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Gallstones: How They Form, Where They Hurt, and How They’re Treated

Bilirubin, Gallbladder Removal, Gallstones, Lithotripsy

What is the gallbladder?

The gallbladder is an organ found behind the liver, easily recognizable because of its pearish shape. Consider the gallbladder as a sort of holding tank for bile. Bile is a mixture of water, salt, cholesterol and bilirubin, which is a pigment that…well…have you ever wondered why poop is brown? Bilirubin is the answer. The gallbladder holds bile like a little tank as it contracts, sending the bile to your small intestine.

What are gallstones?

Gallstones are actually just tiny little nuggets of material found in bile. The gallstone is formed when there is an overabundance of one of those ingredients that make up bile. The overwhelming majority of gallstones occur as a result of too much cholesterol, but gallstones are also formed where there is too much bilirubin. In addition, if the gallbladder isn’t totally voided gallstones can result.

What are the symptoms of gallstones?

The pain associated with gallstones occurs either when the gallstone gets stuck on the way to the intestine, or when it inflames inside the gallbladder. The result will be incredibly intense pain that begins in the upper right portion of your abdomen. Usually the pain then spreads outward to the back, chest and right shoulder. This pain can last as little as a half hour up to several hours. Besides abdominal pain, other symptoms of gallstones include nausea to the point of vomiting, belching and/or flatulence, indigestion, and even yellowing of the skin. Gallstone pain typically sets on after a meal, usually a meal that contains food high in fat.

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Who is most at risk for gallstones?

Those over age 60 have a much higher risk of developing gallstones, and women have a higher risk rate than men. The reason for this is because the hormone estrogen serves to increase cholesterol levels. Keep that in mind when getting hormone replacement therapy or taking birth control pills. Being overweight also raises the risk for gallstone development, as does having diabetes. Before going on a crash diet or fasting, take into consideration that doing so can cause cholesterol to stick around inside the gallbladder longer that it should. And by now you should know what that means. Losing weight rapidly also results in the liver creating more cholesterol into the bile. If you are currently taking medication to reduce your cholesterol, understand that some of those medications actually increase the amount of bile your body produces.

What are the treatments for gallstones?

Some medications are available that can dissolve smaller gallstones, but the drugs can take up to two years to get that job done and, worse still, the success rate is minimal. Worst of all: almost half experience a recurrence. Surgery used to be the go-to treatment, but in recent years some success has found with extracorporeal shock-wave lithotripsy (ESWL). This method uses shock waves to break up the gallstones; if you are suddenly flashing back to the classic video game Asteroids, you’re not way off. This treatment has proven quite successful with kidney stones, but unfortunately hasn’t had the same luck so far with gallstones. Which leaves surgery. Gallbladder removal is still the option of choice and the risk is considerably lessened with so-called keyhole surgery. Gallbladder removal has become a high tech procedure that uses tiny tube cameras to allow the surgeon to see what he is doing projected on a screen.

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What I can do to prevent gallstones?

Eating a diet that is low in fat and high in fiber is certainly a step in the right direction. Keeping your weight down in concert with changing your diet makes it even less likely that you will suffer from gallstones. Of course, if you start eating more fiber, then you will also want to make sure you get your sixty-four ounces of fluid each day as well, preferably water. Some research is leaning toward a diet that contains several servings of fish or monosaturated fats can lower one’s risk of gallstones. And, of course, you should also exercise. What about supplements? Are there any supplements I can take to reduce the risk of gallstones? Psyllium is one supplement that may help; it will reduce your risk of constipation. Even better, psyllium also bonds with the cholesterol in bile, contributing to the inability of gallstones to form.