What are gallstones?

Gallstones are small rock-like particles that develop in the gall bladder. The gallbladder, which aids in digestion, is a small sack-like organ about the size of an egg located just under the liver.

The gall bladder produces several substances, among them bile salts. These substances help in the digestion of foods, including fatty foods. Over time, these bile salts can harden, producing gallstones.

Gallstones can range from the size of a grain of salt to larger than an egg. There are two general types of gallstones:

1) cholesterol stones that are primarily composed of cholesterol. These stones are yellow-green in color. Eighty percent of all gallstones are of the cholesterol type.

2) Pigment stones that are made of the breakdown products of red blood cells (bilirubin).  They tend to be smaller and darker than cholesterol stones. About 20 percent of gallstones are of the pigment type. People with liver disease (cirrhosis) and red blood cell diseases (like sickle cell disease) are more likely to develop pigment stones.

Gallstone risk factors

• High cholesterol diet
• Obesity
• Diabetes
• Fasting or skipping meals
• Taking cholesterol medications
• Rapid weight loss
• Increased levels of estrogen
• Pregnancy
• Positive family history of gallstones
• Elderly
• Being a woman
• Having Native American or Mexican American heritage
• Any medical condition that causes the gall bladder to contract less

Gallstone symptoms

Most gallstones don’t produce any symptoms. Many people have “silent stones” and don’t even know it. Sometimes gallstones are detected when a patient is being examined for something completely different.

When gallstones do produce symptoms, they may include:

• Pain in the upper stomach and upper back that can last for several minutes, even several hours, especially after eating
• Nausea, especially after eating
• Vomiting, especially after eating
• Heartburn
• Gas/bloating

Gallstone diagnosis

If your doctor suspects gallstones, based on your medical history and symptoms, the diagnosis is confirmed by a physical examination coupled with an imaging study (X-ray, Cat scan, and/or ultrasound)

Gallstone treatment

Surgical removal of the gallbladder is the most common treatment. Oftentimes, only a small incision is made in laparoscopic surgery.

If surgery is not an option, there are medications that can be taken to dissolve the gallstones. These may need to be taken for an extended period of time, and sometimes the gallstones can return.

If you have any abdominal pain, discomfort or nausea, especially after eating, be sure to tell your doctor in case a medical evaluation is in order. The problem may very well be gallstones.

Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.