Gall Stones—Cause, Composition and Treatment

Gall stones are known in medicine as choleliths. They cause irritation and inflammation of the gall bladder and if numerous stones are present, they may lead to porcelain gall bladder, which may be a risk factor for gall bladder cancer, although the evidence of that is contradictory.


A stone can vary in size. It may be as small as a grain of sand or as large as a golf ball. It can be present without causing any pain or other symptoms. It could also cause a great deal of pain and lead to infection.


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Nausea, vomiting and fever are sometimes present, although the most common symptom is pain in the upper quadrant of the right abdominal area, just below or underneath the rib cage. Pain sometimes radiates into the upper hip, back or shoulder.


The content or composition of gall stones varies, although cholesterol is always present, to some extent. If 70-80% of the stone is composed of cholesterol, it is classified as a cholesterol stone. It is usually green, but may be white or yellow in color.


A pigment stone is another type that is dark in color and composed mainly of bilirubin and calcium salts. Less than 20% of the composition of the dark stone is cholesterol.

There are specific risk factors for these, rarer types of gall stone. Those include: 

 Hemolytic anemia

• Cirrhosis

 Bilary tract infections

• Sickle cell anemia

• Other inherited blood disorders

In some cases, the high calcium content allows the stone to be viewed by X-ray. A doctor may order an ultrasound to view the size and shape of the stone. The first examination is typically a physical one. The diagnosis is made because of the patient’s symptoms and a test called Murphy’s sign.


Inflammation of the gall bladder is referred to as cholecystitis. Although it is usually caused by gall stones, it can occur in patients that are debilitated or suffering from a trauma.


Murphy’s sign is often used to diagnose cholecystitis and is usually very accurate. It’s a simple test, in which the patient is instructed to exhale and inhale while the doctor presses on the gall bladder. If inflammation of the organ is present, the patient will suddenly stop inhaling, because of the pain.


Other symptoms that may accompany the condition include bloating, belching, gas and indigestion. If yellowing of the skin, chills, low-grade fever or a clay-colored stool are noted, a doctor should be consulted immediately.


Gall stones may require no treatment, the use of ultrasonic shock waves to break them up or removal of the gall bladder. Changes in diet and herbal remedies may be helpful, too.


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