Gallstones (choleliths) are crystallinebodies formed within the body by accretion or concretionof normal or abnormal bilecomponents.
Gallstones can occur anywhere within the biliarytree, including the gallbladder and the common bile duct.Obstruction of the common bile duct is choledocholithiasis; obstruction of thebiliary tree can cause jaundice; obstruction of the outlet of the pancreaticexocrine system can cause pancreatitis. Cholelithiasisis the presence of stones in the gallbladder or bile ducts.
Gallstones usually remain asymptomatic initially. They start developingsymptoms once the stones reach a certain size (>8 mm). A main symptomof gallstones is commonly referred to as a gallstone "attack", alsoknown as biliary colic, in which a person will experienceintense pain in theupper abdominal region that steadily increases for approximately thirty minutesto several hours. A patient may also experience pain in the back, ordinarilybetween the shoulder blades, or pain under the right shoulder. In some cases,the pain develops in the lower region of the abdomen, nearer to the pelvis, butthis is less common. Nausea and vomiting may occur. Patients characteristicallyexhibit a positive Murphy's sign: the patient is instructed to breathein while the gall bladder is deeply palpated. If the gallbladder is inflamed,the patient will abruptly stop inhaling due to the pain, a positive Murphy'ssign.
These attacks are sharp and intensely painful, similar to that of a kidneystone attack. Often, attacks occur after a particularly fatty meal andalmost always happen at night. Other symptoms include abdominal bloating,intolerance of fatty foods, belching, gas, and indigestion. The patient shouldalso make sure they're drinking an appropriate amount of water relative to thenumber of calories being taken in. If the above symptoms coincide with chills, lowgrade fever, yellowing of the skin or eyes, and/or clay-colored stool, adoctor should be consulted immediately.
Some people who have gallstones are asymptomatic and do not feel any painor discomfort. These gallstones are called "silent stones" and do notaffect the gallbladder or other internal organs. They do not needtreatment.