Gallstones are collections of crystals that grow and solidify into “stones” in the gallbladder. Most gallstones are predominantly crystals of cholesterol alone or with some calcium (80-90%). Gallstones can also be composed of crystals containing calcium and bilirubin. Bilirubin is a by-product of red blood cell breakdown and recycling. 

What is going on in the body?

The gallbladder stores bile, a yellowish-green liquid made in the liver. Certain fatty drugs and hormones are excreted from the body in bile. Bile also aids in digestion. When a person eats, bile flows through a series of tubes or ducts into the upper part of the small intestine (the duodenum). It helps to “break up” food, especially fats and vitamins that are dissolved in fat so that they can be absorbed into the body. When bile is supersaturated, that is, when it contains more cholesterol or bilirubin than it can hold in solution, crystals may precipitate that eventually grow into gallstones.

What are the signs and symptoms of the condition?

There are three categories of gallstones: asymptomatic, symptomatic, and those with complications. Sixty to 80% of gallstones are asymptomatic, meaning that they cause no problems.

If gallstones become symptomatic, the person may experience the following symptoms:

• a feeling of abdominal bloating
• nausea and sometimes vomiting
• pain that is usually located in the upper right or middle part of the abdomen and may be described as “colic.” This pain may radiate to the right shoulder or shoulder blade.
• worsening of the pain after a heavy or fatty meal

If complications occur, the individual may develop further symptoms:

• abnormally light-colored stools (if the gallstone blocks the excretion of bile into the intestine)
• obstruction (blockage) of the bowels
• dark-colored urine
• fever from infection that ascends into the liver from the gall bladder
• itching
• jaundice, or yellowing of the eyes and skin
• severe, constant abdominal pain