Gallstones
Understanding Cholesterol & Pigment Stones
Overview
Gallstones are hardened deposits that form in the gallbladder — a small organ beneath the liver that stores bile. They range in size from a grain of sand to a golf ball. About 80% of gallstones are cholesterol stones; the remaining 20% are pigment stones.
Types
Cholesterol Stones
The most common type (80%). Yellow-green in color, formed when bile contains too much cholesterol. Risk factors include obesity, rapid weight loss, and high-fat diet.
Pigment Stones
Dark brown or black stones formed from excess bilirubin. More common in patients with liver disease, blood disorders, or bile duct infections.
Mixed Stones
Combination of cholesterol and pigment components. Most common type found in Indian patients.
Symptoms
- Sudden, intense pain in the upper right abdomen (biliary colic)
- Pain that radiates to the right shoulder or back
- Nausea and vomiting
- Indigestion and bloating after fatty meals
- Fever and chills (if infection develops)
- Jaundice (yellowing of skin/eyes) if bile duct is blocked
Causes & Risk Factors
- Excess cholesterol in bile
- Excess bilirubin production
- Gallbladder not emptying properly
- Obesity and rapid weight loss
- High-fat, low-fiber diet
- Family history of gallstones
- Diabetes and metabolic syndrome
- Prolonged fasting or total parenteral nutrition
Diagnosis
- Ultrasound (most accurate, non-invasive)
- Blood tests (liver function, CBC, amylase)
- CT scan for complications
- MRCP (Magnetic Resonance Cholangiopancreatography)
- HIDA scan for gallbladder function
Treatment Options
- Laparoscopic cholecystectomy (gold standard)
- Robotic-assisted surgery for complex cases
- ERCP for CBD stones
- Single-incision surgery for cosmetic preference
- Medical management (for non-surgical candidates)
⚠️ When to Seek Immediate Treatment
- Severe abdominal pain lasting more than 5 hours
- Fever above 38.5°C with abdominal pain
- Jaundice (yellow skin or eyes)
- Dark urine or pale stools
- Persistent vomiting
Frequently Asked Questions
Can gallstones dissolve on their own?
Small cholesterol stones may dissolve with oral medications (ursodiol), but this takes 6–24 months and stones often recur. Surgery is the most reliable treatment.
What happens if gallstones are left untreated?
Untreated symptomatic gallstones can lead to cholecystitis, bile duct obstruction, pancreatitis, and rarely gallbladder cancer. Treatment is recommended for symptomatic stones.