Sunday, November 27, 2022

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What are gallstones?

About 15-20 out of 100 people in Germany have gallstones, mostly without realizing it. Read about what gallstones are and when they form.

Gallstones often remain asymptomatic. In a quarter of all those affected, however, they eventually lead to symptoms. Biliary colic is particularly striking: it is mainly noticeable by the wavy, cramping pain in the upper abdomen, which can last for hours. General symptoms such as nausea, vomiting or a feeling of fullness can also indicate gallstones.

Gallstones are accumulations of crystals that form in the gallbladder or bile ducts. They form when substances in bile aggregate.

Yellowish bile – bile for short – consists mostly of water and bile acids. Bile also contains various enzymes, degradation products such as bilirubin and biliverdin, and cholesterol.

By the way, bile plays an important role in the digestion of fats in the small intestine. Thus, the liver produces up to a liter of fluid each day and releases it into the tiny bile ducts that run through the liver.

When a person eats food, the bile produced passes directly through the bile ducts into the main bile duct, which opens into the small intestine. If bile is not needed, it is temporarily stored in the gallbladder. The pear-shaped gallbladder is located just below the liver on the right side of the abdomen. When needed, such as when the person is eating, the gallbladder contracts. This is how the extra bile enters the small intestine.

Most gallstones form in the gallbladder as bile acids in the gallbladder stick together more and more. If they enter the main bile duct from there, this can lead to biliary colic. Gallstones develop directly in the bile ducts in only about 5 to 10 out of 100 cases.

Gallstones can be made of different materials. Some stones contain mostly cholesterol and are therefore called cholesterol stones. They usually form when the bile flowing from the liver to the gallbladder contains too much cholesterol. Unneeded cholesterol then builds up in the gallbladder, gradually forming a gallstone.

The so-called pigment stones, on the other hand, are composed mainly of bilirubin. Bilirubin is a breakdown product of the red blood pigment hemoglobin. Stone formation occurs when bile contains too much bilirubin, such as when the body breaks down more blood or as part of severe liver damage.

Gallstones can vary in size. Very small gallstones often occur in large numbers; then there is also talk of biliary grit. Larger stones, on the other hand, usually occur singly. These are usually cholesterol stones. They are often the size of a hazelnut. However, they can also reach a size that is roughly the size of a chicken egg.

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