What Causes Gallstones: Causes

Gallstones are solid formations that form when substances in bile harden. In most people they cause no symptoms and are discovered incidentally during examination for another reason. Below are the formation mechanism, causes, risk factors, symptoms, and diagnosis: this makes it easier to understand exactly what the doctor assesses.

What gallstones are and what they are made of

The gallbladder is a pear-shaped organ under the liver that stores bile produced by the liver for digesting fats. Stones can be located in the gallbladder itself or in the bile ducts — small tubes connecting the gallbladder with the liver and pancreas. By composition, cholesterol, pigment, calcium, and mixed stones are distinguished; mixed stones with a high cholesterol content predominate. Sizes range from grains of sand less than a millimeter to a stone occupying the entire cavity of the gallbladder. The initial stage is the formation of sludge-like bile (biliary sludge).

What causes gallstones: main causes

The etiology of gallstone disease cannot be considered sufficiently studied: known factors increase the likelihood of its occurrence rather than a single cause. Stones form from the main elements of bile when its composition and colloidal structure are disrupted. Primary stones form in unchanged ducts, predominantly in the gallbladder, where bile stagnates and becomes concentrated. Secondary stones arise against the background of an existing disease — with impaired bile outflow (cholestasis) due to obstruction of narrow areas by stones, cicatricial stenoses, and superimposed infection. Diseases with increased red blood cell breakdown, such as hemolytic anemia, are distinguished separately — they are significant for the formation of pigment stones.

Risk factors: who is affected more often

Gallstones are common. The likelihood is higher in the following situations.

• Age over 40 years; after 70 years the prevalence reaches 30% and more.
• Female sex: women are affected 3–5 times more often than men, and stones form especially often in women who have given birth multiple times.
• Excess body weight: it is observed in approximately two thirds of patients.
• A diet high in fat and animal proteins and low in fiber.
• Rapid weight loss, including after weight-loss surgery; the presence of diabetes or Crohn's disease.

How stones manifest and when they are silent

Most people have no symptoms. If a stone blocks the duct, pain occurs: severe, constant, lasting longer than 30 minutes and up to several hours, in the middle of the abdomen or under the ribs on the right, with nausea or vomiting. Such pain is called biliary colic; attacks usually occur after eating. Sometimes the pain radiates to the back or under the right arm.

How stones are detected: diagnosis

Asymptomatic stones are often found incidentally during scanning or X-ray for another reason. When symptoms are present, ultrasound examination and blood tests are used. Further management is determined by the doctor: in the absence of symptoms, treatment may not be required, but follow-up appointments are possible.

Possible complications and when to see a doctor

Complications are rare, but duct blockage can lead to inflammation of the gallbladder (cholecystitis) or pancreas (pancreatitis), as well as jaundice — yellowing of the skin and whites of the eyes, itching of the skin, darker urine, and pale stool.

The presence of stones alone is not a reason to call an ambulance; call 103 or 112 if abdominal pain is sudden and very severe, the pain spreads from the abdomen to the back and is accompanied by vomiting, the temperature is very high or you have chills, the skin or whites of the eyes have turned yellow.

This material is for reference: it explains the mechanism and causes but does not replace a doctor's consultation — only a specialist can accurately assess your situation.

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