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Gallstones 101 – Thing You Need to Know

Updated on March 15, 2012

Gallstones are stones being formed in the gallbladder due to abnormal bile composition. It is quite prevalent worldwide and it is more common in females than in males. Gallstones are divided into two major types, namely: Cholesterol stones and Pigment stones.

Cholesterol stones – this type is the most common, comprising of more than 80% of gallstone cases. This type is usually compose of cholesterol, bile pigment, calcium salts and some proteins.

Pigment stones – this type comprises the remaining 20% of gallstone cases. This type contain less cholesterol and more of calcium bilirubinate.

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Gallstones cause their symptoms by causing inflammation of the gallbladder or by obstructing the outflow of the gallbladder. Both of this condition would present as abdominal pain usually occurring at the right upper quadrant of the abdomen. Pain is usually characterize as severe, feeling of fullness, and usually radiates to the back, right scapula or shoulder. Fever, chills, nausea and vomiting could accompany the abdominal pain described above. Having a fatty meal or a large meal could also precipitate gallstone pain.


After symptoms of gallstone disease, next stop is how to diagnose it. There are some diagnostic procedures in detecting gallstones namely Ultrasound, Abdominal X-ray, and Radioisotope scans.

Ultrasound – ultrasound could identify gallstones in 95% of cases and could also check other organs in the vicinity like your liver, pancreas and the bile ducts. Ultrasound could also detect very small gallbladder stones. This is the procedure of choice for detecting gallbladder stones. Limitations for this diagnostic test are if the patient is massively obese or if there is fluid collection in the abdomen.

Abdominal x-ray – the advantage of this diagnostic test is it is low in cost and is usually readily available in all centers. However, the yield for this diagnostic procedure is low and is usually contraindicated among patients who are pregnant.

Radioisotope scans – this diagnostic test could identify gallbladder stone and bile duct obstruction but it is not readily available.


Medical Therapy – this is by the intake of Ursodeoxycholic acid (UDCA), a drug which decreases cholesterol saturation of bile. However, large stones and pigment stones are not that responsive to this drug.

Surgical Therapy – Cholecystectomy (removal of the gallbladder) is usually the treatment of choice for gallbladder stones. This is recommended to patients who have symptomatic gallstone disease and those who are high risk for complications of gallstones like pancreatitis, cholangitis, etc. In recent years, laparoscopic cholecystectomy has replaced open cholecystectomy as the treatment of choice for gallstone disease.

If you have abdominal pain, especially if it occurs in the right upper quadrant of your stomach, think of gallbladder stones as a possible cause. When diagnose with gallbladder stones, seek consult with your physician for proper treatment planning.


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