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Gallstones are stones that form in the gall (bile). Bile is a watery liquid made by the cells of the liver that is important for digesting food in the intestine, particularly fat. Liver cells secrete the bile they make into small canals within the liver. The bile flows through the canals and into larger collecting ducts within the liver (the intrahepatic bile ducts).Most gallstones are silent. If silent gallstones are discovered in an individual at age 65 (or older), the chance of developing symptoms from the gallstones is only 20% (or less) assuming a life span of 75 years. In this instance, it is reasonable not to treat the individual. Among younger individuals, no treatment also might be appropriate if the individuals have serious, life-threatening diseases, for example, serious heart disease, that are likely to shorten their life span.The normal function of the gallbladder is to store bile produced by the liver, and to aid in the digestion and absorption of fats in the duodenum (the first portion of the small intestine). Gallstones compose a solid formation of cholesterol and bile salts. However, research shows that approximately 80 to 90 percent of all gallstones are cholesterol gallstones which form when the liver begins secreting bile that is abnormally saturated with cholesterol. The excess cholesterol crystallizes and then forms stones which are stored in the gallbladder or the cystic duct. The two types of gallstones are cholesterol stones and pigment stones. Cholesterol stones are usually yellow-green and are made primarily of hardened cholesterol. They account for about 80 percent of gallstones. Pigment stones are small, dark stones made of bilirubin. Gallstones can be as small as a grain of sand or as large as a golf ball. The gallbladder can develop just one large stone, hundreds of tiny stones, or a combination of the two.Gallstones and kidney stones often occur together. When either kind of stone exists, the liver, kidneys and the whole system cannot work efficiently.  Because the kidneys and gallbladder are very close to each other, the stagnation of one organ often causes the other organ to become sluggish too.  This is why kidney stones and gallstones usually occur together as both types of stones are the result of stagnation.  In order to reduce the chance of having stone accumulation and stagnation again, it is better to cleanse both kidney stones and gallstones.The cause of gallstones varies. Some stones form when there is too much cholesterol or bilirubin in the bile. (Bile is a liquid that helps the body digest fats.) Other stones form if there are not enough bile salts or if the gallbladder fails to empty properly. One type of gallstones, called pigment stones, tend to occur in people who have medical conditions that cause the liver to make too much bilirubin. Pigment stones are also more common in persons with liver cirrhosis and biliary tract infections.Cholesterol is the primary element of most gallstones, but gallstones can also form from calcium salts and bile pigments. Cholesterol is a normal component of bile, and usually remains dissolved. However, when the bile becomes oversaturated with cholesterol, small crystals form. These crystals are trapped in mucus within the gallbladder, and gradually grow. Gallstones can be as small as grains of sand or as large as golf balls.

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Gallstones (biliary calculi) are small stones made from cholesterol, bile pigment and calcium salts, usually as a mixture that forms in the gall bladder. The gall bladder is a small sac that holds bile, a digestive juice produced by the liver that is used in the breakdown of dietary fats. The gall bladder extracts water from its store of bile until the liquid becomes highly concentrated. The presence of fatty foods triggers the gall bladder to squeeze its bile concentrate into the small intestine.

Gallstones are a common health problem worldwide. Gallstones can occur anywhere within the biliary tree, including the gallbladder and the common bile duct. Obstruction of the common bile duct is choledocholithiasis; obstruction of the biliary tree can cause jaundice; obstruction of the outlet of the pancreatic exocrine system can cause pancreatitis.

Causes

Weight. A large clinical study showed that being even moderately overweight increases the risk for developing gallstones. The most likely reason is that the amount of bile salts in bile is reduced, resulting in more cholesterol. Increased cholesterol reduces gallbladder emptying. Obesity is a major risk factor for gallstones, especially in women.

Pigment Stones. The cause of pigment stones is uncertain. They tend to develop in people who have cirrhosis, biliary tract infections, and hereditary blood disorders such as sickle cell anemia in which too much bilirubin is formed.

Rapid weight loss. As the body metabolizes fat during prolonged fasting and rapid weight loss—such as “crash diets”—the liver secretes extra cholesterol into bile, which can cause gallstones. In addition, the gallbladder does not empty properly.

Symptoms of Gallstones

Often, there are no symptoms of gallstones. The gallstones lie quietly within the gall bladder and are usually found by chance. If a gallstone is obstructing the gall bladder, there will be severe pain in the upper right side of the abdomen. The pain will come and go in waves as strong muscular contractions. Strong muscular contractions occur because the body is trying to get rid of the obstruction.

Treatment

Laparoscopic cholecystectomy (keyhole gallbladder removal) – This is the most common treatment. Under general anaesthesia a hollow needle is inserted through or near your navel. This is used to inflate the abdomen with carbon dioxide gas. The laparoscope (a long, thin telescope with a light and camera lens at the tip) is then inserted through a small cut at the same spot. This gives the surgeon a view of your internal organs on a video monitor. To remove the gallbladder, specially adapted surgical instruments are then inserted through some more small incisions.

Complications of Gallstones.

Cholecystitis. Cholecystitis means inflammation of the gallbladder. Like biliary colic, it too is caused by sudden obstruction of the ducts by a gallstone, usually the cystic duct. In fact, cholecystitis may begin with an episode of biliary colic. Obstruction of the cystic duct causes the wall of the gallbladder to begin secreting fluid just as with biliary colic, however, for unclear reasons, inflammation sets in.

Cholangitis. Cholangitis is a condition in which bile in the common, hepatic, and intrahepatic ducts becomes infected. Like cholecystitis, the infection spreads through the ducts from the intestine after the ducts become obstructed by a gallstone. Patients with cholangitis are very sick with a high fever and elevated white blood cell counts.

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