The gallbladder is a small pear shaped organ located just below the liver in the upper right part of the abdomen. The bile produced in the liver is stored in the gallbladder until the body needs it. Bile is secreted from the gallbladder into the small intestine during the process of fat digestion and absorption from the food. Bile has water, bile salts, fats, cholesterol, protein and bilirubin. We all produce small gallbladder stones which we never notice. When bile crystallizes into big stones the problem starts. Bile can harden if there is too much of bile salts, cholesterol or bilirubin in it. Gallstones are stones that form in the gallbladder or bile ducts.

There are two main types of gallstone and they are:

• Cholesterol stones – 80% are cholesterol stones. They are made mostly of hardened cholesterol and are usually yellowish – green in color.

• Bilirubin stones – 20% are bilirubin stones and are also called as pigment stones. They are made of biliruben, usually small and have a dark color.

Very rarely calcium is also present in bilirubin stones.

Gallstones can be very small or can be as big as a golf ball. Many people who have gallstones do not have any symptoms. The ducts can be blocked and this can cause excess pain and inflammation. Liver, gallbladder and pancreas can be affected.

The causes or risk factors for gallstones include:

• Diabetes – the increased triglycerides are the risk factor here.

• Crohn’s disease – the patients have less bile acids to keep the cholesterol in the solution and these results gallstones.

• Other diseases - cirrhosis of the liver, sickle cell disease and thalassemia are also risk factors of bilirubin gallstones.

• Cholesterol-lowering drugs – these can reduce the cholesterol level in the blood. But, actually it increases the amount of cholesterol in bile.

• Age – people above 60 years are more likely to develop gallstones.

• Obesity – it is a main risk factor in women. Overweight is also a risk factor.

• Rapid weight loss – crash diet to weight loss can produce more cholesterol.

• Estrogen – excess estrogen is a risk factor. Oral contraceptives, pregnancy and hormone replacement therapy can be the reason.

• Ethnicity – for example, the American Indians have higher risk because of the higher levels of cholesterol in their bile. Scandinavians and Mexico-Americans are also in this group.

• Hereditary – can run in the families

• Gender – women has double the risk than men.

There are surgical as well as non-surgical methods of treatment and you doctor can decide which is right for your problem.