Gallstones are deposits that form in the gallbladder when components of digestive secretions combine and solidify. There are two types of gallstones: cholesterol stones and pigment stones. The former are composed of cholesterol from bile, while the latter are bilirubin, a yellow compound that forms when red blood cells break down. In most circumstances, gallstones are not life-threatening, but they can be painful and cause complications such as infection. Gallstones are the most common reason people with abdominal pain and other symptoms are admitted to the emergency room.
Often, gallstones do not cause symptoms because their presence does not necessarily cause problems. Doctors call these "silent stones," and they do not require treatment. Usually, they are not discovered unless or until a doctor begins investigating for something else. It is when a stone becomes lodged in the bile duct, causing a blockage, that issues develop and the individual should seek medical attention to address symptoms and find a way to remove the stone.
Pain is the first sign that one or more gallstones have lodged in a bile duct. Doctors call this a gallstone attack, and most people feel it in the upper-right or central portion of the abdomen just under the lower ribs. Typically, the pain intensifies for up to five hours and feels quite similar to a kidney stone attack. An x-ray can confirm the location of the stone. These attacks usually occur at night, often after an individual has consumed a fatty meal or a significant amount of alcohol.
Sometimes, a gallstone attack leads to referred pain at a different site than the area directly affected. Gallstones can cause a sharp ache between the shoulder blades or below the right shoulder that lasts for several hours. Often, this pain is less intense than the abdominal pain, so individuals may ignore it.
Gallstones can cause intense pain in the upper right abdomen that lasts for days and may be accompanied by nausea and vomiting. In some cases, these signs indicate a gallbladder infection, and affected individuals should see a doctor promptly to prevent complications such as gangrene and perforation. These symptoms develop when the stones block the biliary ducts, leading to problems with digestion. Fever, chills, and worsening pain are other signs of a gallbladder infection and require immediate medical attention.
Some people with gallstones develop a fever. Even before the pain begins, chills and general feelings of sickness can begin. A fever may require medication to subside. Fever and chills may be a sign that an infection is developing in the gallbladder. People with gallstones are also at higher risk of developing pancreatitis, a serious condition that can cause similar symptoms.
People with gallstones often have indigestion in between acute attacks. Bloating and flatulence are side effects of this symptom, and most prominently affect people who consume meals high in fat. The inability of bile to flow into the small intestine due to the blockage and aid digestion causes these symptoms. This is another symptom people may overlook as simply a sign they ate too much.
Diarrhea is a by-product of impeded bile flow and impaired digestion. While sometimes indigestion only causes bloating and flatulence, at other times, it may cause loose stools. This sign is often assumed to be a consequence of simple indigestion, but this and other digestive symptoms continuing to occur should prompt a medical investigation.
When an infection extends from the gallbladder to the duct (cholangitis), the affected person will experience pain, fever, and rapid heartbeat. This happens because the bile duct is completely blocked, causing a build-up of bile in the gallbladder and eventual infection. As in acute cholecystitis, people with these symptoms should seek medical help immediately and require emergency care.
Sometimes, a gallstone can become lodged in the main duct leading from the liver to the intestine. This may block the flow of bile from the liver, causing bile to back up into the liver and seep into the bloodstream. This leads to jaundice, yellowing of the skin and the white of the eyes. People with jaundice can also experience excessive itchiness. If the gallstone does not pass through the bile duct on its own, the individual may require surgery.
Other side effects of jaundice include pale stool and dark urine. An excess of bilirubin, the product that causes yellowing of the skin and eyes, also darkens the color of urine. Gallstones also block the release of bile salts that are responsible for the brown color of stool, so when bile flow is blocked, stool loses its usual color.
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