Gallstones (cholelithiasis): origin

Gallstones often remain unrecognized for a long time in the gallbladder, where they have room. Sometimes they wander - and block the bile ducts. This buffers the bile, which leads to strong, spasmodic pain. This is usually the situation in which the gallstones are first discovered.

Stones - or "concrements" in technical terms - can form in various places in the body, usually by crystallization and clumping of fats, salts or dyes. Most commonly, they occur in the gall bladder or kidneys and urinary tract, more rarely, salivary glands.

Formation of gallstones

The gallbladder clings tightly to the liver to quickly absorb and store the bile produced there. This so-called bile helps the intestine to digest high-fat food. It contains various dissolved components like

  • bile acids
  • phospholipids
  • cholesterol
  • Dyes from the blood loss
  • hormones

If too many of the individual substances are present or their composition changes, they precipitate out of the solution and settle on the walls of gallbladder (cholecystolithiasis) or bile ducts (choledocholithiasis). They can be solitary or multiple, small or up to plum-sized and calcified.

Cholesterol stones and pigment stones

For gallstones, a distinction is made between cholesterol and pigment stones and a mixed type:

  • Cholesterol stones are caused by a high cholesterol content of the bile, associated with a lack of bile salts. Cholesterol stones are more common in overweight, high cholesterol levels in the blood, taking the pill or in the context of Crohn's disease.
  • Pigment stones consist mainly of the bile pigment bilirubin and are mainly produced in cases of increased blood clots, artificial heart valves, malaria, chronic infections of the biliary tract and liver diseases.

Gallstones of a person are always of the same type (mostly cholesterol stones) and are based on the individual composition of the bile. How far the gallstone disease also has a psychological component is controversial. Especially in alternative medicine, gallstones are often attributed to mental stress and associated with a certain personality type, which is conflict-shy, leaves little to the outside and aggression rather directed against himself.

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