Gallstone Infection

Gallstones are more common in women in the age range of 20 to 50, but the risk for both men and women increases with age. Many people who have gallstones experience no symptoms. However, over time, gallstones can move out of the gallbladder and into one of three small ducts. They can then cause blockages and result in potentially serious infections.

Definition

• The gallbladder is a sac-like organ located just underneath the liver on the right side. The purpose of the gallbladder is to store liquid called bile. Bile is produced in the liver and then flows to the gallbladder where it is stored until the small intestine needs it to digest fats. Bile is a mixture of water, cholesterol, fats, bile salts, proteins, and bilirubin. About 80% of gallstones form when there is too much cholesterol in the bile. Tiny cholesterol crystals separate out from the bile, clump together and then harden into cholesterol stones. Another type of gallstone forms when the bilirubin hardens into crystals. These are called pigment stones. Gallstones can range in size from extremely small to the size of a golf ball. The number of gallstones in the gallbladder can vary from just one or two to hundreds of small stones.

Infection

• Gallstones cause infection when they become trapped in the narrow ducts that are shared by the gallbladder, small intestine, liver and pancreas. Depending on where the blockage occurs, the infection may be called cholecystitis, cholangitis, or gallstone pancreatitis.

Cholecystitis

• If a gallstone gets trapped in the tube leading out of the gallbladder, it causes an infection called cholecystitis. The inflammation damages the tissue and can result in a tear or hole in the gallbladder wall. If that happens, the infection can spread into the abdomen and cause severe inflammation called peritonitis. This infection can be life-threatening, so if you experience any of the symptoms, seek medical help immediately. The symptoms include pain in the abdomen that can be sharp and severe or more like a dull ache, fever and chills, nausea and vomiting, loss of appetite, increased thirst and decreased urine.

Cholangitis

• The common bile duct carries bile between the liver, gallbladder and small intestine. When a gallstone blocks this duct, it becomes inflamed and is called cholangitis. The resulting infection can cause permanent hardening of the bile duct and can move into the liver. The symptoms are similar to cholecystitis: Abdominal pain, chills, diarrhea, fatigue, fever and weight loss. If the liver becomes infected, jaundice can occur.

Gallstone Pancreatitis

• The pancreas produces enzymes that are used in digestion. A tube connects the pancreas to the common bile duct so gallstones moving out of the gallbladder can also block the pancreatic duct. The resulting inflammation and infection is called pancreatitis. This condition can be mild and go away without treatment; it can remain in a chronic state; or it can cause a sudden severe attack. Acute attacks are marked by pain. Pain can be in the upper abdomen, radiate to the back, feel worse after eating, or feel better by curling forward. Chronic pancreatitis, which can exist for years, causes upper abdominal pain, indigestion, weight loss and smelly stools. Repeated episodes of acute pancreatitis and the ongoing chronic disease can result in damage to the pancreas, interfering with its ability to function.