What are gallstones?

Gallstones are hard deposits that can form in your gallbladder which can potentially block the flow of bile and cause serious symptoms. High fiber foods, fruits, vegetables, lean proteins and consuming low-fat dairy may help resolve symptoms and reduce the risk of gallstones returning.
Gallstones are hard deposits that can form in your gallbladder which can potentially block the flow of bile and cause serious symptoms. High fiber foods, fruits, vegetables, lean proteins and consuming low-fat dairy may help resolve symptoms and reduce the risk of gallstones returning.

The gallbladder is a small, pear-shaped organ beneath the liver in the upper right abdomen. It stores bile, a green-yellow liquid that helps digest fat. During the digestion process, your gallbladder releases bile through a duct into the small intestines

Gallstones can form when bile hardens to form pieces of solid material. These can block the flow of bile and cause more serious symptoms.  

Other problems with the gallbladder can include gallbladder cancer, chronic gallbladder disease, cholecystitis (inflammation of the gallbladder), and perforated gallbladder.  

Gallstones are hard deposits that can form in your gallbladder. They can vary in size, ranging from the size of a grain of sand to a golf ball. There are two main types of gallstones

  • Cholesterol stones, which are the most common and tend to be a yellow-green color
  • Pigment stones, which are made of bilirubin and tend to be smaller and darker

Gallstones themselves may not cause any signs or symptoms. Around 80 percent of people have what is called “silent gallstones,” meaning they never experienced any pain or other symptoms . However, if a gallstone gets lodged in a bile duct and causes a blockage, it can lead to the following symptoms: 

Pain from gallstones may last between several minutes and several days. When you experience these symptoms, it’s called biliary colic

Around 80 percent of gallstones are made up of cholesterol. The other 20 percent are made of calcium salts and bilirubin. However, it’s not entirely clear what leads to the formation of gallstones. It may be caused by too much cholesterol or bilirubin in your bile, which may cause gallstones if the gallbladder is unable to break down the excess. It may also be caused by a gallbladder that isn’t able to empty its bile content.

While anyone can develop gallstones, some risk factors are related to diet, genetics, and age. Women, those over 60 years old, or those with a family history of gallstones are more likely to develop them. Other risk factors include: 

Remedies for gallstones

In most cases, small gallstones can pass through the body without any treatment or medication. However, if you’re experiencing pain, your doctor may recommend surgery to remove the gallbladder. 

Laparoscopic cholecystectomy is the most common surgery for gallstones. Your doctor makes several small incisions to insert a narrow tube and remove the gallbladder. Open cholecystectomy involves larger cuts to the abdomen to remove the gallbladder and may lead to a longer recovery time. 

If your doctor thinks you shouldn’t have surgery—due to a medical condition or otherwise—they may recommend medication instead. Chenodiol and ursodiol can dissolve cholesterol stones. They may need to be taken for months or years to fully dissolve the stones.

Foods to eat for gallstones

While surgery is the most common treatment for gallbladder stones, milder cases may be treated through diet and lifestyle changes. These changes can also reduce the likelihood that the gallstones will return. 

Studies show that people who follow a healthy diet have a lower risk of gallstones or gallbladder disease. Knowing which foods to eat and which to avoid may help resolve symptoms and reduce the risk of gallstones returning. Some of the foods which may help with gallstones include:

Fruits and vegetables

A diet high in fruits and vegetables can help improve the health of your gallbladder. Foods that are high in fiber, Vitamin C, calcium, or B vitamins are essential to a healthy gallbladder. Some fruits and vegetables to incorporate in your diet are: 

  • Citrus fruits
  • Bell peppers
  • Leafy greens 
  • Tomatoes 

Fiber 

Fiber is known for promoting digestive health. It may also help the movement of food through the gut and lower the production of bile, which can reduce the risk of developing gallbladder disease. 

One study found that a high fiber diet led to lower production of biliary sludge for people who are losing weight rapidly. Biliary sludge, which may build up when people fast or lose weight quickly, increases the risk of gallbladder disease. Foods that are high in fiber include fruits, vegetables, legumes, nuts, seeds, and whole grains.

Low-fat dairy 

Reducing fat can also help prevent gallstones. Low-fat dairy, like milk or cheese, can help reduce the amount of fat in the diet. 

Milk alternatives, including almond milk, oat milk, or soy milk, can also be substituted for whole milk. 

Lean protein

While red meat and dairy are good sources of protein, they can also be high in fat, which puts stress on the gallbladder. 

Low-fat proteins, like poultry, fish, nuts, seeds, beans, tofu, and soy products, can offer lean protein without the added fat. One study found a link between vegetable proteins and lower risk of gallbladder disease.

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Foods to avoid for gallstones

Certain foods that are higher in fat or cholesterol are more likely to inflame the gallbladder or cause gallstones. Avoid the following foods for a healthier gallbladder: 

  • Refined breads, pastas, etc.  
  • High-fat dairy 
  • Vegetable oil 
  • Peanut oil
  • Processed foods
  • Sugar 
  • Alcohol 

Risks and recovery

While most gallstones are passed without pain, you should go to the hospital if you have any signs of a serious infection, inflammation, or blockage. These signs include: 

  • Severe abdominal
  • Pain that lasts for several hours
  • Fever and chills
  • Yellow skin or eyes
  • Dark colored urine

If you need surgery to remove your gallbladder, recovery can last between several days to several weeks. In most cases of removal, the stones don’t return. If you don’t have surgery or if you’ve taken medication to dissolve the stones, there’s a chance the gallstones can return. 

Making certain lifestyle changes, including changes to the diet, can prevent gallstones from returning or causing problems. 

Why do you get gallstones?

The exact cause of gallstones cannot usually be determined. Some possible causes are as follows:

  • High cholesterol in the bile: Normally, the cholesterol excreted by the liver is digested and dissolved by the chemicals in the bile. If the liver excretes excess cholesterol, beyond what the bile can dissolve, the excess cholesterol may crystallize, forming stones.
  • High bilirubin in the bile: Bilirubin is a chemical that's produced when the body breaks down red blood cells. Certain conditions of the liver like liver cirrhosis, liver infections or blood disorders cause increased production of bilirubin. The excess bilirubin can lead to gallstone formation.
  • Decreased gallbladder emptying: If the gallbladder doesn't empty completely, bile concentration may increase, contributing to the formation of gallstones.

Risk factors for gallstones: Certain factors increase the risk of gallstones, such as:

What is the gallbladder? 

The gallbladder is a small pear-shaped organ located below the liver on the right side of the belly. The main function of the gallbladder is to store bile, a substance secreted by the liver that is required for digestion. The bile contents in the bile may sometimes crystallize and form gallstones. They may be as small as a grain of salt or as large as a tennis ball causing serious symptoms and complications.

What are the types of gallstones?

There are two types of gallstones that can form in the gallbladder:

  • Cholesterol gallstones: This is the most common type of gallstone. They appear yellow in color. These gallstones mainly consist of undissolved cholesterol and small amounts of other components.
  • Pigment gallstones: These stones contain high amount of bilirubin. The appear dark brown or black.

What are the signs and symptoms of gallstones?

There may be no symptoms in the initial stages. Some signs and symptoms that may develop later are as follows

  • Pain in the right upper abdomen, which may be mild or severe 
  • Back pain
  • Digestive discomfort, especially after a heavy meal 
  • Tenderness over the right upper abdomen 
  • Fever with chills, in case of infection 
  • Nausea and vomiting 

How are gallstones treated?

If gallstones are not very large, the doctor may advise nonsurgical treatment methods to dissolve the gallstones.

Nonsurgical treatment options

  • Medication: Medications such as ursodiol cause thinning of the bile, helping gallstones dissolve. Medication to reduce cholesterol levels in the bile may help. These medications usually take years to work and do not prevent recurrence.
  • Extracorporeal shock wave lithotripsy (ECSWL): ECSWL is a nonsurgical treatment that uses external shock waves to fragment the gallstones, less than 2 cm in diameter.
  • Methyl tertiary-butyl ether (MTBE) injection: A solvent called MTBE is injected into the gallbladder to dissolve gallstones.
  • Endoscopic drainage: An endoscope (a thin tube attached to a camera and light) along with a wire is passed down the throat and into the gallbladder, helping the gallbladder resume normal drainage.
  • Percutaneous cholecystostomy: This is ideal for seriously ill patients who are not fit for surgery. A needle is used to withdraw fluid from the gallbladder followed by inserting a catheter through the skin to drain the fluid that is left in place for a few weeks until surgery is possible.
  • Transmural drainage: This involves creating a new tract through the stomach into the gallbladder. A metal stent is placed, allowing gallbladder to drain into the small intestine. 
  • Acute cholecystostomy: In patients with acute cholecystitis, cholecystostomy may be performed for those who are unable to undergo surgery to drain infection.

Surgery 

  • Cholecystectomy (surgery to remove the gallbladder) is indicated if nonsurgical techniques are not possible or in the case of recurrence. Once the gallbladder is removed, the bile flows directly from the liver into the small intestine. Gallbladder is not required to live, and its removal doesn't affect digestion or quality of life. Sometimes, there may be bloating or diarrhea on eating food with a high fat content but having a balanced diet can make such complaints go away.

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Can gallstones be prevented?

The following may help prevent gallstones

  • Maintaining a healthy body weight
  • Eating a balanced diet, with low fat and high fiber
  • Not skipping meals
  • Slow and steady weight loss

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Medically Reviewed on 2/28/2022
References
American College of Gastroenterology: "Gallstones in Women"

American Family Physician

Georgian Medical News: "Dietary Fiber's Benefit for Gallstone Disease Prevention During Rapid Weight Loss in Obese Patients"

Harvard Health Publishing: "What To Do About Gallstones?"

Journal of Health, Population, and Nutrition: "Dietary Patterns and Risk of Gallbladder Disease: A Hospital-based Case-Control Study in Adult Women"

Medscape Medical Reference

National Health Service: "Gallstones"

National Institute of Diabetes and Digestive and Kidney Diseases: "Eating, Diet, and Nutrition for Gallstones"

NHS

Nigerian Journal of Surgery: "Gallstones"

Preventative Medicine: "Vegetable Protein Intake Is Associated With Lower Gallbladder Disease Risk: Findings From the Women's Health Initiative Prospective Cohort"

Statpearls: "Laparoscopic Cholecystectomy"