You might have heard a lot about gallstones and its associated pain and treatment? But do you know what size of gallstone is considered to be large? Well! Some people may form numerous tiny gallstones, while others may form one large stone. Most commonly the size of the gallstones can vary between the sizes of 5-10 mm in diameter which usually does not pose any serious risks. However, sizes larger than this can pose a great threat to your life.
What is a gallstone?
The gallbladder is a pouch located under the liver. It is responsible for storing bile, a fluid that aids digestion that the liver produces. When an excess of cholesterol in the bile is produced by the liver, it leads to deposits in the gallbladder which are called gallstones.
Causes and Symptoms
There are various reasons why gallstones are formed. It may be caused when:
- There is too much cholesterol in the bile: Usually, bile can dissolve the cholesterol that the liver produces. If it produces more cholesterol than the bile can dissolve then it can lead to a yellow gallstone(s).
- There is too much bilirubin in the bile: Bilirubin is produced when the body breaks down red blood cells. The liver produces more bilirubin than necessary if there is liver damage/disorder (liver cirrhosis), biliary tract infection, or blood disorders. In such a case, the gallbladder cannot break down the excess bilirubin. As a result, dark brown or black gallstones are formed.
- The gallbladder is not emptying itself properly: The gallbladder requires to empty the bile it produces completely and often. If it does not, the bile becomes concentrated and forms gallstones.
Maximum people have asymptomatic gallstones which do not cause any pain. For the rest, the gallstones are associated with pain in the upper right abdomen. It can be triggered by eating spicy food, food high in fat, or fried foods as well. Some of the other symptoms are:
- Pain in the centre of the abdomen, just below the breastbone
- Pain in the shoulder blades
Types of Gallstones
- Cholesterol Stones: They are made up of 80% of cholesterol and yellow-green in colour.
- Pigment Stones: They are formed when the bile has too much bilirubin, forming dark brown or black stones.
Size of Gallstone
The size of a gallstone varies from the size of a grain of sand to that of a golf ball. There is no particular size for a gallstone. It can be either singular or multiple in occurrence. Based on the size of the gallstone certain things can be ascertained, such as:
- Whether or not it can pass to the bile duct or cystic ducts. A large gallstone cannot pass through. It reduces the risks of complications associated with gallstones.
- Nature of the gallstone. The nature of the gallstone i.e. whether it is asymptomatic or shows symptoms is associated with the size of gallstones. Only symptomatic or large-sized gallstones require removal via surgery.
Gallstones above 8mm usually show symptoms. If a gallstone is above 2cm in diameter, then it can be termed as large. Only those gallstones which show symptoms or are large in size are removed via surgery. The others can be passed through stool or urine.
There are various complications that can arise due to a large gallstone, such as:
- Cholecystitis: Inflammation of the gallbladder caused when the neck of the gallbladder is blocked due to the gallstone getting lodged on it. It causes severe pain and fever.
- Blocking the common bile duct: The bile in the liver and gallbladder flow through the common bile duct to the small intestine. Large gallstones can block the ducts, restricting passage and leading to an excess concentration of bile in the gallbladder.
- Blocking the pancreatic duct: The pancreatic duct connects the pancreas with the common bile duct. The blockage of the pancreatic duct hinders digestion as it is responsible for allowing pancreatic juices to flow through the pancreatic duct.
- Gallbladder cancer: Family history of gallstones increases the risk of gallbladder cancer, although it is quite rare.
Untreated gallstones, irrespective of size can also lead to other complications like:
- Gallbladder infection
- Bile duct infection
- Sepsis, a blood infection
- Pancreatic inflammation
- Gallbladder cancer
There are a few lifestyle choices which can prevent the formation of a gallstone. Some such are:
- Eating meals on time
- Not losing weight rapidly, as through strict diets
- Eating food rich in fibres
- Regular exercise of 30 minutes, at least 5 days a week
A gallstone can either be removed through medication or need complete removal of your gallbladder. Gallbladder removal or cholecystectomy usually does not have any impact on your life as it only functions to store bile and can be bypassed through the liver even if removed. If you note any of the symptoms of gallstones, visit your doctor immediately.