Different Types of Gallstones
Most of the 20 million Americans with gallstones never know they have them. Even if a doctor discovers the stones, if the stones don’t cause any pain no treatment is needed. Gallstone treatment usually results in the surgical removal of the stones. The body quickly adapts to the loss of the gallbladder and digestion occurs as usual.
Two main types of gallstones, cholesterol and pigmented, can be found in the body. People tend to have one or the other type of gallstone, they usually do not have both types present. Studies have shown that the country in which the patient resides can contribute to the type of gallstone in the body. People from the U.S., Australia, England, Germany, South Africa, and Sweden tend to develop cholesterol stones whereas people from less industrialized countries more often develop pigmented gallstones.
Gallstones range in size from as small as a grain of sand all the way up to the size of a golf ball. The gallbladder is capable of creating any combination of gallstone sizes: one large gallstone, several hundred small stones, etc. Smaller gallstones can move around over time; larger gallstones tend to stay in their original location. Some believe that once gallstone has developed, the chances of other gallstone development is greatly increased.
Cholesterol stones are the most prevalent among people from more developed or industrialized countries. Cholesterol stones form because the bile contains too much cholesterol, too much bilirubin (a brownish substance created when liver breaks down old red blood cells), or not enough bile salts, which are detergent-like chemicals that are stored in the gallbladder. Small cholesterol stones can get lodged in the ducts leading into the pancreas and cause pancreatic inflammation (pancreatitis).
Pigment stones are black or brown in color and are comprised of bilirubin and calcium. Pigment stones most often develop in individuals with biliary tract infections, hereditary blood disorders, or cirrhosis of the liver; conditions where too much bilirubin has formed. If the body destroys too many red blood cells the body produces an excess amount of bilirubin and this causes the formation of pigment stones in the gallbladder. Sickle-cell anemia, a hereditary blood disorder, tends to cause the body to destroy red blood cells too early in the process, resulting in excess bilirubin. As such, statistics show that individuals with sickle-cell anemia tend to require gallbladder removal surgery at a higher rate than those without the condition.
Sometimes gallstones absorb so much calcium that they become calcified, or hardened. Calcified stones can sometimes been seen on a regular x-ray. Because calcified stones are so dense, they’re not good candidates for gallstone dissolving procedures. Instead, if these stones are causing pain or discomfort, gallbladder surgery is usually recommended.
Biliary sludge, a thickened protein found in the gallbladder often accompanied by tiny cholesterol crystals, sometimes serves as an early indicator for gallstones. The most common symptom of biliary sludge is abdominal pain often accompanied by nausea or vomiting. This occurs because the sludge particles obstruct the ducts that lead from the gallbladder to the intestine. In some instances biliary sludge can cause serious health problems, like the inflammation of the pancreas (pancreatitis) or inflammation of the gallbladder (cholecystitis). Biliary sludge is more commonly found in pregnant women, individuals who have experienced rapid weight loss or engage in prolonged fasting, or in patients that have been fed intravenously for prolonged periods of time.
Gallstones can sometimes be treated by having the stones themselves removed (endoscopic surgery) or by being dissolved. The symptoms of gallstones can sometimes be minimized by an adjustment in one’s diet. However, the most common and permanent procedure for removing gallstones is gallbladder removal surgery. As recently as ten years ago this required the surgeon to make a 5″-8″ incision in the abdominal area through which the gallbladder was removed. Presently, most gallbladders are removed laparoscopically, which just requires 4 small incisions through which tiny instruments (a small scope with a camera, a small scope with a cutting tool) are placed. This type of surgery greatly reduces the patient’s hospital stay – many patients return home a few hours after the surgery. Recovery time is also reduced. Approximately 500,000 Americans have their gallbladders removed each year making this surgical procedure one of the most common in the U.S.