Similar to kidney stones (small, hard crystalline deposits that form inside the kidneys), gallstones are pieces of solid material that form in one of your organs. However, gallstones aren’t actually stones made of mineral and acid salts, but hardened deposits of digestive fluid produced by the liver. They form in the gallbladder.
The gallbladder is a small, hollow organ that sits just under the right lobe of the liver. Its purpose is to store and concentrate bile (a digestive fluid produced by the liver). It is usually filled with bile before meals and flat and empty after meals. In response to certain stimuli, the bile is released into the small intestine, where it helps break down fats by dispersing them into tiny little particles.
In addition to gallstones, there are several other conditions that can affect the gallbladder. These conditions include:
- Cholesterolosis (strawberry gallbladder) – refers to changes in the gallbladder wall caused by excess cholesterol. This condition does not produce clinical symptoms and is not related to gallstones at all.
- Cholecystitis (inflammation of the gallbladder) – it usually happens when accumulated bile exerts pressure on the gallbladder wall, caused by gallstones blocking the ducts. The inflammation is sometimes accompanied by bacterial infection. Symptoms include fever and severe pain in the upper right abdomen.
- Gallbladder polyps – benign and asymptomatic growths in the gallbladder wall.
- Gallbladder cancer – very rare and difficult to diagnose, with symptoms resembling those of gallstones.
The majority of people with gallstones (upwards of 80%), never experience any adverse symptoms. Asymptomatic gallstones are called “silent stones” and usually pass on their own. Symptoms occur when a bile duct gets blocked by a particularly large gallstone. The main symptom is a sudden, severe pain and cramping in the right upper part of the abdomen, radiating to the shoulder. This is known as a “gallstone attack” or a “gallbladder attack“.
Pain caused by obstruction with a gallstone is also known as a “biliary colic“. Gallbladder attacks usually occur after fatty meals or after drinking. It is very common for the attacks to happen at night.
Gallbladder Attack Symptoms
Apart from abdominal pain, gallbladder attacks sometimes cause other symptoms, such as excessive sweating, nausea and vomiting. If the gallstones obstruct the bile ducts for longer periods, you may develop the following symptoms:
- rapid heartbeat
- high body temperature
- jaundice (yellowing of the skin and eyes)
- itchy skin
This condition is referred to as “complicated gallstone disease“.
Most of the complications caused by gallstones are rare. The most common complication is the aforementioned inflammation of the gallbladder. Symptoms that include pain that lasts for several hours, yellowish skin, fever, nausea, vomiting and tea-colored urine may point towards some of the following conditions:
- Liver inflammation or hepatitis – although viruses are the most common cause of hepatitis, in rare cases it can happen as a result of cholestatic liver injury, i.e. damage caused by cholestasis.
- Cholestasis – a condition where bile flow from the liver to the duodenum is obstructed. Symptoms include pale stool, jaundice, itchiness, and dark urine. Apart from gallstones, cholestasis can have other causes, such as pregnancy, antibiotics, changes in tissue (cancer), biliary trauma, cystic fibrosis, and many others.
- Pancreatitis – inflammation of the pancreas, most commonly caused by gallstones, alcohol abuse, certain medications and tumors. Severe pain in the upper abdomen that spreads to the back is a clear sign of pancreatitis, especially when accompanied by nausea and vomiting.
- Ascending cholangitis – an infection of the bile duct. When the bile duct is partially obstructed by gallstones, bacteria from the small intestine can rise and enter through the junction with the duodenum, causing jaundice, abdominal pain, fever and, in severe cases, low blood pressure and confusion. This condition can potentially be life-threatening.
- Gallstone ileus – intestinal obstruction caused by a particularly large gallstone. This mechanical obstruction of the small bowel can be a surgical emergency.
- Gallbladder cancer – statistically speaking, a history of gallstones increases the risk of developing gallstone cancer. The majority of people with gallbladder cancer also have a history of gallstones. Still, even if you do have gallstones, your chances of actually getting cancer are less than 1 in 10,000.
What Causes Gallstones?
The majority of gallstones are made up primarily of cholesterol. So, if your liver excretes too much cholesterol, it may eventually form into gallstones. Some gallstones are formed from bilirubin, a chemical left over from breaking down red blood cells. Conditions such as liver cirrhosis, blood disorders and certain infections can cause the liver to produce too much bilirubin, which in turn leads to gallstones. Risk factors for gallstones include:
- being female
- being 40 or older
- being overweight
- birth control pills
- high-fat diet
- high-cholesterol diet
- low-fiber diet
- rapid weight loss
- liver disease
- family history of gallstones
- medications containing estrogen
Gallstones can be prevented by eating a diet rich in fiber and low in simple carbohydrates and maintaining a healthy body weight. In cases where gallstones produce no symptoms, there is no need for treatment. In patients with frequent gallbladder attacks, surgery is generally recommended. Other treatment options include medication to dissolve the stones (for example ursodeoxycholic acid) and lithotripsy, a medical procedure which uses shock waves to physically break down the gallstones. Lithotripsy is mostly reserved for patients who are unable to go through surgery for whatever reason.
Since humans can survive without a gallbladder, the surgical removal of the gallbladder (cholecystectomy) is the standard procedure for patients who frequently suffer from gallbladder attacks. Open cholecystectomy is an older, more invasive procedure, today mostly replaced by laparoscopic cholecystectomy. Several small cuts are made in the abdomen, after which the abdomen is filled with air or carbon dioxide, which allows the surgeon to see clearly. The surgery usually lasts less than two hours.
Gallbladder Removal Side Effects
Even though the body can no longer store bile between meals after the gallbladder has been removed, in most patients, this has no side effects when it comes to digestion. However, the procedure itself may have the following side effects:
- scar tissue
- discomfort and pain
- bile duct injury
- gallbladder perforation and bile leak
Gallbladder Surgery Recovery Time
Gallbladder removal may require a hospital stay of 1-2 days. The majority of patients can go back to their daily routine in a little over a week. The discomfort usually goes away in less than a month. The good news is, there is no need for special diets and other precautions.
Gallstones Natural Treatment
The best natural cure for gallstones is to exercise more and simultaneously reduce fat intake. But lifestyle changes take time and commitment and they are of little help when you’re in pain and looking for a way to feel better fast. If that is the case, consider the following options:
- apple cider vinegar: especially with apple juice, will provide fast pain relief
- turmeric: a root similar to ginger, has the ability to control inflammation and increase the solubility of bile (pro tip: try mixing one teaspoon of ground turmeric with a teaspoon of honey for the best results)
- salt and warm water
- dandelion tea or herbal infusion
- hot compress or a heating pad
- vegetable juice: a mix of beet juice, cucumber juice and carrot juice often does the trick
- citrus fruit
Bitterness of spirit and rancor are among the characteristics the ancient, but influential concept of humorism has traditionally associated with yellow bile. Those suffering from gallstones most certainly know why. Luckily, gallstones rarely produce symptoms and even when they do, there is a relatively safe and fast method to resolve them, with the added benefit of leaving you with a couple of rare bezoars of your own.