Conditions InDepth: Gallstones

Gallstones are hard, stone-like pieces of material in the gallbladder. They can be as small as a grain of sand or as large as a golf ball. A person may have one stone or many. Gallstones are usually:

• Solid cholesterol—can be pure cholesterol or half cholesterol (most common)
• Pigment gallstones—made of calcium bilirubinate, a bile pigment (some cholesterol may also be mixed in)
• Brown pigment stone—form in infected bile and are made of calcium bilirubinate plus calcium fatty acid soaps

Gallstones

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Gallstones can block the normal flow of bile if they get stuck in any of the ducts that carry bile from the liver to the small intestine. This can cause inflammation in the gallbladder, the ducts, or, rarely, the liver.

Gallstones can cause problems, such as:

• Biliary colic—Pain from a gallstone stuck in the bile duct
• Cholangitis—An infection of the bile ducts
• Gallstone pancreatitis—A gallstone blocks the opening to the pancreatic duct, traps digestive enzymes in the pancreas, and leads to pain and inflammation
• Rarely, a person may have:
  • Gallbladder cancer
  • A complete blockage of the common hepatic duct that drains bile from the liver
  • Gallstone ileus—The gallbladder attaches to the small intestine, creating an abnormal opening through which a large stone can travel and cause an obstruction of the small bowel
  • An abnormal opening from the gallbladder to other nearby structures, like the intestines.

Gallstones are common. Most people who have gallstones do not have symptoms. These are called silent gallstones and do not always need to be treated.