Gallstones
Gallstones are stones present in the gall bladder (the name comes from the old English gallea, meaning bile). The medical term is cholelithiasis, from the Greek. Bile consists mainly of three constituents - bile salts, cholesterol and phospholipids. Stones are formed when the proportions of these constituents change and cause them to precipitate into solids.
There are three different types of gallstones: pure cholesterol stones, pure pigment stones containing calcium, and mixed type containing pigments, calcium and cholesterol. While many cause no symptoms, they may irritate the gall bladder causing cholecystitis, or they may pass into the bile duct and cause biliary colic (colicky abdominal pain in the right upper part of the abdomen) which may be severe and associated with vomiting, obstructive jaundice or pancreatitis. The exact cause of gallstones is unknown, but dietary factors may play a part, and people who suffer from diseases causing increased haemolysis of red blood cells such as hereditary spherocytosis (see Haemolytic Anaemia under blood and circulation in the chest cavity section) are at increased risk of developing pigment stones as a result of the increase production of bile. Gallstones causing no symptoms need no treatment. Those causing problems such as bouts of pain and nausea and flatulence, or complications as described above, require removal. They may be removed surgically (which may be performed via a key-hole approach), broken down by shockwave therapy (called lithotrypsy) or, less effectively, dissolved using agents which increase the solubility of cholesterol.
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