Gallstones: Types, Causes, Symptoms, Treatments, and Costs in Sri Lanka

🩺 Understanding Gallstones

Gallstones are hardened deposits that form in the gallbladder, a small organ located beneath the liver that stores bile, which helps digest fats. Gallstones can range in size from a grain of sand to a golf ball. Some people may have one gallstone, while others may have multiple.

While many people remain asymptomatic, gallstones can sometimes lead to severe abdominal pain and digestive complications, making understanding their types, causes, and treatment options crucial.

🔹 Main Types of Gallstones

Gallstones are categorized mainly into three types, each with unique composition and causes:

1. Cholesterol Gallstones

Composition: Mainly made of hardened cholesterol.
Prevalence: Most common type, accounting for 80% of gallstones.
Causes:
- High cholesterol in bile.
- Obesity or rapid weight gain.
- Diets high in fat and low in fiber.
- Genetics and family history.
- Hormonal changes, especially in women (estrogen increases cholesterol secretion).
Symptoms: Can cause biliary colic, indigestion, nausea, and abdominal bloating.

2. Pigment Gallstones

Composition: Made of bilirubin, a substance produced from the breakdown of red blood cells.
Prevalence: Less common than cholesterol stones; often linked to medical conditions.
Causes:
- Chronic hemolytic anemia (e.g., sickle cell disease).
- Liver cirrhosis.
- Certain infections in the bile ducts.
Appearance: Usually dark brown or black.
Symptoms: Often asymptomatic but may cause pain if they block bile flow.

3. Mixed Gallstones

Composition: Contain a combination of cholesterol, calcium salts, and bilirubin.
Prevalence: Common in people with prolonged gallbladder inflammation.
Causes:
- Chronic gallbladder inflammation.
- Gallbladder motility disorders (poor emptying).
- Combination of dietary, genetic, and medical factors.
Symptoms: Similar to cholesterol gallstones, may also lead to recurrent attacks.

🔹 Causes and Risk Factors of Gallstones

Gallstones form due to an imbalance in bile components, causing crystallization in the gallbladder. Key contributing factors include:

Dietary Habits
- High-fat, high-cholesterol diets increase cholesterol concentration in bile.
- Low-fiber diets reduce bile acid secretion, promoting stone formation.
Obesity and Rapid Weight Changes
- Obesity increases cholesterol in bile.
- Rapid weight loss causes the liver to secrete extra cholesterol into bile.
Age and Gender
- People over 40 are more prone.
- Women, especially those on estrogen therapy or pregnant, have higher risk due to hormonal effects.
Genetics
- Family history significantly increases susceptibility.
Medical Conditions
- Diabetes, cirrhosis, and certain hemolytic diseases.
- Gallbladder motility disorders.
Lifestyle
- Sedentary lifestyle and low physical activity contribute to stone formation.

🔹 Symptoms of Gallstones

Many people with gallstones experience no symptoms. When symptomatic, they may include:

Severe abdominal pain in the upper right quadrant, often after eating fatty foods.
Nausea and vomiting.
Jaundice (yellowing of skin and eyes) if bile ducts are blocked.
Fever and chills if gallstones cause infection (cholecystitis).
Indigestion, bloating, and gas.

🔹 Diagnosis

Ultrasound: Most common, non-invasive test to detect gallstones.
CT Scan or MRI: Used if complications are suspected.
Blood Tests: To check for infection, liver, or bile duct obstruction.

🔹 Treatment Options

Non-Surgical Treatments

Medications (Oral Dissolution Therapy)
- Used for small cholesterol stones.
- Can take months or years to dissolve stones.
- Not effective for pigment or mixed stones.
Shock Wave Lithotripsy
- Uses sound waves to break up gallstones.
- Rarely used due to recurrence risk.

Surgical Treatments

Laparoscopic Cholecystectomy
- Minimally invasive removal of gallbladder.
- Most common treatment.
- Short recovery period.
Open Cholecystectomy
- Traditional surgery used in complex cases.
- Longer recovery but necessary if complications exist.

💰 Cost of Gallstone Treatment in Sri Lanka

Private Hospitals: Laparoscopic gallbladder surgery costs 55,000–65,000 INR (~70,000–80,000 LKR).
Public Hospitals: Affordable treatment in general wards at government hospitals like Colombo General Hospital.

🌍 Global Perspective

In the UK, US, and Europe, gallbladder surgeries cost significantly more.
Sri Lanka is becoming a medical tourism hub, offering high-quality care at competitive prices.

✅ Prevention Tips

Eat a balanced diet rich in fiber, low in saturated fat.
Maintain a healthy weight and exercise regularly.
Avoid rapid weight loss.
Regular health check-ups, especially for those with a family history of gallstones.

📝 Conclusion

Gallstones, while common, can be effectively managed with early diagnosis, proper treatment, and lifestyle adjustments. Understanding the types of gallstones, causes, and available treatments empowers patients to make informed decisions. Sri Lanka offers a blend of modern surgical care and alternative treatments, making it an attractive destination for both local and international patients seeking gallstone care.

Note: Always consult with a healthcare professional before making decisions about treatment options.

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