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Liver Stones

When you speak of medical stones, most people think of kidney stones and sometimes of gallstones. Liver stones are less commonly known about. Liver stones are chemically the same as gallstones in that they are formed from gall or bile, a fluid substance produced by the liver that aids in the digestion of fats in the small intestine. Bile produced by the liver is stored in the gallbladder and released into the digestive system when foods rich in fat are consumed. The most common place for gallstones to form is in the gallbladder, where bile is concentrated more so than in the liver itself. Gallstones can form in the liver (liver stones proper) when the gallbladder has been removed and under some other circumstances.

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Liver Stones


Types Of Gallstones


There are three different types of gallstone. These are cholesterol gallstones, pigment gallstones, and mixed gallstones. Cholesterol gallstones, as the name implies, are mostly cholesterol; 80% of the stone's chemical composition must consist of cholesterol to merit this classification.

Pigment gallstones contain less than 20% cholesterol and are primarily composed of bilirubin and calcium salts. Mixed stones are those that contain more than 20% but less than 80% cholesterol. The classification is important because of differences in the size of gallstones and the impact on treatment options.

Symptoms


In most cases, gallstones produce no overt symptoms and in that case no treatment is needed. The stones can vary widely in size, from no bigger than a grain of sand to as big as a golf ball. Only the larger stones present any medical concern.

Larger gallstones may sometimes lodge in a bile duct and block the flow of bile either into or out of the gallbladder. When that happens, symptoms often appear. These include sharp pain, increasing in severity over time ranging from several minutes to several hours, in the upper-right portion of the abdomen (near the liver), in the abdominal center just under the breastbone, in the back between the shoulder blades, and/or in the right shoulder. In some cases, the pain becomes severe enough that sitting still is difficult to impossible. The pain may also be accompanied by jaundice or by fever and chills. When these symptoms occur, it is necessary to seek medical attention.

Risk Factors


Women are at greater risk for gallstones than men. So are people over sixty years of age, Mexican-Americans, and Native Americans. Other risk factors include obesity, diabetes, a diet high in fat or cholesterol or low in fiber, rapid weight loss, certain medications including those prescribed to lower cholesterol levels or to treat hormone deficiencies (estrogen), and having a family history of gallstones.

Complications


Besides the severe pain and other symptoms that can sometimes occur with gallstones, the condition also has potential complications. These include blockage of either the common bile duct or the pancreatic duct, leading to infection and inflammation of either the gallbladder or the pancreas. There is also a measurably increased risk of gallbladder cancer. However, even with this increased risk gallbladder cancer is very rare, so this complication is unlikely to arise.

Treatment


After confirming the presence of gallstones through medical imaging and/or blood tests, in those cases where treatment is required the normal prescription is surgical removal of the gallbladder. Once the gallbladder is removed, bile flows directly from the liver into the small intestine rather than being stored in the gallbladder. This does not interfere with digestion of fats, but may in some cases cause temporary diarrhea.

Alternative treatments may be used to prevent gallstones from worsening if they are discovered before symptoms appear. These treatments include a low-fat, high-fiber diet and weight control to reduce the risk factors.