Gallbladder stone: photo, cause, what to do?

Gallbladder stone photo cause what to do

A gallbladder stone can cause severe pain accompanied by nausea, especially in the event of an attack. If the pain is really very intense, that it is repeated, it is necessary to consult, warns Professor Robert Benamouzig, specialist in gastroenterology.

Gallstones (also called cholelithiasis) are small pebbles that form in the gallbladder or bile ducts. They may not cause any symptoms. When they are symptomatic, then appears a sudden pain in the pit of the stomach or under the ribs. The pain may radiate to the shoulder and be accompanied by nausea and fever. What are the causes gallstones? What are the treatments ? The most effective drugs? When and who to consult? Is removing the gallbladder always necessary? Point.

Definition: what is a gallstone?

A gallstone is a more or less significant mass of crystals (pebbles) present in the vesicle biliary or bile ducts. In general, gallstones are composed of cholesterol, bilirubin, but it can also come from calcium salts.

What is the composition of a gallstone?

Photo of a gallstone © Leonid Eremeychuk – 123RF

A gallstone is a small pebble made up of:

  • cholesterol (mainly cholesterol crystals)
  • bilirubin
  • calcium
  • mucins
  • protein

It exists two types gallstones:

→ The cholesterol stones composed only of cholesterol (when pure) and cholesterol and bile pigments (when mixed)

→ The pigment stones compounds of polymers of bilirubin salts (black stones) or sodium bilirubinate (brown stones)

What are the symptoms of gallstones?

Sometimes the gallstone causes a sharp pain which is sometimes accompanied by nausea. Affected individuals may also experience:

  • A pain in the right shoulder, because neurological interactions exist with the gallbladder.
  • Fever. If the pain is accompanied by fever and worsens with movement and breathing, it may be a cholecystitis.

From the age of 50, it is common to have one or more stones in the gallbladder, but most of them are very small and cause no symptoms.

Most of the time they are painless and asymptomatic. Sometimes, however, they cause hepatic colic very painful, relieved by the evacuation of the responsible calculation. The most characteristic symptom is a sharp painmost often felt after a rich meal,

What is the cause of gallstones?

The gallbladder is a small pocket located under the liverresponsible for storing bile, a substance produced by the liver. The gallbladder is connected to the liver, pancreas and small intestine by various channels (see diagram below). During digestion, the gallbladder contracts and pours bile into the small intestine to promote proper digestion. Bile is made up of water, cholesterol, mineral salts and bile pigments (called bilirubin). If the bile has a too much cholesterol or bilirubincalculations (stones whose size can vary enormously) can form in the gallbladder: they are the ones who are painful. First of all, “it is important to distinguish pain in the right hypochondrium – the region of the gallbladder – from pain in the gallbladder itself“, immediately warns Professor Robert Benamouzig, specialist in gastroenterology at the Avicenne Hospital in Bobigny (AP-HP). And to add “indeed, the pains of the right hypochondrium do not necessarily come from the gallbladder: they can in particular be due to spasms, hepatic pathologies, or an anomaly of the bile ducts“. One of the most common causes of pain is the appearance small pebbles in the gallbladder (we speak of cholelithiasis): these gallstones can slow down the flow of bile, or even completely obstruct the channel it must take to reach the intestine, which causes severe pain, “hepatic colic”. An infectious pathology of the gallbladder, such as cholecystitis, can also cause these pains. Cholecystitis is inflammation of the gallbladder wall.

Diagram of stones in the bile ducts
Diagram of stones in the bile ducts © pattarawit – 123RF

When should you consult?

If the pain is accompanied by fever, it is a medical emergency.

Pain in this area does not necessarily warrant a medical consultation. “In most cases, this is pain in the right hypochondrium“, specifies Professor Benamouzig. “But if the pain is really very intense, if it is repeated, it is necessary on the other hand to consult to identify the precise cause of the malaise. And if the pain is accompanied by fever, it is a medical emergency“. An ultrasound is thus performed to determine the origin of the problem.

The gallstone may go unnoticed and may be discovered incidentally during an examination for another problem. In case of gallstone crisis or a gallbladder infection, the doctor may check for the presence of stones by an ultrasound (ultrasound endoscopy) or by MRI (cholangio-MRI).

What is the treatment for gallstones?

► An asymptomatic stone often resolves on its own and does not require treatment.

► A symptomatic calculation (small in size and composed only of cholesterol) may require the taking ofa bile acid medicinehelping to dissolve calculus.

In the event of a biliary colic attackthe treatment is based on taking analgesics or certain antispasmodics.

In case of complicationsremoval of the gallbladder (cholecystectomy) can be considered. This common and minimally traumatic intervention does not cause any particular problems because, in the absence of a gallbladder, the bile continues to flow into the intestine. Thereafter no special diet is necessary, except in some people.

What are the drugs to relieve gallstones?

Gallstones often resolve on their own. But sometimes a medical treatment (based on ursodeoxycholic acid, a major component of bear bile) is sometimes necessary to deal with it. This drug, effective only on small stones, composed only of cholesterol, will help dissolve the stones in the gallbladder. The treatment should be taken between 6 and 18 months. People prone to these types of stones should also review their dietin particular by eliminating foods that are too fatty.

Examples of bile acids:


When to consider an operation?

In some cases, removal of the gallbladder (called cholecystectomy) is necessary, especially if the stones are too painful and threaten the pancreas. It is a very common operation (practiced on nearly 100,000 people each year in France). It is therefore quite possible to live without a gallbladder: the bile then flows directly from the liver to the small intestine.

Thanks to Pr Robert Benamouzig, specialist in gastroenterology at the Avicenne Hospital in Bobigny (AP-HP)