Because some gallstones never cause pain most people that have gallstones don’t know they have them. At even if a physician determines that a patient has gallstones, if no symptoms are present, there’s usually no need for treatment. However, if treatment is needed and surgery (i.e., gallbladder removal) is the best option, the body soon adjusts itself to not having this organ because the body functions properly without it.
There are two main types of gallstones: cholesterol stones and pigmented stones. Interestingly enough, the type of gallstone present in individuals usually depends on their country of origin. Americans tend to have cholesterol stones whereas people from Asia are most often diagnosed with pigmented gallstones.
Gallstones range in size from as small as a grain of sand all the way up to the size of a golf ball. The gallbladder is capable of creating any combination of gallstone sizes: one large gallstone, several hundred small stones, etc. Smaller gallstones can move around over time; larger gallstones tend to stay in their original location. Some believe that once gallstone has developed, the chances of other gallstone development is greatly increased.
Cholesterol stones are the most prevalent among people from more developed or industrialized countries. Cholesterol stones form because the bile contains too much cholesterol, too much bilirubin (a brownish substance created when liver breaks down old red blood cells), or not enough bile salts, which are detergent-like chemicals that are stored in the gallbladder. Small cholesterol stones can get lodged in the ducts leading into the pancreas and cause pancreatic inflammation (pancreatitis).
The other type of gallstone is pigment stones. These stones develop when the body sheds its old red blood cells either too frequently or too quickly. As a result, the body produces an excess amount of bilirubin, the primary cause of pigment stones. People with sicke-cell anemia or biliary tract infections tend to get pigment stones. Studies show that those with sicke-cell anemia tend to have pigment gallstone problems early in life.
Both cholesterol and pigment stones can become hardened (calcified) over time. Approximately 20% of all gallstones contain enough calcium to make them visible on regular x-rays. Because calcified stones are hardened efforts to dissolve them may not be successful.
One early indicator of gallstones is biliary sludge, a thick protein substance found in the gallbladder. Biliary sludge particles can sometimes get lodge in the ducts that lead into the intestine and cause abdominal pain. It can also lead to inflammation of the pancreas (pancreatitis) or gallbladder. Women who are pregnant can develop biliary sludge. Additionally, people who fast for long periods of time or those that experience rapid weight loss may build up biliary sludge.
Gallstones can sometimes be treated by having the stones themselves removed (endoscopic surgery) or by being dissolved. The symptoms of gallstones can sometimes be minimized by an adjustment in one’s diet. However, the most common and permanent procedure for removing gallstones is gallbladder removal surgery. As recently as ten years ago this required the surgeon to make a 5″-8″ incision in the abdominal area through which the gallbladder was removed. Presently, most gallbladders are removed laparoscopically, which just requires 4 small incisions through which tiny instruments (a small scope with a camera, a small scope with a cutting tool) are placed. This type of surgery greatly reduces the patient’s hospital stay – many patients return home a few hours after the surgery. Recovery time is also reduced. Approximately 500,000 Americans have their gallbladders removed each year making this surgical procedure one of the most common in the U.S.