The liver produces bile, which is a yellowish-green liquid that helps digest the fat in foods. Bile contains water, cholesterol, salts, lecithin, and bilirubin (yellow bile pigment). Bile also helps remove toxins and waste from the body.

The Bile “Journey”

Bile is carried from the liver into the gallbladder where it is stored in a concentrated form. It stays in the gallbladder until you eat food containing fat. When that happens the gallbladder contracts and sends the bile through the ducts into the small intestine. While in the small intestine it begins breaking down the fat in the food to help your body digest it.

How Gallstones Are Created

If the bile contains the wrong proportions of water, cholesterol, salts, lecithin, and bilirubin it can harden into stones. These stones, depending on their location, can affect the bile “journey.” The location and quantity of gallstones can cause pain in the right side of the abdominal area or directly under the rib cage. In some instances the pain is also felt in the back under the right shoulder blade.

The primary indicator (without a blood test) that gallstones may be present is the pain described above. If you have gallstones abdominal pain is most often experienced after eating meals with a high fat content (remember, the gallbladder contracts after you eat a meal with fat and pushes the bile through the ducts into the small intestine). The higher the fat content, the more the gallbladder contracts. If gallstones are partially blocking the flow of bile the gallbladder may go into spasm. It usually also becomes inflamed, a condition called cholecystitis.

Gallstone Calcification

This occurs when gallstones become hardened. Approximately 15% of all gallstones contain high levels calcium which contribute to their “calcification” or hardening. Calcified stones can sometimes become so dense that they appear on regular x-rays.

Gallstone Sizes

Gallstones can range in size from a grain of salt to slightly smaller than a golf ball. The body can develop just one gallstone or several gallstones that vary in size. Gallstones can become embedded in the ducts, remain localized in the gallbladder, or, over time, move around. They do not disappear on their own or decrease in size once they’ve formed.

Again, in order to more accurately diagnose gallstones a doctor’s visit is required. Your doctor can perform a physical examination of the abdominal area, conduct a blood test that will indicate whether the liver function is elevated, and/or perform an ultrasound, which will show the quantity and location of gallstones.