Gallstones often rest undetected for a long time in the gallbladder, where they have room to grow. Sometimes they go on the move – and block the bile ducts. This causes bile to back up, resulting in severe, cramping pain. This is usually the situation when gallstones are first discovered.
Stones – or “concrements” in technical terms – can form in various places in the body, usually by crystallization and clumping of fats, salts or pigments. They are most common in the gallbladder or kidneys and urinary tract, and less common in salivary glands.
Formation of gallstones
The gallbladder nestles closely to the liver to quickly absorb and store the bile produced there. This so-called bile helps the intestines digest fatty foods. It contains various dissolved components such as.
- Bile acids
- Phospholipids
- Cholesterol
- Dyes from blood breakdown
- Hormones
If too many of the individual substances are present or their composition changes, they precipitate out of solution and settle on the walls of gallbladder (cholecystolithiasis) or bile ducts (choledocholithiasis). They may occur singly or in multiples, be small or up to the size of a plum, and calcify.
Cholesterol stones and pigment stones
Gallstones are classified as cholesterol stones, pigment stones, and a mixed type:
- Cholesterol stones are formed by a high cholesterol content in the bile, combined with a deficiency of bile salts. Cholesterol stones form clustered in obesity, increased cholesterol in the blood, taking the “pill” or in the context of Crohn’s disease.
- Pigment stones consist mainly of the bile pigment bilirubin and are formed mainly in increased blood loss, artificial heart valves, malaria, chronic infections of the bile ducts and liver disease.
Gallstones of a person are always of the same type (mostly cholesterol stones) and are based on the individual composition of the bile. How far the gallstone disease also has a psychological component, is controversial. In alternative medicine in particular, gallstone disease is often attributed to psychological stress and assigned to a particular personality type that is conflict shy, allows little outward expression, and tends to direct aggression against itself.
