It is hard to believe that gallstones as small as grains of sand can be painful enough to make you nauseous. They give you fever and chills, too. Fortunately, 80 percent of the people who have gallstones do not have any symptoms at all. There are two types of gallstones: cholesterol gallstones and pigment gallstones. Almost 10 percent of adults have gallstones, and most of them are cholesterol stones. The medical terms for gallstone diseases depend upon the location and what problems they cause.
Cholelithiasis
If you have cholelithiasis, you have either one gallstone in your gallbladder or a lot of them. If you have enough gallstones, or the ones you have get bigger, or they leave the gallbladder but cannot pass through different ducts, then you have symptoms. You will have pain, usually at night or after eating a fatty meal. It will be in the upper right area of your abdomen, but you might feel it going up the right side of your body, as far as your right shoulder blade. It usually starts abruptly, gets worse and gradually gets better. You may feel nauseous and have to vomit, have an upset stomach and pass gas.
Acute Cholecystitis
There is a duct, named the cystic duct, which leads from the gallbladder to what is called the common bile duct. If a gallstone is lodged in the cystic duct for some time, the gallbladder can become inflated and inflamed, which makes it possible to get a bacterial infection there. You will not only have severe, long-lasting pain in your upper right abdomen, be nauseous and vomit, but you will also have a low-grade fever.
Choledocholithiasis
If you have one or more gallstones in the common bile duct, this, too, can cause pain if the stone(s) become lodged there. But besides being painful, gallstones here can also cause jaundice. You become jaundiced because the gallstones are blocking the normal flow of bile. Bile is partly made of bilirubin, and if it cannot pass through the common bile duct, high levels of bilirubin will give a yellow color to the skin.
Gallstone Pancreatitis
If you have gallstones in the common bile duct (choledocholithiasis), this can cause pancreatitis. Pancreatitis is an infection of the pancreas. This problem happens because there is a duct that leads from the pancreas to the common bile duct. That duct is there so enzymes made in the pancreas can be released into the common bile duct, and then travel to the small intestines. But that also means infections can travel from the common bile duct to the pancreas. Gallstones which obstruct the common bile duct may obstruct the pancreatic duct as well.
Acute Cholangitis
If the gallstones are obstructing the common bile duct, bacteria can move to that area from the small intestines. If so, you will have a bacterial infection and what is called Charcot's Triad. This means you have three symptoms: pain in the upper right abdomen, jaundice and fever with chills. If the gallstones obstruct long enough, the pressure inside of the duct will increase so much that the bacteria can leave, spreading throughout your bloodstream. If this happens, it is called Reynold's Pentad because you have five symptoms: pain, jaundice, fever with chills, shock and a change in your level of mental alertness.
References
- "Handbook of Pathophysiology;"Elizabeth Corwin, MSN, PhD, FNP; 2000
- "Robbins Pathologic Basis of Disease;" Ramzi Cotran, M.D., Vinay Kumar, M.D., Stanley Robbins, M.D.; 1994
- The Merck Manual: Cholelithiasis
