About Gallstones and the Gall Bladder

No one can digest ‘indigestion’. Gallstones are often blamed as a cause for indigestion. Actually, gallstones are formed in the gall bladder due to indigestion or a defective digestive process.
The Formation of Gallstones
 The liver excretes (bile pigments) and secretes (bile salts) as yellowish green bile in a continuous process and drains it through the hepatic duct into the small intestine. Most of the bile gets back into the gall bladder (for storage) via the cystic duct due to closure of the sphincter in the intestinal wall. The gall bladder is a small, pear-shaped pouch or sac present adjacent and under the liver surface for storing the bile. The stored bile is concentrated in the gall bladder to about 10 times and poured into the duodenum by periodical contraction of the gall bladder i.e. after ½-1 hour of food intake or when required, through the common bile duct. The gall bladder can store 50-60 ml of bile. Normally, bile flows at the rate of 40-50 ml/hour. The bile stagnation or its composition ratio difference or an infection in the gall bladder can cause stone formation i.e. gallstones.

Bile secreted by the liver is alkaline in nature (pH - 7.5-8.5) and it is mostly composed of 97 per cent water and rest of it consists of conjugated bile salts (sodium and potassium salts of bile acids), cholesterol, lecithin (phospholipids), bilirubin (pigment), and electrolytes. Bile neutralizes the acid food which comes from the stomach and also helps to alkalinize the intestine. It plays a major role in emulsification, absorption and digestion of the fat and oil of our foods. It is a very good natural laxative for the colon. So, only in the case of obstructive common bile duct or liver disorders will there be constipation. The bile salts are important for removal of cholesterol from our body. It combines with lecithin and cholesterol to form micceles which is excreted normally in the stool. Sometimes, bile crystallizes in the gall bladder, due to various reasons, forming gallstones.

Incidence of gallstones –
 The incidence of gallstone formation is increasingly seen in the fourth decade of life, especially in women of obese constitution with high cholesterol level. Also women under contraceptive pills, sedentary lifestyle, multi-para women, and people suffering from chronic ulcerative colitis are major victims. The increased dietary intake of fast foods, pastries, oily, spicy foods can cause gallstones more. Even though it can occur in men, its incidence is more commonly seen in fat, fertile, flatulent and women in their forties. Gallstones are mostly seen in the body of the gall bladder rather than in the common bile duct or in the pouch in the neck of the gall bladder.

* Gallstones are usually soft and vary in size, shape, number and types.
 * Size of the stone - varies from 5 mm to 2 cm
 * Shape varies from round, oval to irregular
 * The number of stones may vary from single or solitary to tiny 100s

Types - The stone types can be classified by two methods, one by its composition and another by its origin. Mostly, it is classified as septic stones and septic stones.

By Prerna Salla