What Causes Gallstones in Children?

The gallbladder is a small organ that stores bile until the body is ready to use it for digestion. When bile is needed, the gallbladder releases it into the intestine. Bile is produced by the liver and helps with fat digestion. It is made up of water, fats, salts, proteins, bilirubin and cholesterol. Gallstones generally form when the cholesterol hardens, but gallstones can also form from hardened bilirubin. Gallstones are more common in adults, but children also sometimes get gallstones. Usually, children who develop gallstones have no specific reason or underlying condition responsible for the gallstone formations; however, several factors and conditions increase the risk of gallstone formations in children. In addition, those children who have parents who have had gallstones are more likely to develop gallstones themselves.

Blood Cell Abnormalities

• Children with abnormal red blood cells may develop gallstones. Hemolytic anemia (spherocytosis) is a problem that occurs when red blood cells break down too quickly and then the cells' hemoglobin is changed into bilirubin. The bilirubin accumulates in the gallbladder and may form gallstones.

Other Underlying Conditions

• Children with cystic fibrosis and sickle cell disease sometimes develop gallstones. Also, children with an impaired immune system may be at a greater risk of developing gallstones. Impaired immune systems may occur as the result of diseases, like HIV, or cancer treatments, such as chemotherapy.

Physical Conditions

• Obese children are more likely to develop gallstones. Also, children who have had multiple abdominal surgeries or a spinal injury may be more prone to develop gallstones.

Intravenous Nutrition

• Children who have been on a feeding tube for a long period of time are at a higher risk of developing gallstones. Intravenous feedings affect the flow of bile by slowing it down, which can promote the formation of gallstones. According to the University of Maryland, about 40 percent of individuals who have received intravenous feedings develop gallstones.

Symptoms

• A child who has gallstones may experience intense pain in the upper right side of the abdomen and back. The pain may be felt at any time, but it often follows meals containing greasy food items. Children with gallstones may also experience nausea and/or vomiting.

Diagnosis and Treatment

• Gallstones can be detected via ultrasound. The only effective treatment for gallstones is to completely remove the gallbladder (cholecystectomy). The gallbladder is removed laparoscopically under general anesthesia. Since the gallbladder's only function is to store bile, it is not a vital part of the digestive system. Without a gallbladder, the bile will simply move directly from the liver to the intestines.