causes

causes of gall bladder stones

Scientists believe cholesterol stones form when bile contains too much cholesterol, too much bilirubin, or not enough bile salts, or when the gallbladder does not empty completely or often enough. The reason these imbalances occur is not known.

The cause of pigment stones is not fully understood. The stones tend to develop in people who have liver cirrhosis, biliary tract infections, or hereditary blood disorders—such as sickle cell anemia—in which the liver makes too much bilirubin.

The mere presence of gallstones may cause more gallstones to develop. Other factors that contribute to the formation of gallstones, particularly cholesterol stones, include

• Sex. Women are twice as likely as men to develop gallstones. Excess estrogen from pregnancy, hormone replacement therapy, and birth control pills appears to increase cholesterol levels in bile and decrease gallbladder movement, which can lead to gallstones.

• Family history. Gallstones often run in families, pointing to a possible genetic link.

• 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.

• Diet. Diets high in fat and cholesterol and low in fiber increase the risk of gallstones due to increased cholesterol in the bile and reduced gallbladder emptying.

• 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.

• Age. People older than age 60 are more likely to develop gallstones than younger people. As people age, the body tends to secrete more cholesterol into bile.

• Ethnicity. American Indians have a genetic predisposition to secrete high levels of cholesterol in bile. In fact, they have the highest rate of gallstones in the United States. The majority of American Indian men have gallstones by age 60. Among the Pima Indians of Arizona, 70 percent of women have gallstones by age 30. Mexican American men and women of all ages also have high rates of gallstones.

• Cholesterol-lowering drugs. Drugs that lower cholesterol levels in the blood actually increase the amount of cholesterol secreted into bile. In turn, the risk of gallstones increases.

• Diabetes. People with diabetes generally have high levels of fatty acids called triglycerides. These fatty acids may increase the risk of gallstones.

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gallstones

What is gallstones

Gallstones are small, pebble-like substances that develop in the gallbladder. The gallbladder is a small, pear-shaped sac located below your liver in the right upper abdomen. Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid—called bile—helps the body digest fats. Bile is made in the liver, then stored in the gallbladder until the body needs it. The gallbladder contracts and pushes the bile into a tube—called the common bile duct—that carries it to the small intestine, where it helps with digestion.

Bile contains water, cholesterol, fats, bile salts, proteins, and bilirubin—a waste product. Bile salts break up fat, and bilirubin gives bile and stool a yellowish-brown color. If the liquid bile contains too much cholesterol, bile salts, or bilirubin, it can harden into gallstones.

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.
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.

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Treatment

Treatment of kidney stones

Self-Care at Home:

• Prevention is always the preferable way to treat kidney stones. Remaining well hydrated and keeping the urine dilute will help prevent kidney stones from forming.
  
  
• Those who have never passed a kidney stone may not appreciate the severity of the symptoms. There is little a person can do with debilitating pain and vomiting other than seek emergency care. If this is the first episode and no previous diagnosis has been established, it is important to be seen by a physician as well. For those who have a history of stones, then home therapy may be appropriate. Most kidney stones, given time, will pass on their own, and treatment is directed towards symptom control. The patient should be instructed to consume oral fluids. Ibuprofen can be used as an anti-inflammatory agent, and if further pain medication is needed, contacting the primary care provider may allow stronger narcotic pain medication to be prescribed.
  
  
• Please note, if there is fever associated with the symptoms of a kidney stone, this becomes a more urgent problem, and medical care should be accessed immediately.

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Symptoms

Symptoms of kidney stones

Many kidney stones don't move and are too small to cause any symptoms. However, if a kidney stone causes a blockage, or moves into your ureter, you may:

• have severe pain or ache on one or both sides of your back
• get sudden spasms of excruciating pain - this usually starts in the back below your ribs, before radiating around your abdomen, and sometimes to your groin and genitals
• have bloody or cloudy urine
• feel sick or vomit
• feel a frequent urge to urinate, or a burning sensation during urination
• get fever and chills

You can also have these symptoms if you have a urinary tract infection (UTI) or cystitis. If you have one or more of these symptoms, you should ask your GP for advice.

The pain of kidney stones - referred to as 'renal colic' - can be very severe. It begins as soon as the stone becomes stuck in the ureter and tends to come in waves. It's not usually associated with the size of the kidney stone - sometimes small stones can cause more pain than very large ones.

Small kidney stones are usually passed out of the body within a day or so and mostly within four weeks of the onset of symptoms. The bigger the stone the less likely it is to pass out of the body spontaneously. Stones greater than 5mm (a quarter of an inch) in diameter are the least likely to pass without medical help.

If you're pregnant and have any symptoms of kidney stones, see your GP straight away.

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