Gallstones are common, hard, pebble-like deposits that form in the gallbladder, a small organ located beneath the liver. The gallbladder stores and concentrates bile, a digestive fluid produced by the liver that aids in fat digestion. Gallstones develop when components of bile, such as cholesterol or bilirubin, harden and crystallize. This occurs if there’s an excess of these substances or if the gallbladder doesn’t empty properly.
Understanding Gallstone Size
A 2 cm gallstone is considered large. Gallstones vary significantly in size, from a grain of sand to a golf ball. While small gallstones (less than 5 mm) might pass unnoticed, larger stones, especially those over 1 cm, are more likely to cause complications. A 2 cm gallstone carries a higher risk of obstructing bile ducts, leading to inflammation or infection, and can increase the potential for severe issues like cholecystitis or, rarely, gallbladder erosion.
Symptoms and Complications
Gallstones often do not cause symptoms, especially when small and not blocking bile flow. However, when a gallstone, particularly a larger one, lodges in a duct and causes a blockage, symptoms can arise. The most common symptom is sudden, rapidly intensifying pain in the upper right abdomen, known as biliary colic. This pain may radiate to the back between the shoulder blades or to the right shoulder. Nausea and vomiting may accompany these pain episodes.
Larger gallstones are more likely to cause complications. These include acute cholecystitis, an inflammation of the gallbladder that causes severe, persistent pain and fever. Blockages of the common bile duct can lead to jaundice (yellowing of the skin and eyes) and bile duct infections (cholangitis). A gallstone blocking the pancreatic duct can also result in pancreatitis, an inflammation of the pancreas characterized by intense abdominal pain.
Treatment Approaches
Treatment for gallstones depends on whether they cause symptoms and the potential for complications. For gallstones that do not cause symptoms, a “watchful waiting” approach is often recommended, where no immediate treatment is needed. Medication, such as bile acid dissolution therapy, can dissolve small cholesterol gallstones, but this treatment may take months or years and is less effective for larger stones.
When gallstones cause recurring symptoms or complications, surgical removal of the gallbladder, known as a cholecystectomy, is a common and effective treatment. The gallbladder is not essential; most individuals live normally without it, as bile flows directly from the liver to the small intestine. This surgery can be performed using minimally invasive laparoscopic techniques or, in some cases, traditional open surgery.
When to Consult a Healthcare Professional
Consult a healthcare professional if you experience symptoms that suggest gallstones, especially if you have known gallstones. Seek immediate medical attention for severe abdominal pain that prevents you from finding a comfortable position or lasts for more than a few hours. Other urgent indicators include a high fever with chills, or yellowing of your skin or the whites of your eyes (jaundice). These symptoms can signal serious complications such as acute inflammation or infection, requiring prompt diagnosis and intervention.