We may have all heard of gallstones, but what actually are they?
I'm here today to tell you all, about the gall...stones!
Hello I’m Dr Ed Hope, and welcome to Sick Notes where I try my very best to explain
medical terms in plain-English.
This one is about Gallstones.
Gallstones are tiny stones that originate from the gallbladder, they are about half
a centimetre to a few centimetres in size and very common, around 1 in 10 people have
them, but the vast majority don't have any symptoms from them.
To help understand them better I’m going to do a quick biology lesson.
So here is our digestive system.
This is our oesphagus, our 'food pipe'.
Our stomach and this goes around to the rest of the intestine.
Now let me draw on the liver.
And now let me draw on the gallbladder and the ducts that connect it to the liver.
So the gallbladder is a pouch-like organ that lives in the upper right quadrant of the abdomen,
just below the liver.
It’s job is to store bile from the liver, and then later on release this bile into the
intestine when we eat food.
The job of the bile is to mix with the food to help us break down and absorb fats.
As we can see there is a series of ducts here that connect the gallbladder to the liver
to the pancreas and to the intestine.
This whole system is called the biliary system.
So when we eat food it comes down the oesophagus into the stomach and when it moves round into
the intestine the cells of the intestine let out chemicals messages in the blood that go
to the gallbladder and tell it to contract.
This forces bile down the biliary system and into the intestine where the bile does it's
job of breaking down the fats.
The bile itself is made up of cholesterol, salts and pigments; and it is the cholesterol
that precipitates out of the bile and make stones.
Kind of like how you get limescale in you kettle.
Gallstones are more common in women, people over 40 years old and people who are overweight.
As I said earlier most people with gallstones do not have any problems with them, however
thats not to say gallstones cannot cause problems.
So let me show you on our diagram.
I'll draw a couple of gallstones in the gallbladder.
If a stone moves out of the gallbladder and gets stuck in the ducts this will cause severe
abdominal pain, what we call colic.
And because it's happened in the biliary system we call this biliary colic.
So if our gallstones got stuck here in the neck of the gallbladder it would cause biliary
colic, and it's a lot worse after eating.
As we explained earlier when the food comes through the digestive system it sends messages
to make the gallbladder contract.
This contraction against a blockage causes a lot of pressure in the gallbladder which
causes the pain.
Therefore eating less fatty food prevents biliary colic attacks, but stops gallstones
forming in the first place.
Biliary Colic is a severe pain associated with nausea and sweating and typically lasting
around an hour until the gallstone moves out of the ducts.
Although biliary colic is extremely painful it is not a serious complication, however
if the stone gets stuck in another part of the duct and does not move this can lead to
serious complications.
Complications such as infection or inflammation of the biliary tract, for example in the gallbladder
where we'd call it cholecystitis, or in the actual biliary tree biliary ducts which we
call cholangitis or even in the pancreas which we call pancreatitis.
These have more severe symptoms of pain, fever and even jaundice - which is when your eyes
and skin go yellow.
Any of these symptoms would warrant an immediate visit to the hospital.
If people have any of these complications or recurrent attacks of biliary colic then
they will be offered a keyhole surgery to remove the gallbladder.
This is called a cholecystectomy.
So thank you for watching I hope this has helped you better understand gallstones.
I've put some clarifications and some useful links below.
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