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INTRODUCTION: Gallstones are pieces of hard solid matter in the gallbladder and may be as small as a grain of sand or as large as a golf ball, depending on how long they have been forming. They often have no symptoms and are usually discovered by a routine x-ray, surgery, or autopsy.

They also may move around within bile, for example, from the gallbladder into the cystic or common duct. They are a common health problem worldwide and happen more frequently in women than men becoming more common with age in both males and females. More than 20 million Americans have them and approximately 1 million new cases are found per year.

SYMPTOMS: They may feel like chest pain produced by a heart attack and other serious problems. Signs usually begin after a large stone blocks the cystic duct or the common bile duct and typically do not return after the gallbladder has been removed. Nearly 80 percent of people do not have any symptoms for many years, if ever, especially if the stones remain in the gallbladder.

If you have symptoms, you most likely will have mild pain in the pit of your stomach or in the upper right part of your belly. About 15% of people who have symptoms also have stones in the common bile duct.

Exactly how diet affects gallstone formation is not clear, but diets which are high in cholesterol and fat, and low in fiber may increase the risk of developing Them.

There are 2 basic types of gallstones. Pigmented (bilirubin) types are found most often in Patients with severe liver disease and patients with some blood disorders such as sickle cell anemia.

Cholesterol types are found most often in: Women over 20, especially pregnant women, and men over 60 years old, People on “crash diets” who lose a lot of weight quickly, Patients who use certain medications including birth control pills and cholesterol lowering agents, Native-Americans and Mexican-Americans.

TREATMENTS: Gallstones that do not cause symptoms do not require treatment, But if they block a duct, they do. Surgery to remove the gallbladder (cholecystectomy) is the treatment of choice for stones that cause moderate to severe pain or other symptoms. However, only 1 of 5 people can have this treatment. People who have it often form new stones after a few years. Half of these require treatment, with a cost to society of several billion dollars annually.

Many new approaches to treatment have been tested over the past several years, however surgical removal of the gallbladder (cholecystectomy) is still the most widely used therapy. Non-surgical treatment includes pain medicines, antibiotics to fight infection, and a low-fat diet (when food can be tolerated).

A licensed doctor should be consulted for diagnosis and treatment of any and all medical conditions.

CONCLUSION: Gallstones normally form in the gallbladder; however, they also can form anywhere there is bile: in the intrahepatic, hepatic, common bile, and cystic ducts. They form when cholesterol and other things found in bile make stones.

They can develop in many people without causing symptoms and do not cause belching and bloating. Gallstones usually occur in adults between the ages of 20 and 50, and are more common in women in this age group.