Where do gallstones come from?

Risk factors for gallstones

Women are two to three times more likely to develop gallstones than men. The incidence of the disease increases from the 20th to the 30th Year of life steadily. Gallstone disease does not occur by chance, it always has a cause.

• The risk of developing gallstones is significantly increased if you eat a high-calorie, high-carb, and low-fiber diet. A diet rich in fiber promotes bowel activity. This leads to less acid formation in the intestine, which in the long term can promote the formation of gallstones.
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• Other risk factors are female gender and pregnancy. Even if you are overweight and physically inactive, the risk of gallstone formation increases. In general, the likelihood of developing gallstone disease increases with age. In this respect, age is also a risk factor.
• Fat metabolism disorders are also leading the way for gallstones. Even Medicationthat you need to take regularly can contribute to the development of gallstones. These include estrogens and some drugrecommended against lipid metabolism disorders.
• Occasional crash diets can also promote gallstone formation. The risk increases especially if you lose over one percent of your body weight per week. This also applies if you have had a stomach reduction, for example, because you are very overweight.


Gallstones again after the operation? - Possible causes

If you have successfully survived a gallstone operation, that doesn't mean ...

• Also certain Diseases can give you a gallstone. These include Crohn's disease, vitamin B12 or folic acid deficiency, and cirrhosis of the liver.
• As twin studies have shown, genetic factors also play a not inconsiderable role. If you have gallstones, your genes will make up 25 percent of their production.

What happens when gallstones develop?

A distinction is made between different types of gallstone. In over 90 percent of the cases it is a question of cholesterol stones, the rest is divided between brown and black pigment stones.

• The formation of cholesterol stones in your gallbladder is the result of cholesterol oversaturation in the bile. At the same time there is sluggishness of the gallbladder. The gallbladder has fine muscle cells in its wall. When they contract, the bile secretion is released to the intestines for fat digestion. If this doesn't work properly, the bile secretion, including cholesterol, will linger in the gallbladder and thicken.
• Cholesterol oversaturation is caused by an overproduction of cholesterol in the liver. This initially leads to the formation of cholesterol crystals in your gallbladder, which eventually clump together to form gallstones.
• Black pigment stones are relatively rare in this country. They are due to an increased attack of bilirubin (bile pigment). You can develop the pigment stones in certain blood diseases in which red blood cells are broken down in excess. Bilirubin is a waste product of hemoglobin found in blood cells.
• Black pigment stones also arise when excessive amounts of bile acids are lost in the intestine. This is the case, for example, if you have Crohn's disease. Or larger parts of the small and large intestines had to be removed during an operation.
• You can develop brown pigment stones when the bile builds up in the gallbladder and bile duct, similar to the cholesterol stones in the gall bladder and bile duct. If there is also bacterial colonization, this can lead to pigment stones. The bacteria produce substances that the bilirubin in the bile secretion causes, among other things, to react with fatty acids. In the long term, this can lead to gallstone disease.

Discomfort from gallstone disease

Most gallstone carriers are symptom-free. It becomes problematic when the gallstones migrate and trigger colic or lead to gallbladder inflammation.

• Gallstones don't have to cause you discomfort. In the majority of cases, they remain calm and are discovered by accident. This is often the case when doing an abdominal ultrasound scan.
• In around 25 to 30 percent of cases, however, gallstones lead to colic. These arise when one or more small gallstones slip out of the gallbladder and migrate over the main bile duct towards the duodenum. If you have biliary colic, it will leave a lasting memory as colic is intense pains prepare.
• The pain attacks of biliary colic take place in the right upper abdomen. You can also go to the pit of your stomach, in the move and radiate into the right shoulder. Most of the time, colic also gives you severe ones nausea and occasionally causes vomiting.
• Colic lasts for 15 to 30 minutes, then the stone passage through the bile duct is finished. If the symptoms persist much longer, the stone has got stuck in the bile duct. Then you should seek medical help as soon as possible, otherwise there is a risk of inflammation of the gallbladder, bile duct and pancreas.
• A typical sign of a stone trapped in the bile duct is the yellow discolouration of sclera (the whites of the eyes) and skin. Usually you notice this a day or two after a colic. In this case, too, you should see a doctor quickly, preferably to the nearest hospital. Because the trapped stone has to be removed from the duct via a bile duct specimen (similar to a gastroscopic specimen).
• If you got through your first colic without complications like this, you shouldn't rejoice too soon. The likelihood of further colic is over 50 percent.

Gall bladder surgery - who has to go under the knife?

• If your gallstones are not causing any discomfort and have been discovered by accident, you do not necessarily have to go under the knife. You can just wait and see if the gallstones even make themselves felt at some point.
• However, there are exceptions to this rule. You will be advised to have the gallbladder removed as a precaution if there are large polyps of the mucous membrane in your gallbladder. You will also be advised to have an operation if you have what is known as a porcelain gall bladder. It occurs when the gallbladder is chronically inflamed and unnoticed, causing the wall to become calcified. In these cases, the risk of gallbladder cancer is increased by up to 50 percent.
• Otherwise, if your gallstones give you symptoms, it is best to separate yourself from your gallbladder. This is how you can prevent the complications of gallstone disease.
• The surgical removal of the gallbladder is nowadays carried out in a minimally invasive manner using an abdominal cavity specimen (laparoscopy). The procedure is now routine in every hospital. If all goes well, you will be back home within a few days.
• It gets a little more complicated if not only are there gallbladder stones, but stones have also clogged the bile duct. A bile duct mirror is then done before the operation to remove the stone or stones from the duct. If this does not succeed, the gang stones must be surgically removed. This can usually also be done with a laparoscopic gallbladder removal. If not, open surgery with an incision in the abdomen must be performed.
• Of course, once the gallbladder has been removed, you can no longer get gallbladder stones. However, new stones can form in the bile ducts, but this is rarely the case. The question of whether gallstones can come back after an operation still has to be answered with a “yes”.

Precautionary measures against gallbladder stones

Basically, it is possible to prevent the formation of gallstones by taking suitable measures. However, the reliability of such measures can never be precisely foreseen, as many individual factors play a role in gallstone formation. In principle, the genetic predisposition to the development of gallstones cannot be influenced.

• Physical activity improves the function of the gallbladder, i.e. the release of bile into the intestine. Two to three hours of jogging or cycling a week will reduce your gallstone risk by 20 to 40 percent.
• Do you eat fiber or fiber rich. A high-fiber diet includes plenty of fresh fruits and vegetables, legumes, and whole grains.
• If you want to lose weight if you are overweight, then do it slowly. If you lose more than 25 kilograms in four months, the risk of stone stones is over 28 percent. With a slow weight reduction of less than one kilogram per week, only eight percent.
• You will likely only achieve rapid weight loss of 25 kilograms with surgery (for example, stomach reduction). Here, the daily intake of 500 milligrams ursodeoxycholic acid is said to reduce the risk of stones. The drug reduces the cholesterol saturation of the bile.
• Other measures that may reduce your risk of stone stones include adding fat to a low-calorie diet (15 to 25 grams of fat per day). Moderate alcohol consumption is advisable. Regular meals (three to five a day) and plenty of vitamin C should also help.

Gallstones are by no means rare, but in the majority of cases they do not cause them complaints. If so, surgical removal of the gallbladder makes sense to prevent complications from gallstones. Preventive measures against the formation of gallstones are possible, but their success is only partially predictable.