Definition
Gallstones are a deposit of solid substances which, due to a variety of causes, emerge from the bile, flocculate and can lead to pain as well as to obstruction of the bile ducts and the flow of bile.
Synonyms
Cholelithiasis. One distinguishes gallstones according to the type of stone and the place of origin. Gallstones whose main component is cholesterol (cholesterol stones) are the most common and account for about 70-80% of all gallstones.
The causes of can be partly inherited. It has been found that many members of a family often suffer from gallstones. There were also certain Indian tribes in which gallstones were particularly frequent or never occurred.
Gene mutations can also trigger chronic gallstone disease. Age, body weight and blood cholesterol levels are considered risk factors and causes of cholesterol stones. The second group of stones (20%) is called bilirubin or pigment stones.
The causes can lie in a chronic dissolving of blood components (hemolysis) or in liver cirrhosis. Other causes of bilirubin stones are suspected, but the exact cause is unknown. Many people are carriers of gallstones and may develop a gallstone disease (biliary colic).
Mostly, however, they do not cause any symptoms and thus remain unnoticed for years in the gallbladder (gallstone), the main site of formation. A small number of gallstones leave the gallbladder and migrate to the adjacent bile ducts (gallstone). There, even the smallest stones can lead to constipation and thus to severe pain.
Over time, small stones that have remained in the gallbladder can increase in volume. In most cases, they then trigger the first symptoms. 75% of gallstones do not cause complaints (silent gallstone). Only 25% lead to a symptomatic gallstone disease. 10-15% of patients with gallbladder stones also have stones in the adjacent bile duct (ductus choledochus).
Epidemiology
Women are more frequently affected than men by gallstone disease (biliary colic). The ratio is about 2:1, and it is assumed that 15% of all women and 7.5% of all men are carriers of gallstones. If Crohn’s disease or cirrhosis of the liver is a concomitant disease, the frequency of gallstones increases (25%-30% of all patients). If a pregnancy exists or if estrogen preparations are taken in addition, the ratio of women to men increases to 3:1. There is a rule of thumb that states which patients are particularly at risk for gallstones (6 F rule):
- Female = female,
- Fair=light-skinned,
- Fat=overweight,
- Forty=over 40 years old,
- Fertile=fertile,
- Family= already brought children into the world.
