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Before understanding gallstones, it is important to first understand what the gallbladder is and the role it plays in the body.

The gallbladder is a small, pear-shaped organ that stores and releases bile—a fluid produced by the liver to help digest fats in food. It is located in the upper right part of the abdomen, just below the liver.

What is the Function of the Gallbladder?

The gallbladder is part of the digestive system. Its main role is to store bile, which helps break down fats during digestion.

Bile is made up primarily of cholesterol, bilirubin, and bile salts. The gallbladder connects to other parts of the digestive system through a series of bile ducts, collectively called the biliary system, which transports bile from the liver to the small intestine.

How Does the Gallbladder Work?

Before eating, the gallbladder is full of bile. Once food intake begins, it receives a signal to contract and release the stored bile through the bile ducts.

The bile then travels through the common bile duct into the duodenum (the first part of the small intestine), where it mixes with food to help digest it.

After digestion, the gallbladder becomes empty—similar to a deflated balloon—until it fills up again with bile.

Gallbladder Problems

The gallbladder can face several issues, the most common being gallstones, which are usually harmless but can lead to medical conditions.

Common gallbladder problems include:

• Gallstones: These are stone-like objects made from bile material that form in the gallbladder or bile ducts. They can be as small as sand grains or as large as golf balls. Though often harmless, they can cause pain, inflammation, or nausea.
• Cholecystitis (gallbladder inflammation): Occurs when a gallstone blocks bile flow, leading to pain and fever. This condition often requires surgical removal of the gallbladder.
• Gallstone pancreatitis: Inflammation of the pancreas caused when a gallstone blocks the common bile duct at the point where it joins the pancreatic duct.
• Gallbladder cancer: Rare, but may present with pain in the upper right abdomen. However, such pain may also be due to other causes.

Risk Factors for Gallstones

Several factors may increase the likelihood of developing gallstones, including:

• Excess cholesterol secretion by the liver
• Lack of sufficient bile salts to break down cholesterol
• Incomplete emptying of bile from the gallbladder
• Family history or genetic predisposition
• Diabetes
• Low physical activity
• High triglycerides
• Low HDL (good cholesterol)
• Obesity, especially central obesity
• Rapid weight loss
• Age over 40
• Pregnancy
• High-fat or high-cholesterol diet
• Low fiber intake
• Blood disorders (e.g., sickle cell anemia, leukemia)
• Estrogen-containing medications (e.g., oral contraceptives, hormone therapy)
• Liver diseases

Types of Gallstones

There are two main types:

1. Cholesterol Gallstones:
   The most common type, yellow in color, formed primarily from undissolved cholesterol and other substances.
2. Pigment Gallstones:
   Dark brown or black stones, formed when bile contains high levels of bilirubin.

Symptoms of Gallstones

In some cases, gallstones cause no symptoms. However, when symptoms do occur, they may include:

• Pain in the upper right abdomen
• Abdominal pain after eating fatty foods
• Yellowing of the skin (jaundice)
• Right shoulder pain
• Chills and high fever
• Nausea or vomiting

Causes of Gallstones

Although no single direct cause is confirmed, possible reasons include:

• Excess cholesterol in bile:
  If the liver produces more cholesterol than bile can dissolve, the excess forms crystals, then stones.
• High bilirubin in bile:
  Bilirubin is a byproduct of breaking down red blood cells. High levels may result from liver cirrhosis, bile duct infections, or blood disorders, increasing the risk of stone formation.
• Incomplete emptying of the gallbladder:
  If bile remains in the gallbladder too long, it becomes overly concentrated, leading to stone formation.

How Common are Gallstones?

Gallstones are common in developed countries. They affect about 10% of adults and 20% of people over 65 years old. Only 20% of those affected will require treatment.

Gallstone Treatment Options

Treatment may include:

• Weight reduction if overweight — consider a diet plan (e.g., Four-Week Plan – Dr. Ruba Musharbash)
• Avoiding high-fat foods
• Following a healthy eating pattern
• Adopting an active lifestyle

Tips to Increase Physical Activity

• Take the stairs instead of elevators
• Park further from your destination and walk
• Choose active family or group activities like biking, soccer, or basketball

Dietary Guidelines

Recommended Foods:

• Grilled skinless chicken
• Fresh fruits and vegetables
• Grilled lean meats
• Whole grains (e.g., brown bread, bran bread)
• Raw nuts
• Olive oil
• Skim milk

Foods to Avoid or Limit:

• Fried chicken or meats
• Fried fruits or those cooked in fat
• Refined starches and fatty desserts like cakes
• Ghee, white bread, roasted nuts
• Full-fat milk