What causes gallstones

what causes gallstones

Gallstone is one of the diseases of the gastrointestinal tract, occurring when there is the presence of cholesterol stones, bile pigment stones, or mixed stones in the gallbladder and the bile duct system in the liver, the common bile duct. Let’s find out what causes gallstones in this article!

About 80% of gallstones are mainly caused by excessive cholesterol in the bile, which exceeds the solubility of bile salts. The remaining 20% may develop bile pigment stones related to abnormally high levels of the bile pigment bilirubin.

Normally, the gallbladder stores bile to help digest fats in food from the liver. When we eat, the gallbladder functions by contracting and secreting bile into the small intestine. However, if liver function is impaired, poor biliary motility causes cholestasis or inflammation, and the components in bile will be disturbed and aggregated to form gallstones. The presence of gallstones obstructs the flow of bile, increasing the pressure in the biliary tract every time the gallbladder contracts or causing inflammation, and damage to the bile ducts, and gallbladder.

Gallstones can cause bile duct obstruction in episodes, if prolonged, will lead to cholangitis, cholecystitis (90% of patients with gallstones admitted to the hospital are due to cholangitis, cholecystitis) acute or chronic, Acute pancreatitis, more severe is shock due to biliary tract infection, gallbladder necrosis, peritonitis, sepsis… If not treated quickly and promptly, it can even cause death.

Liver stones can cause cholestasis in the liver, liver abscesses, and cirrhosis leading to liver failure, and reducing the body’s ability to metabolize.

Causes of Gallstone

General causes of gallstones can include:

Fasting: causes the gallbladder to not secrete as it should

Rapid weight loss: causes the liver to make more cholesterol, which can lead to gallstones

High blood cholesterol levels

Obesity is one of the biggest risk factors. Obesity can raise cholesterol levels and make it difficult to empty the gallbladder

Taking birth control pills, using hormone replacement therapy for menopausal symptoms, or being pregnant: can raise blood cholesterol levels and increase the risk of cholestasis in the gallbladder

Chronic diseases: such as diabetes

Hematologic pathology: hemolytic anemia

Due to heredity

Causes of cholesterol stones:

  • Old
  • Eat foods high in cholesterol and high in animal fat
  • Due to multiple births (women)
  • Due to complications from some digestive diseases such as Crohn’s disease, ileostomy
  • Due to taking a lot of drugs such as clofibrate, estrogen

Causes of bile pigment stones:

  • Old
  • Biliary tract disease: bile stasis, a bacterial or parasitic infection of the biliary tract
  • Other conditions: cirrhosis, hemolytic anemia, Mediterranean anemia, sickle cell anemia

Symptoms of Gallstone Disease

Signs of gallstones are often nonspecific, easily confused with other diseases such as stomach disease, and often include:


Where do gallstones hurt? Most cases of gallstones have pain in the right upper quadrant, but there are also a few cases where the pain occurs in the epigastrium (abdomen above the navel and below the breastbone).

Gallstone pain often occurs after meals, especially when eating a lot of fat or at night, causing the patient to lose sleep. The pain is severe and continuous, lasting from 30 minutes to several hours.

Depending on the location of the stone formation, the nature of the pain will vary:

Gallstones: When a stone is stuck in the neck of the gallbladder, the patient often has severe abdominal pain in the right lower quadrant.

Stones in the liver or common bile duct: the patient has pain in the right lower quadrant, spreading to the right shoulder or back, and the epigastrium.

Digestive disorders

Gallstones interfere with the flow of bile to the digestive tract, leading to bloating, slow digestion, loss of appetite, and fear of greasy foods.

Gastrointestinal symptoms usually appear after meals and may be accompanied by nausea and vomiting.

Patients need to go to the hospital for treatment as soon as possible when one of the following signs appears:

  • Severe abdominal pain that lasts for hours and does not get better with pain relievers.
  • High fever over 38 degrees Celsius, accompanied by chills, and sweating.
  • Nausea and vomiting with a feeling of bloating.
  • Skin itching is associated with jaundice or yellowing of the eyes.

Subjects at risk of Gallstone disease
Women: Women have a much higher risk of developing gallstones than men because the female hormone estrogen stimulates the liver to increase cholesterol production and excretion into bile.

Diet high in saturated fat, low in fiber, and green vegetables

Overweight or obese: overweight people with a body mass index (BMI) > 25 have an increased risk of gallstones.

Age 40 and over: the older you are, the more likely you are to get gallstones

People with digestive disorders or chronic inflammatory bowel disease: making the body reabsorb bile salts poorly, increasing the risk of gallstones

Family history of gallstones

Lose weight fast

Decreased biliary activity: people who do office work, are sedentary, sit a lot or people who are fed intravenously for a long time (vegetative people) are very susceptible to this condition.

Constipation also creates an opportunity for intestinal bacteria to grow, leading to inflammation of the duodenum, gallbladder, and bile ducts, making it easier for bile to settle into stones.

Pathology: metabolic disorders, diabetes, chronic liver disease (fatty liver, hepatitis, cirrhosis, elevated liver enzymes), dyslipidemia

Pregnant: due to hormonal changes and decreased contractility of the gallbladder due to the size of the fetus

Use medicine:

Long-term use of oral contraceptives increases estrogen, thereby increasing the excretion of cholesterol in the bile

Using cholesterol-lowering drugs (lowering blood fat) increases the excretion of cholesterol in bile

How to prevent Gallstone Disease

Prevention of gallstones is mainly by changing the diet:

Reduce fat: it is necessary to limit cholesterol-rich foods such as animal viscera and eggs.

Increase protein to increase damaged liver cells and prevent fatty degeneration of liver cells.

Rich in powdered sugar: This food is easy to digest, does not affect bile, and has a lot of fiber to help good digestion and avoid constipation.

Rich in vitamin C and B vitamins (to increase the metabolism of fats and carbohydrates) found in fresh fruits and vegetables

The ratio between nutrients protein, fat, and sugar in normal adults is 1/0.75/5 and in people with gallstones, it should be 1/0.5/5.

Foods not to eat: tea, coffee, cocoa, chocolate, fatty fish, palm oil, coconut oil.

Recommended foods: Juices, fresh fruits of all kinds, fresh vegetables, confectionery with low butter eggs, lean fish meat such as lean pork loin, beef, snakehead fish, carp, legumes such as soybean, green beans, and black beans. In addition, there are some honey foods such as turmeric, and lemon leaves that can be used.

To stimulate the gallbladder to contract gently, you can use a little easily digestible fat such as butter, herb oil, and chicken fat.

Divide into many small meals, eat several times a day

Diagnostic measures for Gallstone disease

Blood tests: help evaluate liver function and blood cholesterol levels.

Diagnostic imaging: abdominal ultrasound, abdominal X-ray, and abdominal CT scan are effective methods in diagnosing gallstones.

Cholesterol stones are usually solitary, pale in color, and do not block X-rays, so they cannot be seen on X-rays but can be seen on ultrasound. Bile pigment stones are mainly calcium bilirubin, dark in color, often forming stones, blocking many X-rays, so they can be seen on X-ray films.

How to temporarily relieve gallstone pain:

Warm the abdomen: with a thermos bag or warm water bottle

Drink fruit juice: drink orange juice, lemon juice, or vegetable juice. These vitamin-rich drinks are not only good for health but also very tasty, helping to lift the spirits and ease the pain of gallstones.

Long-term solutions:

Treatment of gallstones depends on the composition of the stone and the severity of the disease. There are many ways to treat gallstones: medication, using vibration waves to disperse stones outside the body, surgery to remove stones, and change in diet. If the stone is silent, there is no treatment, only treatment when the stone is symptomatic, however, bile duct stones must be treated even if there are no symptoms.

Medications for the treatment of gallstones:

Due to the complex nature of the structure, location, and form of stones, there is no universal treatment for all stones. Only cholesterol stones can be removed by drugs with a similar composition to bile acids.

Conditions for taking oral medications for gallstones:

  • Gravel no larger than 1cm
  • The volume of all stones in the gallbladder is not more than 1/3 of the gallbladder volume
  • Gallbladder function is still good
  • The bile duct is not blocked
  • The patient is not taking fat-reducing drugs, stomach medicine

Should take the drug in the afternoon, because in the evening the liver often produces bile to promote stone formation.

Drug treatment of gallstones can last from 3 months to 2 years, the success rate is 40-70%. Women must avoid becoming pregnant while taking the drug.

Surgery to treat gallstones: It is a common and safe surgery, but in some patients there can still be complications. About 25% of patients still have symptoms of discomfort after surgery. Therefore, it is recommended to treat gallstones with conservative methods, only when the above methods fail, surgery is the last resort.

It is now possible to remove gallstones by laparoscopic procedure, thus avoiding major surgery and shortening the hospital stay.

Final thought

A healthy diet helps reduce gallstone symptoms such as bloating and indigestion, while partially preventing the risk of stones increasing in size.

Eat plenty of fresh fruits and vegetables and drink enough water.

Limit foods high in cholesterol such as viscera, fried food, and fast food.

Top News hopes this article can help you learn more about what causes gallstones and wishes your health is always good!

Maybe you are interested: