A gallstone occurs when the bile fluid in the gallbladder remains stagnant for a long time. The liquid then becomes thick and crystallizes. The so-called gallstone is then formed from this thick paste. A gallstone can become stuck in front of the gallbladder outlet or in the bile duct, after which the characteristic pain of a gallstone attack occurs.

Symptoms

The presence of one or more gallstones does not necessarily cause complaints. Symptoms only occur when a gallstone becomes stuck. As a result, the bile fluid does not flow properly. This causes the following complaints:

• Pain that comes in alternating attacks, on the right side of the upper abdomen
• Pain radiates to the back or shoulder blade
• Nausea
• Yield
• Not being able to sit or lie still during a gallstone attack
• Discolored feces

Gallstone attack

The gallbladder tries to remove a stuck gallstone itself. This is done by violent contractions. These attacks cause extreme pain in the upper right abdomen. These attacks are known as gallstone colic. An attack can last one to two hours. If the gallbladder fails to remove the stone, complications can occur.

The gallbladder

The gallbladder acts as a sac where bile fluid is stored. The liver produces bile fluid. The bile ducts transport the bile fluid to the gallbladder. The fluid leaves the gallbladder via the duodenum, which uses the bile fluid for the digestion of fats. In the body, the gallbladder is located in the upper right side of the abdominal cavity. The gallbladder is close to the liver.

Cause

It is not known exactly how a gallstone is formed. The development of a gallstone may have to do with the structure of the bile fluid and the functioning of the gallbladder. One cause of this may be that the gallbladder does not empty completely when eating. It is clear that a gallstone is formed when the bile fluid crystallizes. It is striking that obese women aged 40 and older suffer from gallstone attacks. Furthermore, a quarter of people over fifty sometimes suffer from a gallstone. Those who have high cholesterol are more likely to have a cholesterol gallstone.

Diagnosis

If you suspect that you are dealing with a gallstone attack, it is important to consult your doctor. If they also think that the patient has a gallstone, they will be referred to the hospital. Hospital admission usually follows in the event of a complication. Gallstones can be detected via ultrasound and MRI examination. Often a gallstone cannot be found because it has already left the body. The gallstone may then be present in the stool. The diagnosis can still often be made. Often other gallstones are visible in the gallbladder.

Complications

When a gallstone ensures that the bile fluid in its entirety can no longer be drained, a dangerous complication arises. The patient then gets a full skin color. Bacteria then flow from the intestine to the bile ducts where they can cause (severe) inflammation. The gallbladder and pancreas can also become inflamed. Inflammation of the pancreas occurs when a gallstone is stuck near the papilla of Vater. The papilla ensures the drainage of the bile fluid from the pancreas to the bile ducts and duodenum.

Therapy

Pain relief

The gallbladder usually succeeds in removing a gallstone to the intestine. The gallstone comes out with the stool. Because contraction of the gallbladder is very painful, it is advisable to consult a doctor for proper pain relief.

Operation

If multiple gallstones are present in a gallbladder, the gallbladder is surgically removed. This is done via abdominal surgery or keyhole surgery. This is called a gallbladder resection or a cholecystectomy. It is usually decided to remove the gallbladder via keyhole surgery. People can live well without a gallbladder, because the gallbladder only temporarily stores bile fluid. In rare cases, a removed gallbladder continues to cause permanent complaints.

ERCP

A gallstone can also be removed by ERCP (Endoscopic rhetograde cholangiopancreaticography). A doctor can reach the bile ducts via a tube through the mouth, esophagus, stomach and duodenum. The stone is grabbed with pliers and removed. ERCP widens the bile duct exit so that gallstones can flow away more easily. In people who have multiple gallstones, it is more advisable to opt for complete removal of the gallbladder.

Medication

There are also medications that ensure that small gallstones disappear on their own. Often this medication is ineffective. After taking the medication, new gallstones often form.