Gallstones: what it is, types of stones and signs

You have heard the diagnosis of gallstone disease or seen the line "gallbladder calculi" on an ultrasound — and now you are trying to understand what it means. Take it easy: gallstone disease is very common, and in most people the stones cause no symptoms for years.

What gallstone disease is

Gallstone disease, or cholelithiasis, is the formation of stones (calculi) in the gallbladder and bile ducts. The gallbladder is a small pear-shaped organ under the liver that stores bile and releases it through the common bile duct, helping to digest fats.

Gallstone disease is not necessarily a disease with symptoms: in most people the stones cause no symptoms. Stones form when substances in bile harden. According to statistics, cholelithiasis occurs in women 3–5 times more often than in men, and after age 70 — in 30% or more of the population.

Types of gallstones: cholesterol and bilirubin stones

Types of gallstones are distinguished by composition. The vast majority of stones have a mixed composition with a predominance of cholesterol: their cholesterol content exceeds 90%. The formation of pigment (bilirubin) stones is promoted by diseases with increased red blood cell breakdown, such as hemolytic anemia; they often contain an admixture of calcium salts, which is why they are called pigment-calcium stones.

Stones made of a single component are rare. Sizes range from grains of sand less than a millimeter to a stone weighing 60–80 g that fills the entire cavity of the gallbladder.

Why gallstones form

The exact causes have not been fully studied, but risk factors are known: age over 40, female sex, obesity, a diet high in fat and low in fiber, rapid weight loss, diabetes and Crohn's disease. The initial stage is considered to be biliary sludge — thickened, putty-like bile; in 80–85% of cases it disappears, but most often it returns.

Stones can be located not only in the gallbladder but also in the bile ducts; secondary stones arise due to impaired bile outflow and the infection associated with it.

Symptoms of gallstone disease and biliary colic

Most people have no symptoms, and stones are found incidentally during examination for another reason. If a stone blocks the duct, biliary colic occurs:

• severe constant pain in the middle of the abdomen or under the ribs on the right;
• pain lasts longer than 30 minutes and up to several hours;
• nausea or vomiting;
• the attack often occurs after eating.

Pain lasting more than 30 minutes is a reason to see a doctor urgently.

How gallstone disease is diagnosed: the role of ultrasound

The main method is ultrasound of the abdominal organs; a blood test may be ordered additionally. Asymptomatic stones usually do not require treatment, but they are monitored. If symptoms or complications appear, removal of the gallbladder is discussed — a person can live without it, as bile finds other routes to the intestine.

Possible complications and when a doctor is needed

Complications are rare but serious: inflammation of the gallbladder (cholecystitis) or pancreas (pancreatitis), jaundice with yellowing of the skin and whites of the eyes, darkening of the urine and lightening of the stool.

Gallstone disease itself is not a reason to call an ambulance; 103 or 112 — if the pain is sudden and very severe, radiates from the abdomen to the back and is accompanied by vomiting, the temperature is very high or you have chills, and the skin or whites of the eyes have turned yellow.

This material is for reference and does not replace a doctor's consultation: your situation is assessed by a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer