdominal pain from duct obstruction.
• Cholecystitis: Gallbladder inflammation/infection, causing fever and tenderness
• Pancreatitis: Gallstones blocking the pancreatic duct, leading to life-threatening inflammation
• Cholangitis: Bile duct infection with jaundice, sepsis, and organ failure
• Gallbladder cancer (rare): Long-term inflammation increases risk.

Gallbladder Stones Diagnosis

Medical History & Physical Exam

• The doctor will ask about symptoms such as abdominal pain, nausea, vomiting, fever, or jaundice.
• A physical exam may reveal tenderness in the upper right abdomen.

Ultrasound (Abdominal Ultrasound)

• First-line imaging test for detecting gallstones.
• Non-invasive and highly accurate for spotting stones in the gallbladder and signs of inflammation.

Blood Tests

• Used to check for infection, inflammation, or bile duct blockage.
• Tests may include:
  
  • White blood cell count (for infection)
  • Liver function tests (ALT, AST, ALP, bilirubin)
  • Pancreatic enzymes (amylase, lipase)

CT Scan (Computed Tomography)

• Can detect complications like gallbladder rupture, abscess, or pancreatitis.
• Less sensitive than ultrasound for gallstones but useful in emergencies.

HIDA Scan (Hepatobiliary Iminodiacetic Acid Scan)

• A nuclear medicine test that evaluates gallbladder function and checks for blockage or inflammation (cholecystitis).
• A radioactive tracer is injected to track bile flow.

MRI / MRCP (Magnetic Resonance Cholangiopancreatography)

• Provides detailed images of the bile ducts, gallbladder, liver, and pancreas.
• Useful for identifying bile duct stones or structural issues.

Endoscopic Ultrasound (EUS)

• Combines endoscopy with ultrasound to get high-resolution images of the bile ducts and gallbladder, especially useful if other tests are inconclusive.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

• Primarily a therapeutic test used when gallstones are suspected in the bile duct.
• Can be used to remove bile duct stones during the procedure.

Gallbladder Stones Treatment

• Cholecystectomy : The most common and effective remedy for gallstones, particularly if they are causing very nasty symptoms or complications, is to remove the gallbladder in a procedure called cholecystectomy. There are two main ways of having the operation done.
• 3D-Laparoscopic Cholecystectomy : It is a less invasive surgery where a few small cuts are made, and a camera and surgical instruments are inserted to remove the gallbladder. It is the most sought-after technique because it has a faster recovery time, smaller incisions, and less discomfort.
• ERCP : ERCP (Endoscopic Retrograde Cholangiopancreatography) is a procedure used to diagnose and treat problems in the bile ducts, pancreas, and gallbladder. It combines endoscopy and X-ray to detect blockages, infections, or other issues.
• Open Cholecystectomy : In complicated situations, open cholecystectomy may be required, where a larger incision is done. This is less common now since laparoscopic surgery has become more sophisticated.