Gallstones are also called gallbladder stones. They are solid deposits that group together in the gallbladder, a tiny organ located immediately beneath the liver. The gallbladder plays a critically important role in digestion by holding bile. That is actually a fluid produced by the liver to help break down fats. Gallstones can range in size from tiny (like a grain of sand) to as big as a golf ball. Although some people can have gallstones with no symptoms, some may develop pain and other complications. In this article, we will explore how the size of gallstones affects their potential to cause harm, and how they relate to overall gallbladder illnesses.
Types and Causes of Gallstones
Two primary types of gallstones are:
- 1. Cholesterol Stones: These are the most common type, accounting for about 80% of cases. These develop due to an excess cholesterol content within the bile.
- 2. Pigment Stones: These are smaller & darker and develop due to an excessive bilirubin content, a substance produced from the breakdown of red blood cells. These are more common among people with liver diseases, some infections, and certain blood disorders, such as sickle cell disease.
Several factors increase the likelihood of gallstone formation. The factors include being overweight, having a diet rich in fats and cholesterol, marked weight loss, being pregnant, or genetics. More women are affected by this disease than men. Hormonal changes during pregnancy and the use of contraceptives can cause gallstones.
Size of Gallstones: Why Size Matters?
The size of the gallstones differs greatly, and the risk depends on the dimensions. Depending on their sizes, the gallstones can be mainly grouped into three main sizes:
- Small Gallstones (Less than 5 mm): These stones are generally harmless and typically not diagnosed. Small gallstones pass through the bile ducts and are eliminated without symptoms in most cases. An increased risk occurs when multiple small gallstones obstruct one or more bile ducts and cause biliary colic. Biliary colic is a severe pain caused by a stone’s temporary obstruction of the bile duct.
- Medium-Sized Gallstones (5 to 15 mm): This diameter is most likely to induce complications as larger stones are at higher risk, while small stones are less likely to induce complications. Since these stones are big, they obstruct either the bile ducts or the cystic duct. When the bile flow is blocked, it leads to sharp pain and potential infection, known as cholecystitis. The stones might also cause inflammation of the bile duct and damage them, so it has to be treated medically.
- Large Gallstones (More than 15mm): These are even more dangerous. While large stones are less likely to move into the bile ducts, if they do, the consequences can be severe. Large stones are also more likely to cause prolonged obstructive conditions including jaundice, acute pancreatitis, or gallbladder rupture, which can be life-threatening if not treated promptly.
Gall Bladder Illnesses: Effects of Gallstones
Gallstones cause many gall bladder illnesses, some relatively minor but others major.
- Biliary Colic: The first symptom of gallstones is due to temporary blockage in the cystic duct. It can cause acute and severe pain in the upper right abdomen for hours.
- Acute Cholecystitis: Prolonged obstruction in the cystic duct leads to inflammation of the gallbladder. The symptoms include abdominal pain, which could be excruciating, fever and nausea. It can result in rupture of the gallbladder or peritonitis if untreated.
- Choledocholithiasis: Gallstones move to the bile ducts and block their flow, causing jaundice. This can cause damage to the liver or lead to cholangitis if it is not treated.
- Acute Pancreatitis: Gallstones divert digestive fluids, which, if trapped, cause extremely painful inflammation and damage to the pancreas.
- Chronic Cholecystitis: The gallbladder gets repeatedly inflamed, resulting in scars which can cause loss of function and increase the risk of gallbladder cancer.
Diagnosis and Treatment of Gallstones
If the suspicion of gallstones arises, a doctor will prescribe some tests, such as ultrasound, a CT scan, or blood tests to check the function of the liver. The treatment measures would really depend upon the severity of symptoms and size of stones:
- Observation: For asymptomatic gallstones, doctors may recommend monitoring without immediate intervention.
- Medications: Some medicines can dissolve cholesterol gallstones; however, they act very slowly and are not hundred percent effective.
- Surgery (Cholecystectomy): The main treatment for symptomatic gallstones is cholecystectomy, removal of the gallbladder. Surgery can be done with a laparoscopic approach (minimally invasive) or by an open surgery procedure. The gallbladder is not necessary for life, and most people live normally after it.
Conclusion
Gallstones can vary in size, and the larger a gallstone is, the greater its danger. If the stones are very small, they can pass from the gallbladder without much harm. Large gallstones can cause intense pain, besides having many complications. Most of the patients with gallstones can lead healthy, symptom-free lives if treated appropriately.
