Linda Crampton is a writer and teacher with a first-class honors degree in biology. She often writes about the scientific basis of disease.
A Helpful Organ
The gallbladder is a small but useful organ. It's located under the liver on the right side of the upper abdomen (from the owner’s point of view). It stores a liquid called bile, which is made by the liver. When fat from food enters the small intestine, the gallbladder contracts and sends bile into the intestine through a duct. The bile emulsifies the fat, breaking it up into small droplets. Emulsification makes it easier for enzymes to digest the fat.
Although the gallbladder is a helpful organ, it can cause problems in some people. While bile is stored, water is removed and the remaining liquid becomes concentrated. This may lead to the formation of solid lumps known as gallstones. The presence of these lumps can lead to a painful condition known as a gallbladder attack.
The pain of a gallbladder attack may occur while the gallstones are in the gallbladder. It's more likely to develop if a stone leaves the gallbladder and enters one of the bile ducts, however. Fortunately, the condition can be treated.
The Gallbladder and Bile Ducts
The gallbladder is shaped like a pear and can hold about 50 ml of bile. When full, it's about 8 cm (3.2 inches) long and 4 cm (1.6 inches) wide. It's connected to ducts, or tubes, which transport the bile to where it's needed. These ducts are shown in the illustration above. The word "bowel" in the illustration is another name for the intestine.
The tube that transports bile out of the gallbladder is called the cystic duct. This joins with the hepatic duct, which transports bile out of the liver, forming the common bile duct. The common bile duct then joins with the pancreatic duct coming from the pancreas and sends the bile into the duodenum, which is the first section of the small intestine. The small intestine is known as the small bowel in some countries.
Bile can flow in either direction in the cystic duct—either into the gallbladder from the liver or out of the gallbladder towards the small intestine.
Gallstones are often referred to as simply "stones", although they are made of a different material from stones outside the body. The technical name for the presence of gallstones in the gallbladder is cholelithiasis.
Composition of Gallstones
Bile is a watery solution that contains bile salts, cholesterol, fats, a small amount of protein, and bilrubin. Bilirubin is a yellow pigment formed from the breakdown of hemoglobin from old or damaged red blood cells.
Two types of gallstones are produced from bile—cholesterol stones and pigment ones. About eighty percent of gallstones are made of solidified cholesterol mixed with smaller quantities of other substances. These are known as cholesterol stones. Pigment stones may contain some of the same chemicals as cholesterol ones, but the most abundant substance in them is often solidified bilrubin in the form of calcium bilirubinate.
Cholesterol stones are often yellow in color. If they contain a significant quantity of other substances, they may be greenish yellow or brownish yellow. Pigment stones are black or dark brown. Black pigment stones generally form in the gallbladder. Brown pigment stones often form in the bile ducts and may be related to infections. Gallstones may be tiny or as large as a golf ball.
The cause of gallstones isn't completely understood. Stone formation seems to be due to a combination of factors. It’s thought that heredity plays a role, but lifestyle may also affect the possibility of developing stones.
Doctors and researchers do know that certain factors increase the probability of gallstone formation. For example, if the gallbladder has a decreased ability to contract and release its bile, the likelihood of gallstone formation increases.
Another factor that may be important is the composition of the bile. Bile contains bile salts or very similar compounds called bile acids. These chemicals are responsible for emulsifying fats in the duodenum. They also break up some of the cholesterol in the bile. Therefore if the bile doesn’t contain enough bile salts, gallstones may form. Yet another possible cause of stones is the presence of too much bilirubin in the bile.
Some Risk Factors
Risk factors for gallstone formation include:
- gender (woman are more susceptible than men)
- age (people over the age of sixty are more likely to develop gallstones than younger people)
- excess estrogen in the body (such as estrogen provided by birth control pills or hormone replacement therapy)
- pregnancy (since pregnant woman have a high level of estrogen in their body)
- diabetes (perhaps because diabetics often have a high level of triglycerides, or fats, in their blood)
- ethnicity (People of Native North American, Native South American, Hispanic, or Northern European descent have a higher tendency than other ethnic groups to develop gallstones. Asian people are more likely to develop brown pigment stones than other stone types.)
The Effect of Excess Weight
It’s important to maintain a healthy weight to reduce the chance of developing gallstones. Research has shown that being even moderately overweight increases the risk of stone formation.
If you’re trying to lose weight, the excess weight should be lost gradually. During rapid weight loss, the liver excretes extra cholesterol into the bile. This is one way in which excess cholesterol is removed from the body. Unfortunately, the action increases the risk of gallstones. Some medications prescribed to lower blood cholesterol cause also stimulate secretion of the substance into bile, which may result in stone formation.
Although weight gain should be avoided, regularly eating a small amount of fat helps to prevent gallstones because it stimulates the gallbladder to contract in order to release bile.
Steps That May Prevent Stone Formation
A high fiber diet appears to reduce the chance of gallstone formation. Soluble fiber from grains and other foods is believed to lower the blood cholesterol level. Oats and barley are good sources of this type of fiber. Several research studies have discovered that drinking caffeinated coffee regularly and ingesting vitamin C seem to reduce the risk of gallstone formation. Scientists are not ready to make definite claims that certain foods or nutrients are beneficial for the gallbladder, however.
It's always good to follow a healthy diet. It's important to keep in mind that ingesting a particular food or drink in excess or taking an excessive dose of a vitamin supplement may be harmful. Questions about the best diet to follow with respect to gallstones should be referred to a doctor.
A particular symptom can be caused by many different disorders. In addition, a person with a specific disorder may not have all of the common symptoms for that condition and may have some unusual ones.
Some Possible Symptoms
If gallstones move out of the gallbladder, they can block any of the passageways in the biliary system, including the cystic duct, the hepatic duct, and the common bile duct. Gallstones may also enter the pancreatic duct.
While gallstones are in the gallbladder there may be no symptoms, although there may be pain after eating a fatty meal if many stones are present or if they are large. If gallstones move into the tubes that conduct bile and block them, however, a person may experience the symptoms of a gallbladder attack, also known as biliary colic.
Symptoms of biliary colic may include pain in the middle of the upper abdomen, in the upper right abdomen, under the right shoulder, and between the shoulder blades. The pain may be severe. It usually starts shortly after eating and may last for several hours. Nausea and vomiting may be additional symptoms. Gallbladder attacks are sometimes recurrent.
In some people, blocked bile ducts or a blocked pancreatic duct can lead to complications such as inflammation of the gallbladder (cholecystitis), inflammation of the pancreas (pancreatitis), and infections. Yellow skin and whites of the eyes (jaundice) may result when the bile ducts are obstructed by gallstones, causing bilirubin from the trapped bile to collect in the body. Although jaundice itself is generally not serious, it may have a serious cause. Abdominal pain that does not go away or abdominal pain accompanied by fever, chills, or jaundice requires immediate medical attention.
Anyone who has unexplained abdominal pain or suspects that they have gallstones must visit a doctor for a diagnosis. Some treatments are described below, but the treatment that is right for a particular patient must be prescribed by a physician.
Some Nonsurgical Treatments
Gallstones that stay in the gallbladder and don’t cause any problems are known as silent gallstones. These may not be treated, although a doctor's advice is needed if the stones are discovered.
The body may be able to deal with small gallstones that leave the gallbladder by itself. These gallstones move with the bile into the duodenum. From here, the stones travel through the rest of the small intestine, into the large intestine, and then out of the body in the feces. Larger gallstones or gallstones that block passageways are more problematic.
Some nonsurgical methods to treat gallstones exist. One of these methods is the ingestion of bile acids. Ursodiol (also known as ursodeoxycholic acid) is a bile acid prescribed to break up cholesterol gallstones. Ursodiol works best with small stones. However, it may need to be taken for months before it starts to work and may even need to be taken for up to two years. For fifty percent of patients, gallstones may reappear within five years of stopping the ursodiol treatment.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
Some doctors use an endoscope to find and remove gallstones. An endoscope is a flexible tube that has an attached light and camera. Inserting the endoscope into the body enables a physician to explore and sometimes treat certain health problems without using surgery.
Lithotripsy may be used to break up gallstones when an endoscope is used. (Other techniques for removing the stones with an endoscope exist.) One type of lithotripsy involves the use of high-energy sound waves to disintegrate the stones. The remnants of the destroyed gallstones are removed.
Some Surgical Treatments
Removal of the gallbladder is another method used to treat gallstones. We don’t need the organ to survive. Some bile normally flows directly from the liver through the hepatic duct towards the duodenum. If a person lacks a gallbladder, all the bile flows from the liver to the duodenum.
Traditional surgery to remove the gallbladder is called a cholecystectomy. Another method of removing the organ is known as a laparoscopy. The method is sometimes known as "keyhole surgery" and is minimally invasive. In this type of surgery, very small incisions are made. A tiny camera attached to a tube is inserted through one incision so that the surgeon can see inside the body. Surgical instruments are inserted through other incisions to remove the gallbladder.
Gallbladder Cleanse or Flush
There are many recipes on the Internet for gallbladder cleanses or flushes to remove gallstones. These generally include some combination of apples, apple juice, apple cider vinegar, lemon or grapefruit juice, magnesium (usually in the form of Epsom salts), and a large quantity of olive oil.
Components of the apple juice are supposed to soften the stones and the olive oil is supposed to force the gallbladder to contract and push the softened gallstones into the intestine.
Ingesting a gallbladder flush recipe often causes the appearance of solid lumps in the feces, often in large numbers, even in people with no symptoms of gallstones. Scientists have analyzed the lumps released from some people who have undergone a flush, however, and have found that they aren’t gallstones but are derived from olive oil. In general, medical doctors consider gallbladder flushes to be ineffective for removing gallstones.
Treatment in the Future
Scientists still have a lot to learn about the factors that cause and prevent gallstone formation. Hopefully, in the near future they will understand the stones and their production better and will have improved treatment methods that don't require removal of the gallbladder. Modern surgical techniques for removing the gallbladder are efficient, and we can live well without the organ. It would be nice if stones could be removed without surgery and if the gallbladder could be left in the body, though.
- Gallbladder and biliary tract from the Merck Manual
- Information about gallstones from the NIH (National Institutes of Health)
- Facts about gallstone treatment from the NHS (National Health Service)
- Eating guidelines for gallbladder disease from HealthLinkBC (a Government of British Columbia website)
- Gallbladder diet from WebMD
- Information about bile duct stones from the University of Michigan
- An assessment of a gallbladder cleanse for gallstones from the Mayo Clinic
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2010 Linda Crampton
Linda Crampton (author) from British Columbia, Canada on February 09, 2018:
Thank you for commenting, Lynette.
Lynette on February 09, 2018:
This was SO impressive and helpful-I am so grateful for the information---THe Best!! THank YOu.
Linda Crampton (author) from British Columbia, Canada on April 15, 2013:
I'm sorry that you are having such a big problem with gallstones, jagapathi. I hope that you find a solution to your problem very soon.
jagapathi on April 15, 2013:
i am suffering from 1 year, but i am rude in this, trying to get out of this problem without galbladdar removal, just 50%succeded , i get to know that there are somo people near tirupathi in andhrapradesh....they will remove the stones from the Gallbladdar and also from kidneys.......that too wih in 10 mins..... i have been there for 4 times and i am the witness as a patient............ with in 10 mins they will remove the stones from the body...... the only problem right now is they are forming fastly in my body....aroung 30-35 stoney they removed those 4trips......... and now using some mediciine in AYURVEDAM..... i hope it may works.........
just pray for the god to bless me with a good health
Linda Crampton (author) from British Columbia, Canada on March 01, 2012:
Hi, Rachel. The gall bladder is an interesting structure and is useful - as long as it's in good condition!
Rachel McNamara on March 01, 2012:
I LOVE GALL BLADDER!!! WHHOOOHOOO GO GALLBLADDER!!!!!!!!!!!!!!!!!!!
Linda Crampton (author) from British Columbia, Canada on October 01, 2011:
Thanks a lot for the visit and the comment, Ummijj. It's very nice to meet you.
Ummijj from East Coast on October 01, 2011:
Great informative Hub! Thanks for sharing!
Linda Crampton (author) from British Columbia, Canada on April 10, 2011:
Docmo, thank you very much for your wonderful comment and the vote!
Mohan Kumar from UK on April 10, 2011:
Superb- well written, informative and highly readable- brilliantly done. As a medic I am so used to reading millions of misinformed pieces and it is refreshing to see a hub with such great, reliable information. voted up!
Linda Crampton (author) from British Columbia, Canada on March 21, 2011:
Thank you very much for the comment, Chatkath. It's great to meet you!
Kathy from California on March 21, 2011:
Wow, you have so many incredibly interesting hubs! Thanks for the information!
Linda Crampton (author) from British Columbia, Canada on January 03, 2011:
Thanks for your vote. Gall bladder problems can cause horrible symptoms. I’m so glad that there is no trend to develop gallbladder disease in my family.
2patricias from Sussex by the Sea on January 02, 2011:
Very useful advice (and this hub is voted up). One of our younger friends has gall bladder problems. She has had to pull out of all holiday dinners this year as she has been feeling so unwell. She is not yet 40! Her younger sister had to have her gall bladder removed last year, so this seems to be a hereditary issue for them both.
Linda Crampton (author) from British Columbia, Canada on December 29, 2010:
My goodness! Yes, I would say that heredity is involved in gall bladder problems! I hope your pain is removed soon. Thank you for the welcome.
sagebrush_mama from The Shadow of Death Valley...Snow Covered Mountain Views Abound! on December 28, 2010:
Excellent hub...I'm awaiting approval for gall bladder removal, having spent most of the last month dealing with an inflamed gall bladder. I have a terrible family history of related issues, with a great grandmother having died from a ruptured gall bladder. Many of my cousins have had theirs removed, and nearly all of my aunts, as well. I have a hunch that heredity is definitely involved!
Welcome to HubPages!
Linda Crampton (author) from British Columbia, Canada on December 26, 2010:
Thank you, kashmir56!
Thomas Silvia from Massachusetts on December 25, 2010:
Thank you for all this great and important information,great hub!