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class="vector-toc-numb">2</span> <span>Signs and symptoms</span> </div> </a> <button aria-controls="toc-Signs_and_symptoms-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Signs and symptoms subsection</span> </button> <ul id="toc-Signs_and_symptoms-sublist" class="vector-toc-list"> <li id="toc-Other_complications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Other complications</span> </div> </a> <ul id="toc-Other_complications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Risk_factors" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Risk_factors"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Risk factors</span> </div> </a> <ul id="toc-Risk_factors-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pathophysiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Pathophysiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Pathophysiology</span> </div> </a> <button aria-controls="toc-Pathophysiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Pathophysiology subsection</span> </button> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> <li id="toc-Composition" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Composition"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Composition</span> </div> </a> <ul id="toc-Composition-sublist" class="vector-toc-list"> <li id="toc-Cholesterol_stones" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Cholesterol_stones"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1.1</span> <span>Cholesterol stones</span> </div> </a> <ul id="toc-Cholesterol_stones-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Pigment_stones" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Pigment_stones"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1.2</span> <span>Pigment stones</span> </div> </a> <ul id="toc-Pigment_stones-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mixed_stones" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Mixed_stones"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1.3</span> <span>Mixed stones</span> </div> </a> <ul id="toc-Mixed_stones-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Prevention</span> </div> </a> <ul id="toc-Prevention-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Treatment" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Treatment"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Treatment</span> </div> </a> <button aria-controls="toc-Treatment-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Treatment subsection</span> </button> <ul id="toc-Treatment-sublist" class="vector-toc-list"> <li id="toc-Lithotripsy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Lithotripsy"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Lithotripsy</span> </div> </a> <ul id="toc-Lithotripsy-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgical" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgical"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2</span> <span>Surgical</span> </div> </a> <ul id="toc-Surgical-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medical" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medical"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3</span> <span>Medical</span> </div> </a> <ul id="toc-Medical-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Use_in_alternative_medicine" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Use_in_alternative_medicine"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Use in alternative medicine</span> </div> </a> <ul id="toc-Use_in_alternative_medicine-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Gallstone</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 40 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-40" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">40 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AD%D8%B5%D8%A7%D8%A9_%D8%B5%D9%81%D8%B1%D8%A7%D9%88%D9%8A%D8%A9" title="حصاة صفراوية – Arabic" lang="ar" hreflang="ar" data-title="حصاة صفراوية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%AA%E0%A6%BF%E0%A6%A4%E0%A7%8D%E0%A6%A4%E0%A6%AA%E0%A6%BE%E0%A6%A5%E0%A7%81%E0%A6%B0%E0%A7%80" title="পিত্তপাথুরী – Bangla" lang="bn" hreflang="bn" data-title="পিত্তপাথুরী" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-bo mw-list-item"><a href="https://bo.wikipedia.org/wiki/%E0%BD%98%E0%BD%81%E0%BE%B2%E0%BD%B2%E0%BD%A6%E0%BC%8B%E0%BD%A2%E0%BE%A1%E0%BD%BC%E0%BC%8B" title="མཁྲིས་རྡོ་ – Tibetan" lang="bo" hreflang="bo" data-title="མཁྲིས་རྡོ་" data-language-autonym="བོད་ཡིག" data-language-local-name="Tibetan" class="interlanguage-link-target"><span>བོད་ཡིག</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/%C5%BDlu%C4%8Dov%C3%A9_kameny" title="Žlučové kameny – Czech" lang="cs" hreflang="cs" data-title="Žlučové kameny" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Galdesten" title="Galdesten – Danish" lang="da" hreflang="da" data-title="Galdesten" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Gallenstein" title="Gallenstein – German" lang="de" hreflang="de" data-title="Gallenstein" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-dv mw-list-item"><a href="https://dv.wikipedia.org/wiki/%DE%8A%DE%A8%DE%8C%DE%AA%DE%8E%DE%A6%DE%87%DE%A8_%DE%80%DE%A8%DE%8D%DE%A6%DE%87%DE%AA%DE%8A%DE%AC%DE%8B%DE%AA%DE%82%DE%B0" title="ފިތުގައި ހިލައުފެދުން – Divehi" lang="dv" hreflang="dv" data-title="ފިތުގައި ހިލައުފެދުން" data-language-autonym="ދިވެހިބަސް" data-language-local-name="Divehi" class="interlanguage-link-target"><span>ދިވެހިބަސް</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Gal%C5%9Dtono" title="Galŝtono – Esperanto" lang="eo" hreflang="eo" data-title="Galŝtono" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%D9%86%DA%AF_%DA%A9%DB%8C%D8%B3%D9%87_%D8%B5%D9%81%D8%B1%D8%A7" title="سنگ کیسه صفرا – Persian" lang="fa" hreflang="fa" data-title="سنگ کیسه صفرا" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Cloch_dhomlais" title="Cloch dhomlais – Irish" lang="ga" hreflang="ga" data-title="Cloch dhomlais" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%8B%B4%EC%84%9D" title="담석 – Korean" lang="ko" hreflang="ko" data-title="담석" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%BC%D5%A5%D5%B2%D5%A1%D5%B5%D5%AB%D5%B6_%D6%84%D5%A1%D6%80" title="Լեղային քար – Armenian" lang="hy" hreflang="hy" data-title="Լեղային քար" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%AA%E0%A4%BF%E0%A4%A4%E0%A5%8D%E0%A4%A4%E0%A4%BE%E0%A4%B6%E0%A4%AF_%E0%A4%95%E0%A5%80_%E0%A4%AA%E0%A4%A5%E0%A4%B0%E0%A5%80" title="पित्ताशय की पथरी – Hindi" lang="hi" hreflang="hi" data-title="पित्ताशय की पथरी" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/%C5%BDu%C4%8Dni_kamenci" title="Žučni kamenci – Croatian" lang="hr" hreflang="hr" data-title="Žučni kamenci" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Batu_empedu" title="Batu empedu – Indonesian" lang="id" hreflang="id" data-title="Batu empedu" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-is mw-list-item"><a href="https://is.wikipedia.org/wiki/Gallsteinar" title="Gallsteinar – Icelandic" lang="is" hreflang="is" data-title="Gallsteinar" data-language-autonym="Íslenska" data-language-local-name="Icelandic" class="interlanguage-link-target"><span>Íslenska</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%90%D7%91%D7%A0%D7%99_%D7%9B%D7%99%D7%A1_%D7%9E%D7%A8%D7%94" title="אבני כיס מרה – Hebrew" lang="he" hreflang="he" data-title="אבני כיס מרה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-sw mw-list-item"><a href="https://sw.wikipedia.org/wiki/Kijiwe_cha_nyongo" title="Kijiwe cha nyongo – Swahili" lang="sw" hreflang="sw" data-title="Kijiwe cha nyongo" data-language-autonym="Kiswahili" data-language-local-name="Swahili" class="interlanguage-link-target"><span>Kiswahili</span></a></li><li class="interlanguage-link interwiki-lv mw-list-item"><a href="https://lv.wikipedia.org/wiki/%C5%BDultsakme%C5%86i" title="Žultsakmeņi – Latvian" lang="lv" hreflang="lv" data-title="Žultsakmeņi" data-language-autonym="Latviešu" data-language-local-name="Latvian" class="interlanguage-link-target"><span>Latviešu</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%86%E0%B4%97%E0%B5%8D%E0%B4%A8%E0%B5%87%E0%B4%AF%E0%B4%97%E0%B5%8D%E0%B4%B0%E0%B4%A8%E0%B5%8D%E0%B4%A5%E0%B5%80_%E0%B4%B6%E0%B4%BF%E0%B4%B2" title="ആഗ്നേയഗ്രന്ഥീ ശില – Malayalam" lang="ml" hreflang="ml" data-title="ആഗ്നേയഗ്രന്ഥീ ശില" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Galsteen" title="Galsteen – Dutch" lang="nl" hreflang="nl" data-title="Galsteen" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%83%86%E7%9F%B3" title="胆石 – Japanese" lang="ja" hreflang="ja" data-title="胆石" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Gallestein" title="Gallestein – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Gallestein" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%AA%E0%AC%BF%E0%AC%A4%E0%AD%8D%E0%AC%A4%E0%AC%BE%E0%AC%B8%E0%AD%8D%E0%AC%AE%E0%AC%B0%E0%AD%80" title="ପିତ୍ତାସ୍ମରୀ – Odia" lang="or" hreflang="or" data-title="ପିତ୍ତାସ୍ମରୀ" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target"><span>ଓଡ଼ିଆ</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Kamie%C5%84_%C5%BC%C3%B3%C5%82ciowy" title="Kamień żółciowy – Polish" lang="pl" hreflang="pl" data-title="Kamień żółciowy" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt badge-Q70894304 mw-list-item" title=""><a href="https://pt.wikipedia.org/wiki/C%C3%A1lculo_biliar" title="Cálculo biliar – Portuguese" lang="pt" hreflang="pt" data-title="Cálculo biliar" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%96%D1%91%D0%BB%D1%87%D0%BD%D1%8B%D0%B5_%D0%BA%D0%B0%D0%BC%D0%BD%D0%B8" title="Жёлчные камни – Russian" lang="ru" hreflang="ru" data-title="Жёлчные камни" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Gallstone" title="Gallstone – Simple English" lang="en-simple" hreflang="en-simple" data-title="Gallstone" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/%C5%BDl%C4%8Dn%C3%ADkov%C3%A9_kamene" title="Žlčníkové kamene – Slovak" lang="sk" hreflang="sk" data-title="Žlčníkové kamene" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/%C5%BDol%C4%8Dni_kamen" title="Žolčni kamen – Slovenian" lang="sl" hreflang="sl" data-title="Žolčni kamen" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-ckb mw-list-item"><a href="https://ckb.wikipedia.org/wiki/%D8%A8%DB%95%D8%B1%D8%AF%DB%8C_%D8%B2%D8%B1%D8%A7%D9%88" title="بەردی زراو – Central Kurdish" lang="ckb" hreflang="ckb" data-title="بەردی زراو" data-language-autonym="کوردی" data-language-local-name="Central Kurdish" class="interlanguage-link-target"><span>کوردی</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9A%D0%B0%D0%BC%D0%B5%D0%BD_%D1%83_%D0%B6%D1%83%D1%87%D0%BD%D0%BE%D1%98_%D0%BA%D0%B5%D1%81%D0%B8" title="Камен у жучној кеси – Serbian" lang="sr" hreflang="sr" data-title="Камен у жучној кеси" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Sappikivi" title="Sappikivi – Finnish" lang="fi" hreflang="fi" data-title="Sappikivi" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Gallsten" title="Gallsten – Swedish" lang="sv" hreflang="sv" data-title="Gallsten" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li 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class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Disease where stones form in the gallbladder</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Gallstone</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Gallstone disease, cholelith, cholecystolithiasis (gallstone in the gallbladder), choledocholithiasis (gallstone in a bile duct)<sup id="cite_ref-Qui2013_1-0" class="reference"><a href="#cite_note-Qui2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Gallstones.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/73/Gallstones.png/220px-Gallstones.png" decoding="async" width="220" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/73/Gallstones.png/330px-Gallstones.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/73/Gallstones.png/440px-Gallstones.png 2x" data-file-width="1200" data-file-height="1200" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Gallstones typically form in the <a href="/wiki/Gallbladder" title="Gallbladder">gallbladder</a> and may result in symptoms if they block the biliary system.</td></tr><tr><th scope="row" class="infobox-label">Pronunciation</th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"><ul><li>Cholelith <span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˈ/: primary stress follows">ˈ</span><span title="'k' in 'kind'">k</span><span title="/oʊ/: 'o' in 'code'">oʊ</span><span title="'l' in 'lie'">l</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'l' in 'lie'">l</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="/θ/: 'th' in 'thigh'">θ</span></span>/</a></span></span>, cholelithiasis <span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'k' in 'kind'">k</span><span title="/oʊ/: 'o' in 'code'">oʊ</span><span title="'l' in 'lie'">l</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'l' in 'lie'">l</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="/θ/: 'th' in 'thigh'">θ</span><span title="/aɪ/: 'i' in 'tide'">aɪ</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'s' in 'sigh'">s</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="'s' in 'sigh'">s</span></span>/</a></span></span> </li></ul></div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Gastroenterology" title="Gastroenterology">Gastroenterology</a><br /><a href="/wiki/General_surgery" title="General surgery">General surgery</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">None, crampy pain in the right upper <a href="/wiki/Abdomen" title="Abdomen">abdomen</a><sup id="cite_ref-NIH2013_2-0" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Lee2015_3-0" class="reference"><a href="#cite_note-Lee2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WS2016_4-0" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Complication_(medicine)" title="Complication (medicine)">Complications</a></th><td class="infobox-data"><a href="/wiki/Cholecystitis" title="Cholecystitis">Inflammation of the gallbladder</a>, <a href="/wiki/Pancreatitis" title="Pancreatitis">inflammation of the pancreas</a>, <a href="/wiki/Hepatitis" title="Hepatitis">liver inflammation</a><sup id="cite_ref-NIH2013_2-1" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WS2016_4-1" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">After 40 years old<sup id="cite_ref-NIH2013_2-2" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="/wiki/Birth_control_pill" class="mw-redirect" title="Birth control pill">Birth control pills</a>, <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a>, family history, <a href="/wiki/Obesity" title="Obesity">obesity</a>, <a href="/wiki/Diabetes" title="Diabetes">diabetes</a>, <a href="/wiki/Cirrhosis" title="Cirrhosis">liver disease</a>, rapid weight loss<sup id="cite_ref-NIH2013_2-3" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on symptoms, confirmed by <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a><sup id="cite_ref-NIH2013_2-4" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-WS2016_4-2" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data">Healthy weight, diet high in fiber, diet low in <a href="/wiki/Simple_carbohydrates" class="mw-redirect" title="Simple carbohydrates">simple carbohydrates</a><sup id="cite_ref-NIH2013_2-5" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><b>Asymptomatic</b>: none,<sup id="cite_ref-NIH2013_2-6" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> ursodeoxycholic acid (UDCA) and Chenodeoxycholic acid <br /><b>Pain</b>: surgery <a href="/wiki/Endoscopic_retrograde_cholangiopancreatography" title="Endoscopic retrograde cholangiopancreatography">ERCP</a>, <a href="/wiki/Cholecystectomy" title="Cholecystectomy">Cholecystectomy</a><sup id="cite_ref-NIH2013_2-7" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a></th><td class="infobox-data">Good after surgery<sup id="cite_ref-NIH2013_2-8" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">10–15% of adults (developed world)<sup id="cite_ref-WS2016_4-3" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></td></tr></tbody></table> <p>A <b>gallstone</b> is a <a href="/wiki/Calculus_(medicine)" title="Calculus (medicine)">stone</a> formed within the <a href="/wiki/Gallbladder" title="Gallbladder">gallbladder</a> from <a href="/wiki/Precipitated" class="mw-redirect" title="Precipitated">precipitated</a> <a href="/wiki/Bile" title="Bile">bile</a> components.<sup id="cite_ref-NIH2013_2-9" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The term <b>cholelithiasis</b> may refer to the presence of gallstones or to any disease caused by gallstones,<sup id="cite_ref-NICE2014_5-0" class="reference"><a href="#cite_note-NICE2014-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Choledocholithiasis" class="mw-redirect" title="Choledocholithiasis">choledocholithiasis</a> refers to the presence of migrated gallstones within <a href="/wiki/Bile_duct" title="Bile duct">bile ducts</a>. </p><p>Most people with gallstones (about 80%) are asymptomatic.<sup id="cite_ref-NIH2013_2-10" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Lee2015_3-1" class="reference"><a href="#cite_note-Lee2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> However, when a gallstone obstructs the bile duct and causes acute <a href="/wiki/Cholestasis" title="Cholestasis">cholestasis</a>, a <a href="/wiki/Reflex" title="Reflex">reflexive</a> <a href="/wiki/Smooth_muscle" title="Smooth muscle">smooth muscle</a> <a href="/wiki/Spasm" title="Spasm">spasm</a> often occurs, resulting in an intense <a href="/wiki/Cramp" title="Cramp">cramp</a>-like <a href="/wiki/Visceral_pain" title="Visceral pain">visceral pain</a> in the <a href="/wiki/Quadrant_(abdomen)" class="mw-redirect" title="Quadrant (abdomen)">right upper part</a> of the <a href="/wiki/Abdomen" title="Abdomen">abdomen</a> known as a <a href="/wiki/Biliary_colic" title="Biliary colic">biliary colic</a> (or "gallbladder attack").<sup id="cite_ref-WS2016_4-4" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> This happens in 1–4% of those with gallstones each year.<sup id="cite_ref-WS2016_4-5" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Complications from gallstones may include inflammation of the gallbladder (<a href="/wiki/Cholecystitis" title="Cholecystitis">cholecystitis</a>), inflammation of the <a href="/wiki/Pancreas" title="Pancreas">pancreas</a> (<a href="/wiki/Pancreatitis" title="Pancreatitis">pancreatitis</a>), <a href="/wiki/Jaundice#Post-hepatic" title="Jaundice">obstructive jaundice</a>, and infection in bile ducts (<a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">cholangitis</a>).<sup id="cite_ref-WS2016_4-6" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NHS2018_6-0" class="reference"><a href="#cite_note-NHS2018-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Symptoms of these complications may include pain that lasts longer than five hours, <a href="/wiki/Fever" title="Fever">fever</a>, yellowish skin, vomiting, dark <a href="/wiki/Urine" title="Urine">urine</a>, and pale <a href="/wiki/Feces" title="Feces">stools</a>.<sup id="cite_ref-NIH2013_2-11" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Risk factors for gallstones include <a href="/wiki/Birth_control_pill" class="mw-redirect" title="Birth control pill">birth control pills</a>, <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a>, a <a href="/wiki/Family_history_(medicine)" title="Family history (medicine)">family history</a> of gallstones, <a href="/wiki/Obesity" title="Obesity">obesity</a>, <a href="/wiki/Diabetes" title="Diabetes">diabetes</a>, <a href="/wiki/Cirrhosis" title="Cirrhosis">liver disease</a>, or rapid weight loss.<sup id="cite_ref-NIH2013_2-12" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The bile components that form gallstones include <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a>, <a href="/wiki/Bile_salts" class="mw-redirect" title="Bile salts">bile salts</a>, and <a href="/wiki/Bilirubin" title="Bilirubin">bilirubin</a>.<sup id="cite_ref-NIH2013_2-13" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Gallstones formed mainly from cholesterol are termed <i>cholesterol stones</i>, and those formed mainly from bilirubin are termed <i>pigment stones</i>.<sup id="cite_ref-NIH2013_2-14" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Lee2015_3-2" class="reference"><a href="#cite_note-Lee2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Gallstones may be suspected based on symptoms.<sup id="cite_ref-WS2016_4-7" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Diagnosis is then typically confirmed by <a href="/wiki/Ultrasound" title="Ultrasound">ultrasound</a>.<sup id="cite_ref-NIH2013_2-15" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Complications may be detected using blood tests.<sup id="cite_ref-NIH2013_2-16" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>The risk of gallstones may be decreased by maintaining a healthy weight with exercise and a <a href="/wiki/Healthy_diet" title="Healthy diet">healthy diet</a>.<sup id="cite_ref-NIH2013_2-17" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> If there are no symptoms, treatment is usually not needed.<sup id="cite_ref-NIH2013_2-18" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> In those who are having gallbladder attacks, <a href="/wiki/Cholecystectomy" title="Cholecystectomy">surgery to remove the gallbladder</a> is typically recommended.<sup id="cite_ref-NIH2013_2-19" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> This can be carried out either <a href="/wiki/Laparoscopic_surgery" class="mw-redirect" title="Laparoscopic surgery">through several small incisions</a> or through a single larger incision, usually under <a href="/wiki/General_anesthesia" class="mw-redirect" title="General anesthesia">general anesthesia</a>.<sup id="cite_ref-NIH2013_2-20" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> In rare cases when surgery is not possible, medication can be used to dissolve the stones or <a href="/wiki/Lithotripsy" title="Lithotripsy">lithotripsy</a> can be used to break them down.<sup id="cite_ref-NIH2017Tx_7-0" class="reference"><a href="#cite_note-NIH2017Tx-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>In <a href="/wiki/Developed_country" title="Developed country">developed countries</a>, 10–15% of adults experience gallstones.<sup id="cite_ref-WS2016_4-8" class="reference"><a href="#cite_note-WS2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Gallbladder and biliary-related diseases occurred in about 104 million people (1.6% of people) in 2013 and resulted in 106,000 deaths.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Gallstones are more common among women than men and occur more commonly after the age of 40.<sup id="cite_ref-NIH2013_2-21" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Gallstones occur more frequently among <a href="/wiki/Race_and_health" title="Race and health">certain ethnic groups</a> than others.<sup id="cite_ref-NIH2013_2-22" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> For example, 48% of <a href="/wiki/Native_Americans_in_the_United_States" title="Native Americans in the United States">Native Americans</a> experience gallstones, whereas gallstone rates in many parts of Africa are as low as 3%.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-NIH2013_2-23" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Once the gallbladder is removed, outcomes are generally positive.<sup id="cite_ref-NIH2013_2-24" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Definition">Definition</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=1" title="Edit section: Definition"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Gallstone disease refers to the condition where gallstones are either in the gallbladder or common bile duct.<sup id="cite_ref-NICE2014_5-1" class="reference"><a href="#cite_note-NICE2014-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> The presence of stones in the gallbladder is referred to as <i>cholelithiasis</i>, from the Greek <i lang="en"><a href="https://en.wiktionary.org/wiki/chole-#English" class="extiw" title="wikt:chole-">chole-</a></i> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc">χολή</span></span>, 'bile') + <i lang="en"><a href="https://en.wiktionary.org/wiki/lith-#English" class="extiw" title="wikt:lith-">lith-</a></i> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc">λίθος</span></span>, 'stone') + <i lang="en"><a href="https://en.wiktionary.org/wiki/-iasis#English" class="extiw" title="wikt:-iasis">-iasis</a></i> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc">ἴασις</span></span>, 'process').<sup id="cite_ref-Qui2013_1-1" class="reference"><a href="#cite_note-Qui2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The presence of gallstones in the <a href="/wiki/Common_bile_duct" title="Common bile duct">common bile duct</a> is called <i><a href="/wiki/Choledocholithiasis" class="mw-redirect" title="Choledocholithiasis">choledocholithiasis</a></i>, from the Greek <i lang="en"><a href="https://en.wiktionary.org/wiki/choledocho-#English" class="extiw" title="wikt:choledocho-">choledocho-</a></i> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc">χοληδόχος</span></span>, 'bile-containing', from <span title="Ancient Greek (to 1453)-language text"><i lang="grc-Latn">chol-</i></span> + <span title="Ancient Greek (to 1453)-language text"><i lang="grc-Latn">docho-</i></span>, 'duct') + <span title="Ancient Greek (to 1453)-language text"><i lang="grc-Latn">lith-</i></span> + <span title="English-language text"><i lang="en">-iasis</i></span>.<sup id="cite_ref-Qui2013_1-2" class="reference"><a href="#cite_note-Qui2013-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> Choledocholithiasis is frequently associated with obstruction of the bile ducts, which can lead to <i><a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">cholangitis</a></i>, from the Greek: <span title="Ancient Greek (to 1453)-language text"><i lang="grc-Latn">chol-</i></span> + <i lang="en"><a href="https://en.wiktionary.org/wiki/angio-#English" class="extiw" title="wikt:angio-">ang-</a></i> (<span title="Ancient Greek (to 1453)-language text"><span lang="grc">ἄγγος</span></span>, 'vessel') + <i lang="en"><a href="https://en.wiktionary.org/wiki/-itis#English" class="extiw" title="wikt:-itis">-itis</a></i> (<span lang="grc"><a href="https://en.wiktionary.org/wiki/-%E1%BF%96%CF%84%CE%B9%CF%82#Ancient_Greek" class="extiw" title="wikt:-ῖτις">-ῖτις</a></span>, 'inflammation'), a serious infection of the bile ducts. Gallstones within the <a href="/wiki/Ampulla_of_Vater" title="Ampulla of Vater">ampulla of Vater</a> can obstruct the <a href="/wiki/Exocrine_gland" title="Exocrine gland">exocrine</a> system of the <a href="/wiki/Pancreas" title="Pancreas">pancreas</a> and can result in <a href="/wiki/Pancreatitis" title="Pancreatitis">pancreatitis</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=2" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Prevalence2.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/81/Prevalence2.png/520px-Prevalence2.png" decoding="async" width="520" height="78" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/81/Prevalence2.png/780px-Prevalence2.png 1.5x, //upload.wikimedia.org/wikipedia/commons/8/81/Prevalence2.png 2x" data-file-width="911" data-file-height="136" /></a><figcaption>The proportion of people with gallstones who experience symptoms as a result of them. <sup id="cite_ref-:3_11-0" class="reference"><a href="#cite_note-:3-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>Gallstones, regardless of size or number, are often asymptomatic.<sup id="cite_ref-Acalovschi2003_12-0" class="reference"><a href="#cite_note-Acalovschi2003-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> These "silent stones" do not require treatment and can remain asymptomatic even years after they form.<sup id="cite_ref-NDDIC_13-0" class="reference"><a href="#cite_note-NDDIC-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Heuman2010_14-0" class="reference"><a href="#cite_note-Heuman2010-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Sometimes, the pain may be referred to tip of the scapula in cholelithiasis; this is called "Collin's sign".<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>A characteristic symptom of a <a href="/wiki/Biliary_colic" title="Biliary colic">gallstone attack</a> is the presence of <a href="/wiki/Colic" title="Colic">colic-like</a> pain in the <a href="/wiki/Upper_right_quadrant" class="mw-redirect" title="Upper right quadrant">upper-right side of the abdomen</a>, often accompanied by nausea and vomiting. Pain from symptomatic gallstones may range from mild to severe and can steadily increase over a period lasting from 30 minutes to several hours. Other symptoms may include fever, as well as <a href="/wiki/Referred_pain" title="Referred pain">referred pain</a> between the <a href="/wiki/Scapula" title="Scapula">shoulder blades</a> or below the right shoulder. If one or more gallstones block the bile ducts and cause bilirubin to leak into the bloodstream and surrounding tissue, jaundice and itching may also occur. In this case, liver enzyme levels are likely to be raised.<sup id="cite_ref-:1_16-0" class="reference"><a href="#cite_note-:1-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>Often, gallbladder attacks occur after eating a heavy meal. Attacks are most common in the evening or at night.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other_complications">Other complications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=3" title="Edit section: Other complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In rare cases, gallstones that cause severe inflammation can erode through the gallbladder into adherent bowel, potentially causing an obstruction termed <a href="/wiki/Gallstone_ileus" title="Gallstone ileus">gallstone ileus</a>.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>Other complications can include <a href="/wiki/Ascending_cholangitis" title="Ascending cholangitis">ascending cholangitis</a>, which occurs when a bacterial infection causes purulent inflammation in the biliary tree and liver, and <a href="/wiki/Acute_pancreatitis" title="Acute pancreatitis">acute pancreatitis</a> caused by blockage of the bile ducts that prevents active enzymes from being secreted into the bowel, instead damaging the pancreas.<sup id="cite_ref-:1_16-1" class="reference"><a href="#cite_note-:1-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> Rarely, <a href="/wiki/Gallbladder_cancer" title="Gallbladder cancer">gallbladder cancer</a> may occur as a complication.<sup id="cite_ref-NHS2018_6-1" class="reference"><a href="#cite_note-NHS2018-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Risk_factors">Risk factors</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=4" title="Edit section: Risk factors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Gallstone risk increases for females (especially before menopause) and for people near or above 40 years;<sup id="cite_ref-Roizen2005_19-0" class="reference"><a href="#cite_note-Roizen2005-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> the condition is more prevalent among people of European or American Indigenous descent than among other ethnicities.<sup id="cite_ref-:0_20-0" class="reference"><a href="#cite_note-:0-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> A lack of <a href="/wiki/Melatonin" title="Melatonin">melatonin</a> could significantly contribute to gallbladder stones, as melatonin inhibits cholesterol secretion from the gallbladder, enhances the conversion of cholesterol to bile, and is an antioxidant, which is able to reduce oxidative stress to the gallbladder.<sup id="cite_ref-Koppisetti2008_21-0" class="reference"><a href="#cite_note-Koppisetti2008-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Gilbert%27s_syndrome" title="Gilbert's syndrome">Gilbert syndrome</a> has been linked to an increased risk of gallstones.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> Researchers believe that gallstones may be caused by a combination of factors, including inherited body chemistry, <a href="/wiki/Human_weight" class="mw-redirect" title="Human weight">body weight</a>, gallbladder <a href="/wiki/Motility" title="Motility">motility</a> (movement), and low-calorie diet.<sup id="cite_ref-:0_20-1" class="reference"><a href="#cite_note-:0-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> The absence of such risk factors does not, however, preclude the formation of gallstones. </p><p>Nutritional factors that may increase risk of gallstones include <a href="/wiki/Constipation" title="Constipation">constipation</a>; eating fewer meals per day; low intake of the nutrients <a href="/wiki/Folic_acid" class="mw-redirect" title="Folic acid">folate</a>, <a href="/wiki/Magnesium" title="Magnesium">magnesium</a>, <a href="/wiki/Calcium" title="Calcium">calcium</a>, and <a href="/wiki/Vitamin_C" title="Vitamin C">vitamin C</a>;<sup id="cite_ref-Ortega1997_23-0" class="reference"><a href="#cite_note-Ortega1997-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> low fluid consumption;<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> and, at least for men, a high intake of <a href="/wiki/Carbohydrate" title="Carbohydrate">carbohydrate</a>, a high <a href="/wiki/Glycemic_load" title="Glycemic load">glycemic load</a>, and high <a href="/wiki/Glycemic_index" title="Glycemic index">glycemic index</a> diet.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> Wine and whole-grained bread may decrease the risk of gallstones.<sup id="cite_ref-Misciagna1996_26-0" class="reference"><a href="#cite_note-Misciagna1996-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p><p>Rapid weight loss increases risk of gallstones.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> The weight loss drug <a href="/wiki/Orlistat" title="Orlistat">orlistat</a> is known to increase the risk of gallstones.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> </p><p>Cholecystokinin deficiency caused by <a href="/wiki/Celiac_disease" class="mw-redirect" title="Celiac disease">celiac disease</a> increases risk of gallstone formation, especially when diagnosis of celiac disease is delayed.<sup id="cite_ref-WangLiu2017_29-0" class="reference"><a href="#cite_note-WangLiu2017-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p><p>Pigment gallstones are most commonly seen in the developing world. Risk factors for pigment stones include <a href="/wiki/Hemolytic_anemia" title="Hemolytic anemia">hemolytic anemias</a> (such as from <a href="/wiki/Sickle-cell_disease" class="mw-redirect" title="Sickle-cell disease">sickle-cell disease</a> and <a href="/wiki/Hereditary_spherocytosis" title="Hereditary spherocytosis">hereditary spherocytosis</a>), <a href="/wiki/Cirrhosis" title="Cirrhosis">cirrhosis</a>, and biliary tract infections.<sup id="cite_ref-pmid7410545_30-0" class="reference"><a href="#cite_note-pmid7410545-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> People with <a href="/wiki/Erythropoietic_protoporphyria" title="Erythropoietic protoporphyria">erythropoietic protoporphyria</a> (EPP) are at increased risk to develop gallstones.<sup id="cite_ref-Merck2006_31-0" class="reference"><a href="#cite_note-Merck2006-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Thunell2008_32-0" class="reference"><a href="#cite_note-Thunell2008-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> Additionally, prolonged use of <a href="/wiki/Proton_pump_inhibitors" class="mw-redirect" title="Proton pump inhibitors">proton pump inhibitors</a> has been shown to decrease gallbladder function, potentially leading to gallstone formation.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p><p>Cholesterol modifying medications can affect gallstone formation. <a href="/wiki/Statin" title="Statin">Statins</a> inhibit cholesterol synthesis and there is evidence that their use may decrease the risk of getting gallstones.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:2_35-0" class="reference"><a href="#cite_note-:2-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Fibrate" title="Fibrate">Fibrates</a> increase cholesterol concentration in bile and their use has been associated with an increased risk of gallstones.<sup id="cite_ref-:2_35-1" class="reference"><a href="#cite_note-:2-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Bile_acid_malabsorption" title="Bile acid malabsorption">Bile acid malabsorption</a> may also be a risk. </p> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=5" title="Edit section: Pathophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Cholesterol gallstones develop when bile contains too much cholesterol and not enough <a href="/wiki/Bile_acid" title="Bile acid">bile salts</a>. Besides a high concentration of cholesterol, two other factors are important in causing gallstones. The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become overconcentrated and contribute to gallstone formation. This can be caused by high resistance to the flow of bile out of the gallbladder due to the complicated internal geometry of the cystic duct.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> The second factor is the presence of proteins in the liver and bile that either promote or inhibit cholesterol crystallization into gallstones. In addition, increased levels of the hormone <a href="/wiki/Estrogen" title="Estrogen">estrogen</a>, as a result of <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a> or <a href="/wiki/Hormone_therapy" title="Hormone therapy">hormone therapy</a>, or the use of combined (estrogen-containing) forms of <a href="/wiki/Hormonal_contraception" title="Hormonal contraception">hormonal contraception</a>, may increase cholesterol levels in bile and also decrease gallbladder motility, resulting in gallstone formation.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2022)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Composition">Composition</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=6" title="Edit section: Composition"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Types_of_Gallstones.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/b7/Types_of_Gallstones.jpg/290px-Types_of_Gallstones.jpg" decoding="async" width="290" height="163" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/b7/Types_of_Gallstones.jpg/435px-Types_of_Gallstones.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/b7/Types_of_Gallstones.jpg/580px-Types_of_Gallstones.jpg 2x" data-file-width="1920" data-file-height="1080" /></a><figcaption>From left to right: cholesterol stone, mixed stone, pigment stone.</figcaption></figure> <p>The composition of gallstones is affected by age, diet and <a href="/wiki/Ethnic_group" class="mw-redirect" title="Ethnic group">ethnicity</a>.<sup id="cite_ref-Channa2007_37-0" class="reference"><a href="#cite_note-Channa2007-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> On the basis of their composition, gallstones can be divided into the following types: cholesterol stones, pigment stones, and mixed stones.<sup id="cite_ref-Lee2015_3-3" class="reference"><a href="#cite_note-Lee2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> An ideal classification system is yet to be defined.<sup id="cite_ref-Kim2003_38-0" class="reference"><a href="#cite_note-Kim2003-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Cholesterol_stones">Cholesterol stones</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=7" title="Edit section: Cholesterol stones"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Cholesterol" title="Cholesterol">Cholesterol</a> stones vary from light yellow to dark green or brown or chalk white and are oval, usually solitary, between 2 and 3 cm long, each often having a tiny, dark, central spot. To be classified as such, they must be at least 80% cholesterol by weight (or 70%, according to the Japanese classification system).<sup id="cite_ref-Kim2003_38-1" class="reference"><a href="#cite_note-Kim2003-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Between 35% and 90% of stones are cholesterol stones.<sup id="cite_ref-Lee2015_3-4" class="reference"><a href="#cite_note-Lee2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Pigment_stones">Pigment stones</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=8" title="Edit section: Pigment stones"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Bilirubin" title="Bilirubin">Bilirubin</a> ("pigment", "black pigment") stones are small, dark (often appearing black), and usually numerous. They are composed primarily of bilirubin (insoluble bilirubin pigment polymer) and <a href="/wiki/Calcium" title="Calcium">calcium</a> (calcium phosphate) <a href="/wiki/Salt_(chemistry)" title="Salt (chemistry)">salts</a> that are found in bile. They contain less than 20% of cholesterol (or 30%, according to the Japanese classification system).<sup id="cite_ref-Kim2003_38-2" class="reference"><a href="#cite_note-Kim2003-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Between 2% and 30% of stones are bilirubin stones.<sup id="cite_ref-Lee2015_3-5" class="reference"><a href="#cite_note-Lee2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Mixed_stones">Mixed stones</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=9" title="Edit section: Mixed stones"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Mixed (<a href="/wiki/Stercobilin#Brown_pigment_stone" title="Stercobilin">brown pigment</a> stones) typically contain 20–80% cholesterol (or 30–70%, according to the Japanese classification system).<sup id="cite_ref-Kim2003_38-3" class="reference"><a href="#cite_note-Kim2003-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Other common constituents are <a href="/wiki/Calcium_carbonate" title="Calcium carbonate">calcium carbonate</a>, <a href="/wiki/Palmitate" class="mw-redirect" title="Palmitate">palmitate</a> phosphate, bilirubin and other <a href="/wiki/Bilin_(biochemistry)" title="Bilin (biochemistry)">bile pigments</a> (calcium bilirubinate, calcium palmitate and <a href="/wiki/Calcium_stearate" title="Calcium stearate">calcium stearate</a>). Because of their calcium content, they are often <a href="/wiki/Radiolucent" class="mw-redirect" title="Radiolucent">radiographically visible</a>. They typically arise secondary to infection of the biliary tract which results in the release of <a href="/wiki/%CE%92-glucuronidase" class="mw-redirect" title="Β-glucuronidase">β-glucuronidase</a> (by injured <a href="/wiki/Hepatocyte" title="Hepatocyte">hepatocytes</a> and bacteria) which hydrolyzes bilirubin <a href="/wiki/Glucuronide" title="Glucuronide">glucuronides</a> and increases the amount of unconjugated bilirubin in bile. Between 4% and 20% of stones are mixed.<sup id="cite_ref-Lee2015_3-6" class="reference"><a href="#cite_note-Lee2015-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Gallstones can vary in size and shape from as small as a grain of sand to as large as a golf ball.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> The gallbladder may contain a single large stone or many smaller ones. Pseudoliths, sometimes referred to as sludge, are thick <a href="/wiki/Secretion" title="Secretion">secretions</a> that may be present within the gallbladder, either alone or in conjunction with fully formed gallstones. </p> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 295.33333333333px"> <div class="thumb" style="width: 293.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Gallstones.JPG" class="mw-file-description" title="Gallbladder opened to show small cholesterol gallstones"><img alt="Gallbladder opened to show small cholesterol gallstones" src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Gallstones.JPG/440px-Gallstones.JPG" decoding="async" width="294" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Gallstones.JPG/660px-Gallstones.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a1/Gallstones.JPG/880px-Gallstones.JPG 2x" data-file-width="1024" data-file-height="768" /></a></span></div> <div class="gallerytext">Gallbladder opened to show small cholesterol gallstones</div> </li> <li class="gallerybox" style="width: 62px"> <div class="thumb" style="width: 60px;"><span typeof="mw:File"><a href="/wiki/File:Gallstone_%C2%B5CT.jpg" class="mw-file-description" title="X-ray microtomograph of a gallstone"><img alt="X-ray microtomograph of a gallstone" src="//upload.wikimedia.org/wikipedia/commons/thumb/6/62/Gallstone_%C2%B5CT.jpg/82px-Gallstone_%C2%B5CT.jpg" decoding="async" width="55" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/62/Gallstone_%C2%B5CT.jpg/124px-Gallstone_%C2%B5CT.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/62/Gallstone_%C2%B5CT.jpg/165px-Gallstone_%C2%B5CT.jpg 2x" data-file-width="1820" data-file-height="7251" /></a></span></div> <div class="gallerytext"><a href="/wiki/X-ray_microtomography" title="X-ray microtomography">X-ray microtomograph</a> of a gallstone</div> </li> <li class="gallerybox" style="width: 362.66666666667px"> <div class="thumb" style="width: 360.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Gallstones.jpg" class="mw-file-description" title="The large, yellow stone is largely cholesterol, while the green-to-brown stones are mostly composed of bile pigments"><img alt="The large, yellow stone is largely cholesterol, while the green-to-brown stones are mostly composed of bile pigments" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e4/Gallstones.jpg/541px-Gallstones.jpg" decoding="async" width="361" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/e/e4/Gallstones.jpg 1.5x" data-file-width="600" data-file-height="366" /></a></span></div> <div class="gallerytext">The large, yellow stone is largely cholesterol, while the green-to-brown stones are mostly composed of <a href="/wiki/Bilin_(biochemistry)" title="Bilin (biochemistry)">bile pigments</a></div> </li> <li class="gallerybox" style="width: 378.66666666667px"> <div class="thumb" style="width: 376.66666666667px;"><span typeof="mw:File"><span><video id="mwe_player_0" poster="//upload.wikimedia.org/wikipedia/commons/thumb/4/48/Gallenstein_FRONT.ogv/565px--Gallenstein_FRONT.ogv.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="377" height="220" data-durationhint="11" data-mwtitle="Gallenstein_FRONT.ogv" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/4/48/Gallenstein_FRONT.ogv/Gallenstein_FRONT.ogv.480p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="480p.vp9.webm" data-width="822" data-height="480" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/4/48/Gallenstein_FRONT.ogv/Gallenstein_FRONT.ogv.720p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="720p.vp9.webm" data-width="1232" data-height="720" /><source src="//upload.wikimedia.org/wikipedia/commons/4/48/Gallenstein_FRONT.ogv" type="video/ogg; codecs="theora"" data-width="1424" data-height="832" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/4/48/Gallenstein_FRONT.ogv/Gallenstein_FRONT.ogv.144p.mjpeg.mov" type="video/quicktime" data-transcodekey="144p.mjpeg.mov" data-width="246" data-height="144" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/4/48/Gallenstein_FRONT.ogv/Gallenstein_FRONT.ogv.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="410" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/4/48/Gallenstein_FRONT.ogv/Gallenstein_FRONT.ogv.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="616" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/4/48/Gallenstein_FRONT.ogv/Gallenstein_FRONT.ogv.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="616" data-height="360" /></video></span></span></div> <div class="gallerytext"><a href="/wiki/CT_scan" title="CT scan">CT</a> images of gallstones</div> </li> <li class="gallerybox" style="width: 295.33333333333px"> <div class="thumb" style="width: 293.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:Big_Gallstone.JPG" class="mw-file-description" title="Large gallstone"><img alt="Large gallstone" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/88/Big_Gallstone.JPG/440px-Big_Gallstone.JPG" decoding="async" width="294" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/88/Big_Gallstone.JPG/660px-Big_Gallstone.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/88/Big_Gallstone.JPG/880px-Big_Gallstone.JPG 2x" data-file-width="1280" data-file-height="960" /></a></span></div> <div class="gallerytext">Large gallstone</div> </li> <li class="gallerybox" style="width: 328.66666666667px"> <div class="thumb" style="width: 326.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Human_gallstones_2015_G1.jpg" class="mw-file-description" title="Numerous small gallstones made up largely of cholesterol"><img alt="Numerous small gallstones made up largely of cholesterol" src="//upload.wikimedia.org/wikipedia/commons/thumb/1/17/Human_gallstones_2015_G1.jpg/490px-Human_gallstones_2015_G1.jpg" decoding="async" width="327" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/17/Human_gallstones_2015_G1.jpg/735px-Human_gallstones_2015_G1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/17/Human_gallstones_2015_G1.jpg/980px-Human_gallstones_2015_G1.jpg 2x" data-file-width="4900" data-file-height="3300" /></a></span></div> <div class="gallerytext">Numerous small gallstones made up largely of <a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a></div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=10" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Diagnosis is typically confirmed by <a href="/wiki/Abdominal_ultrasound" class="mw-redirect" title="Abdominal ultrasound">abdominal ultrasound</a>. Other imaging techniques used are <a href="/wiki/ERCP" class="mw-redirect" title="ERCP">ERCP</a> and <a href="/wiki/Magnetic_resonance_cholangiopancreatography" title="Magnetic resonance cholangiopancreatography">MRCP</a>. Gallstone complications may be detected on blood tests.<sup id="cite_ref-NIH2013_2-25" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>On abdominal ultrasound, sinking gallstones usually have posterior acoustic shadowing. In floating gallstones, reverberation echoes (or comet-tail artifact) is seen instead in a clinical condition called <a href="/wiki/Adenomyomatosis" title="Adenomyomatosis">adenomyomatosis</a>. Another sign is wall-echo-shadow (WES) triad (or double-arc shadow) which is also characteristic of gallstones.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p><p>A positive <a href="/wiki/Murphy%27s_sign" title="Murphy's sign">Murphy's sign</a> is a common finding on <a href="/wiki/Physical_examination" title="Physical examination">physical examination</a> during a gallbladder attack. </p> <ul class="gallery mw-gallery-packed"> <li class="gallerybox" style="width: 256px"> <div class="thumb" style="width: 254px;"><span typeof="mw:File"><a href="/wiki/File:Gallstones.PNG" class="mw-file-description" title="A 1.9 cm gallstone impacted in the neck of the gallbladder and leading to cholecystitis as seen on ultrasound. There is 4 mm gall bladder wall thickening."><img alt="A 1.9 cm gallstone impacted in the neck of the gallbladder and leading to cholecystitis as seen on ultrasound. There is 4 mm gall bladder wall thickening." src="//upload.wikimedia.org/wikipedia/commons/thumb/a/af/Gallstones.PNG/381px-Gallstones.PNG" decoding="async" width="254" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/a/af/Gallstones.PNG 1.5x" data-file-width="420" data-file-height="364" /></a></span></div> <div class="gallerytext">A 1.9 cm gallstone impacted in the neck of the gallbladder and leading to cholecystitis as seen on <a href="/wiki/Medical_ultrasonography" class="mw-redirect" title="Medical ultrasonography">ultrasound</a>. There is 4 mm gall bladder wall thickening.</div> </li> <li class="gallerybox" style="width: 220.66666666667px"> <div class="thumb" style="width: 218.66666666667px;"><span typeof="mw:File"><a href="/wiki/File:Ultrasonography_of_sludge_and_gallstones,_annotated.jpg" class="mw-file-description" title="Biliary sludge and gallstones. There is borderline thickening of the gallbladder wall."><img alt="Biliary sludge and gallstones. There is borderline thickening of the gallbladder wall." src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3d/Ultrasonography_of_sludge_and_gallstones%2C_annotated.jpg/328px-Ultrasonography_of_sludge_and_gallstones%2C_annotated.jpg" decoding="async" width="219" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3d/Ultrasonography_of_sludge_and_gallstones%2C_annotated.jpg/492px-Ultrasonography_of_sludge_and_gallstones%2C_annotated.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3d/Ultrasonography_of_sludge_and_gallstones%2C_annotated.jpg/656px-Ultrasonography_of_sludge_and_gallstones%2C_annotated.jpg 2x" data-file-width="1378" data-file-height="1386" /></a></span></div> <div class="gallerytext"><a href="/wiki/Biliary_sludge" title="Biliary sludge">Biliary sludge</a> and gallstones. There is borderline thickening of the gallbladder wall.</div> </li> <li class="gallerybox" style="width: 268px"> <div class="thumb" style="width: 266px;"><span typeof="mw:File"><a href="/wiki/File:StonesXray.PNG" class="mw-file-description" title="Gallstones as seen on plain X-ray"><img alt="Gallstones as seen on plain X-ray" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/de/StonesXray.PNG/399px-StonesXray.PNG" decoding="async" width="266" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/de/StonesXray.PNG/598px-StonesXray.PNG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/de/StonesXray.PNG/797px-StonesXray.PNG 2x" data-file-width="1110" data-file-height="919" /></a></span></div> <div class="gallerytext">Gallstones as seen on plain X-ray</div> </li> <li class="gallerybox" style="width: 267.33333333333px"> <div class="thumb" style="width: 265.33333333333px;"><span typeof="mw:File"><a href="/wiki/File:LargeGstoneMark.png" class="mw-file-description" title="Large gallstone as seen on CT"><img alt="Large gallstone as seen on CT" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/LargeGstoneMark.png/398px-LargeGstoneMark.png" decoding="async" width="266" height="220" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f7/LargeGstoneMark.png/597px-LargeGstoneMark.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f7/LargeGstoneMark.png/796px-LargeGstoneMark.png 2x" data-file-width="965" data-file-height="800" /></a></span></div> <div class="gallerytext">Large gallstone as seen on CT</div> </li> <li class="gallerybox" style="width: 372.66666666667px"> <div class="thumb" style="width: 370.66666666667px;"><span typeof="mw:File"><span><video id="mwe_player_1" poster="//upload.wikimedia.org/wikipedia/commons/thumb/b/b5/UOTW_8_-_Ultrasound_of_the_Week_1.webm/556px--UOTW_8_-_Ultrasound_of_the_Week_1.webm.jpg" controls="" preload="none" data-mw-tmh="" class="mw-file-element" width="371" height="220" data-durationhint="7" data-mwtitle="UOTW_8_-_Ultrasound_of_the_Week_1.webm" data-mwprovider="wikimediacommons"><source src="//upload.wikimedia.org/wikipedia/commons/b/b5/UOTW_8_-_Ultrasound_of_the_Week_1.webm" type="video/webm; codecs="vp8"" data-width="792" data-height="470" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/b/b5/UOTW_8_-_Ultrasound_of_the_Week_1.webm/UOTW_8_-_Ultrasound_of_the_Week_1.webm.240p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="240p.vp9.webm" data-width="404" data-height="240" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/b/b5/UOTW_8_-_Ultrasound_of_the_Week_1.webm/UOTW_8_-_Ultrasound_of_the_Week_1.webm.360p.vp9.webm" type="video/webm; codecs="vp9, opus"" data-transcodekey="360p.vp9.webm" data-width="606" data-height="360" /><source src="//upload.wikimedia.org/wikipedia/commons/transcoded/b/b5/UOTW_8_-_Ultrasound_of_the_Week_1.webm/UOTW_8_-_Ultrasound_of_the_Week_1.webm.360p.webm" type="video/webm; codecs="vp8, vorbis"" data-transcodekey="360p.webm" data-width="606" data-height="360" /></video></span></span></div> <div class="gallerytext">A normal gallbladder on ultrasound with bowel peristalsis creating the false appearance of stones</div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=11" title="Edit section: Prevention"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Maintaining a healthy weight by getting sufficient exercise and eating a <a href="/wiki/Healthy_diet" title="Healthy diet">healthy diet</a> that is high in <a href="/wiki/Dietary_fiber" title="Dietary fiber">fiber</a> may help prevent gallstone formation.<sup id="cite_ref-NIH2013_2-26" class="reference"><a href="#cite_note-NIH2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Ursodeoxycholic_acid" title="Ursodeoxycholic acid">Ursodeoxycholic acid</a> (UDCA) appears to prevent formation of gallstones during weight loss. A high fat diet during weight loss also appears to prevent gallstones.<sup id="cite_ref-stokes_41-0" class="reference"><a href="#cite_note-stokes-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Treatment">Treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=12" title="Edit section: Treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Lithotripsy">Lithotripsy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=13" title="Edit section: Lithotripsy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Extracorporeal_shockwave_therapy" title="Extracorporeal shockwave therapy">Extracorporeal shock wave lithotripsy</a> is a non-invasive method to manage gallstones that uses high-energy sound waves to disintegrate them first applied in January 1985.<sup id="cite_ref-Johns_Hopkins_Medicine_42-0" class="reference"><a href="#cite_note-Johns_Hopkins_Medicine-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> Side effects of extracorporeal shock wave lithotripsy include biliary pancreatitis and liver haematoma.<sup id="cite_ref-Paumgartner_Sauter_2005_pp._525–527_44-0" class="reference"><a href="#cite_note-Paumgartner_Sauter_2005_pp._525–527-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> The term is derived from the Greek words meaning 'breaking (or pulverizing) stones': <i lang="en"><a href="https://en.wiktionary.org/wiki/litho-#English" class="extiw" title="wikt:litho-">litho-</a></i> + <span lang="grc"><a href="https://en.wiktionary.org/wiki/%CF%84%CF%81%CE%AF%CE%B2%CF%89#Ancient_Greek" class="extiw" title="wikt:τρίβω">τρίψω</a></span>, <span title="Ancient Greek (to 1453)-language text"><i lang="grc-Latn">tripso</i></span>). </p> <div class="mw-heading mw-heading3"><h3 id="Surgical">Surgical</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=14" title="Edit section: Surgical"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Cholecystectomy" title="Cholecystectomy">Cholecystectomy</a> (gallbladder removal) has a 99% chance of eliminating the recurrence of cholelithiasis. The lack of a gallbladder has no negative consequences in most people, however 10 to 15% of people develop <a href="/wiki/Postcholecystectomy_syndrome" title="Postcholecystectomy syndrome">postcholecystectomy syndrome</a>,<sup id="cite_ref-eMedicine_45-0" class="reference"><a href="#cite_note-eMedicine-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> which may cause nausea, indigestion, diarrhea, and episodes of abdominal pain.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-halign-none" typeof="mw:File/Thumb"><a href="/wiki/File:Benefits.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Benefits.png/500px-Benefits.png" decoding="async" width="500" height="410" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/Benefits.png/750px-Benefits.png 1.5x, //upload.wikimedia.org/wikipedia/commons/3/3e/Benefits.png 2x" data-file-width="970" data-file-height="796" /></a><figcaption>The outcomes of choosing to 'do nothing' (watchful waiting) and having cholecystectomy in the case of symptomatic gallstones, as shown in the NHS decision aid for gallstones.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> Data from <sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup>.</figcaption></figure> <p>There are two surgical options for cholecystectomy: </p> <ul><li>Open cholecystectomy is performed via an abdominal incision (<a href="/wiki/Laparotomy" title="Laparotomy">laparotomy</a>) below the lower right ribs. Recovery typically requires 3–5 days of hospitalization, with a return to normal diet a week after release and to normal activity several weeks after release.<sup id="cite_ref-NDDIC_13-1" class="reference"><a href="#cite_note-NDDIC-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Laparoscopy" title="Laparoscopy">Laparoscopic</a> cholecystectomy, introduced in the 1980s, is performed via three to four small puncture holes for a camera and instruments. Post-operative care typically includes a same-day release or a one-night hospital stay, followed by a few days of home rest and pain medication.<sup id="cite_ref-NDDIC_13-2" class="reference"><a href="#cite_note-NDDIC-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> Perforation of the gall bladder is not uncommon—it has been reported in the range of 10% to 40%. Unretrieved gallstone spillage has been reported as 6% to 30%, but gallstones that are not retrieved rarely cause complications (0.08%–0.3%).<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup></li></ul> <figure class="mw-halign-none" typeof="mw:File/Thumb"><a href="/wiki/File:Risks.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/66/Risks.png/500px-Risks.png" decoding="async" width="500" height="193" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/66/Risks.png/750px-Risks.png 1.5x, //upload.wikimedia.org/wikipedia/commons/6/66/Risks.png 2x" data-file-width="960" data-file-height="371" /></a><figcaption>Risks of cholecystectomy.<sup id="cite_ref-:3_11-1" class="reference"><a href="#cite_note-:3-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-53" class="reference"><a href="#cite_note-53"><span class="cite-bracket">[</span>53<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>Obstruction of the common bile duct with gallstones can sometimes be relieved by endoscopic retrograde sphincterotomy (ERS) following <a href="/wiki/Endoscopic_retrograde_cholangiopancreatography" title="Endoscopic retrograde cholangiopancreatography">endoscopic retrograde cholangiopancreatography</a> (ERCP).<sup id="cite_ref-NHS_54-0" class="reference"><a href="#cite_note-NHS-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <figure class="mw-halign-none" typeof="mw:File/Thumb"><a href="/wiki/File:ERCP_Risks.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d4/ERCP_Risks.png/500px-ERCP_Risks.png" decoding="async" width="500" height="204" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d4/ERCP_Risks.png/750px-ERCP_Risks.png 1.5x, //upload.wikimedia.org/wikipedia/commons/d/d4/ERCP_Risks.png 2x" data-file-width="958" data-file-height="390" /></a><figcaption>Risks of ERCP. <sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">[</span>55<span class="cite-bracket">]</span></a></sup></figcaption></figure><p>Surgery carries risks and some people continue to experience symptoms (including pain) afterwards, for reasons that remain unclear. An alternative option is to adopt a ‘watch and wait’ strategy before operating to see if symptoms resolve. A study compared the 2 approaches for uncomplicated gallstones and after 18 months, both approaches were associated with similar levels of pain. The watch and wait approach was also less costly (more than £1000 less per patient).<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">[</span>56<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">[</span>57<span class="cite-bracket">]</span></a></sup> </p><div class="mw-heading mw-heading3"><h3 id="Medical">Medical</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=15" title="Edit section: Medical"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The medications <a href="/wiki/Ursodeoxycholic_acid" title="Ursodeoxycholic acid">ursodeoxycholic acid</a> (UDCA) and <a href="/wiki/Chenodeoxycholic_acid" title="Chenodeoxycholic acid">chenodeoxycholic acid</a> (CDCA) have been used in treatment to dissolve gallstones.<sup id="cite_ref-pmid4580472_58-0" class="reference"><a href="#cite_note-pmid4580472-58"><span class="cite-bracket">[</span>58<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-PMID2672842_59-0" class="reference"><a href="#cite_note-PMID2672842-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> A 2013 meta-analysis concluded that UDCA or higher dietary fat content appeared to prevent formation of gallstones during weight loss.<sup id="cite_ref-stokes_41-1" class="reference"><a href="#cite_note-stokes-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> Medical therapy with oral bile acids has been used to treat small cholesterol stones, and for larger cholesterol gallstones when surgery is either not possible or unwanted. CDCA treatment can cause diarrhea, mild reversible hepatic injury, and a small increase in the plasma cholesterol level.<sup id="cite_ref-PMID2672842_59-1" class="reference"><a href="#cite_note-PMID2672842-59"><span class="cite-bracket">[</span>59<span class="cite-bracket">]</span></a></sup> UDCA may need to be taken for years.<sup id="cite_ref-NHS_54-1" class="reference"><a href="#cite_note-NHS-54"><span class="cite-bracket">[</span>54<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Use_in_alternative_medicine">Use in alternative medicine</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=16" title="Edit section: Use in alternative medicine"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Gallstones can be a valued by-product of animals butchered for meat because of their use as an <a href="/wiki/Antipyretic" title="Antipyretic">antipyretic</a> and antidote in the <a href="/wiki/Traditional_medicine" title="Traditional medicine">traditional medicine</a> of some cultures, particularly <a href="/wiki/Traditional_Chinese_medicine" title="Traditional Chinese medicine">traditional Chinese medicine</a>. The most highly prized gallstones tend to be sourced from old <a href="/wiki/Dairy_cattle" title="Dairy cattle">dairy cows</a>, termed <a href="/wiki/Calculus_bovis" title="Calculus bovis">calculus bovis</a> or <i>niu-huang</i> (yellow thing of cattle) in Chinese. Some slaughterhouses carefully scrutinize workers for gallstone theft.<sup id="cite_ref-Wise_60-0" class="reference"><a href="#cite_note-Wise-60"><span class="cite-bracket">[</span>60<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=17" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Mirizzi%27s_syndrome" title="Mirizzi's syndrome">Mirizzi's syndrome</a></li> <li><a href="/wiki/Porcelain_gallbladder" title="Porcelain gallbladder">Porcelain gallbladder</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=18" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width" style="column-width: 30em;"> <ol class="references"> <li id="cite_note-Qui2013-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-Qui2013_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Qui2013_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Qui2013_1-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFQuickReedHarperSaeb-Parsy2013" class="citation book cs1">Quick CR, Reed JB, Harper SJ, Saeb-Parsy K, Deakin PJ (2013). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=RYhRAAAAQBAJ&pg=PA281"><i>Essential Surgery E-Book: Problems, Diagnosis and Management: With student consult online access</i></a>. 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class="Z3988"></span></span> </li> <li id="cite_note-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-9">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGBD_2013_Mortality_and_Causes_of_Death_Collaborators2015" class="citation journal cs1">GBD 2013 Mortality and Causes of Death Collaborators (January 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340604">"Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013"</a>. <i>Lancet</i>. <b>385</b> (9963): <span class="nowrap">117–</span>71. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0140-6736%2814%2961682-2">10.1016/s0140-6736(14)61682-2</a>. 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title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Lancet&rft.atitle=Global%2C+regional%2C+and+national+age-sex+specific+all-cause+and+cause-specific+mortality+for+240+causes+of+death%2C+1990%E2%80%932013%3A+a+systematic+analysis+for+the+Global+Burden+of+Disease+Study+2013&rft.volume=385&rft.issue=9963&rft.pages=%3Cspan+class%3D%22nowrap%22%3E117-%3C%2Fspan%3E71&rft.date=2015-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4340604%23id-name%3DPMC&rft_id=info%3Apmid%2F25530442&rft_id=info%3Adoi%2F10.1016%2Fs0140-6736%2814%2961682-2&rft.au=GBD+2013+Mortality+and+Causes+of+Death+Collaborators&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4340604&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGallstone" class="Z3988"></span> <span class="cs1-visible-error citation-comment"><code class="cs1-code">{{<a href="/wiki/Template:Cite_journal" title="Template:Cite journal">cite journal</a>}}</code>: </span><span class="cs1-visible-error citation-comment"><code class="cs1-code">|author1=</code> has generic name (<a href="/wiki/Help:CS1_errors#generic_name" title="Help:CS1 errors">help</a>)</span><span class="cs1-maint citation-comment">CS1 maint: numeric names: authors list (<a href="/wiki/Category:CS1_maint:_numeric_names:_authors_list" title="Category:CS1 maint: numeric names: authors list">link</a>)</span></span> </li> <li id="cite_note-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-10">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRosenthalZenilmanKatlic2011" class="citation book cs1">Rosenthal RA, Zenilman ME, Katlic MR, eds. 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Berlin: Springer. p. 944. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4419-6999-6" title="Special:BookSources/978-1-4419-6999-6"><bdi>978-1-4419-6999-6</bdi></a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20160815224542/https://books.google.ca/books?id=VcgmpMZE6a8C&pg=PA944">Archived</a> from the original on 2016-08-15.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Principles+and+practice+of+geriatric+surgery&rft.place=Berlin&rft.pages=944&rft.edition=2nd&rft.pub=Springer&rft.date=2011&rft.isbn=978-1-4419-6999-6&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DVcgmpMZE6a8C%26pg%3DPA944&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGallstone" class="Z3988"></span></span> </li> <li id="cite_note-:3-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-:3_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:3_11-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGurusamyDavidsonGluudDavidson2013" class="citation journal cs1">Gurusamy KS, Davidson C, Gluud C, Davidson BR (2013-06-30). 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Transcrip"</a>. Omaha, Nebraska: Medscape (WebMD). Archived from <a rel="nofollow" class="external text" href="http://sgp1.paddington.ninemsn.com.au/sunday/cover_stories/transcript_785.asp">the original</a> on 2010-11-21<span class="reference-accessdate">. Retrieved <span class="nowrap">2010-11-06</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Interview+with+Darren+Wise.+Transcrip&rft.place=Omaha%2C+Nebraska&rft.pub=Medscape+%28WebMD%29&rft_id=http%3A%2F%2Fsgp1.paddington.ninemsn.com.au%2Fsunday%2Fcover_stories%2Ftranscript_785.asp&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGallstone" class="Z3988"></span></span> </li> </ol></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Gallstone&action=edit&section=19" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style><div class="side-box side-box-right plainlinks sistersitebox"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Commons-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></a></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Gallstones" class="extiw" title="commons:Category:Gallstones">Gallstones</a></span>.</div></div> </div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/gallstones.html">"Gallstones"</a>. <a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>. U.S. National Library of Medicine.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Gallstones&rft.pub=U.S.+National+Library+of+Medicine&rft_id=https%3A%2F%2Fmedlineplus.gov%2Fgallstones.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AGallstone" class="Z3988"></span></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output 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href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q272714" class="extiw" title="d:Q272714">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/K80">K80</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=574">574</a></li><li><b><a href="/wiki/Online_Mendelian_Inheritance_in_Man" title="Online Mendelian Inheritance in Man">OMIM</a></b>: <a rel="nofollow" class="external text" href="https://omim.org/entry/600803">600803</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D042882">D042882</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb2533.htm">2533</a></li><li><b><a href="/wiki/SNOMED_CT" title="SNOMED CT">SNOMED CT</a></b>: <a rel="nofollow" class="external text" href="http://snomed.info/id/235919008">235919008</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000273.htm">000273</a></li><li><b><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a></b>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/emerg/97-overview">emerg/97</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Diseases_of_the_human_digestive_system290" style="padding:3px"><table class="nowraplinks mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Digestive_system_diseases" title="Template:Digestive system diseases"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Digestive_system_diseases" title="Template talk:Digestive system diseases"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Digestive_system_diseases" title="Special:EditPage/Template:Digestive system diseases"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_human_digestive_system290" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Human_digestive_system" title="Human digestive system">human digestive system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Upper_gastrointestinal_tract" title="Gastrointestinal tract">Upper GI tract</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Esophageal_disease" title="Esophageal disease">Esophagus</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Esophagitis" title="Esophagitis">Esophagitis</a> <ul><li><a href="/wiki/Esophageal_candidiasis" title="Esophageal candidiasis">Candidal</a></li> <li><a href="/wiki/Eosinophilic_esophagitis" title="Eosinophilic esophagitis">Eosinophilic</a></li> <li><a href="/wiki/Herpetiform_esophagitis" class="mw-redirect" title="Herpetiform esophagitis">Herpetiform</a></li></ul></li> <li><i>Rupture</i> <ul><li><a href="/wiki/Boerhaave_syndrome" class="mw-redirect" title="Boerhaave syndrome">Boerhaave syndrome</a></li> <li><a href="/wiki/Mallory%E2%80%93Weiss_syndrome" title="Mallory–Weiss syndrome">Mallory–Weiss syndrome</a></li></ul></li> <li><a href="/wiki/Zenker%27s_diverticulum" title="Zenker's diverticulum">Zenker's diverticulum</a></li> <li><a href="/wiki/Barrett%27s_esophagus" title="Barrett's esophagus">Barrett's esophagus</a></li> <li><a href="/wiki/Esophageal_motility_disorder" title="Esophageal motility disorder">Esophageal motility disorder</a> <ul><li><a href="/wiki/Nutcracker_esophagus" title="Nutcracker esophagus">Nutcracker esophagus</a></li> <li><a href="/wiki/Achalasia" class="mw-redirect" title="Achalasia">Achalasia</a></li> <li><a href="/wiki/Esophagogastric_junction_outflow_obstruction" title="Esophagogastric junction outflow obstruction">Esophagogastric junction outflow obstruction</a></li> <li><a href="/wiki/Diffuse_esophageal_spasm" title="Diffuse esophageal spasm">Diffuse esophageal spasm</a></li> <li><a href="/wiki/Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">Gastroesophageal reflux disease</a> (GERD)</li></ul></li> <li><a href="/wiki/Laryngopharyngeal_reflux" title="Laryngopharyngeal reflux">Laryngopharyngeal reflux</a> (LPR)</li> <li><a href="/wiki/Esophageal_stricture" title="Esophageal stricture">Esophageal stricture</a></li> <li><a href="/wiki/Esophageal_inlet_patch" title="Esophageal inlet patch">Inlet patch</a></li> <li><a href="/wiki/Megaesophagus" title="Megaesophagus">Megaesophagus</a></li> <li><a href="/wiki/Esophageal_intramural_pseudodiverticulosis" title="Esophageal intramural pseudodiverticulosis">Esophageal intramural pseudodiverticulosis</a></li> <li><a href="/wiki/Acute_esophageal_necrosis" title="Acute esophageal necrosis">Acute esophageal necrosis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Stomach_disease" title="Stomach disease">Stomach</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Gastritis" title="Gastritis">Gastritis</a> <ul><li><a href="/wiki/Atrophic_gastritis" title="Atrophic gastritis">Atrophic</a></li> <li><a href="/wiki/M%C3%A9n%C3%A9trier%27s_disease" title="Ménétrier's disease">Ménétrier's disease</a></li> <li><a href="/wiki/Gastroenteritis" title="Gastroenteritis">Gastroenteritis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (gastric) ulcer</a> <ul><li><a href="/wiki/Cushing_ulcer" title="Cushing ulcer">Cushing ulcer</a></li> <li><a href="/wiki/Dieulafoy%27s_lesion" title="Dieulafoy's lesion">Dieulafoy's lesion</a></li></ul></li> <li><a href="/wiki/Dyspepsia" class="mw-redirect" title="Dyspepsia">Dyspepsia</a> <ul><li><a href="/wiki/Functional_dyspepsia" title="Functional dyspepsia">Functional dyspepsia</a></li></ul></li> <li><a href="/wiki/Pyloric_stenosis" title="Pyloric stenosis">Pyloric stenosis</a></li> <li><a href="/wiki/Achlorhydria" title="Achlorhydria">Achlorhydria</a></li> <li><a href="/wiki/Gastroparesis" title="Gastroparesis">Gastroparesis</a></li> <li><a href="/wiki/Gastroptosis" title="Gastroptosis">Gastroptosis</a></li> <li><a href="/wiki/Portal_hypertensive_gastropathy" title="Portal hypertensive gastropathy">Portal hypertensive gastropathy</a></li> <li><a href="/wiki/Gastric_antral_vascular_ectasia" title="Gastric antral vascular ectasia">Gastric antral vascular ectasia</a></li> <li><a href="/wiki/Gastric_dumping_syndrome" class="mw-redirect" title="Gastric dumping syndrome">Gastric dumping syndrome</a></li> <li><a href="/wiki/Gastric_volvulus" title="Gastric volvulus">Gastric volvulus</a></li> <li><a href="/wiki/Buried_bumper_syndrome" title="Buried bumper syndrome">Buried bumper syndrome</a></li> <li><a href="/wiki/Gastrinoma" title="Gastrinoma">Gastrinoma</a> <ul><li><a href="/wiki/Zollinger%E2%80%93Ellison_syndrome" title="Zollinger–Ellison syndrome">Zollinger–Ellison syndrome</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_tract#Lower_gastrointestinal_tract" title="Gastrointestinal tract">Lower GI tract</a> <br /> <a href="/wiki/Enteropathy" title="Enteropathy">Enteropathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Small_intestine" title="Small intestine">Small intestine</a> <br /> (<a href="/wiki/Duodenum" title="Duodenum">Duodenum</a>/<a href="/wiki/Jejunum" title="Jejunum">Jejunum</a>/<a href="/wiki/Ileum" title="Ileum">Ileum</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enteritis" title="Enteritis">Enteritis</a> <ul><li><a href="/wiki/Duodenitis" title="Duodenitis">Duodenitis</a></li> <li><a href="/wiki/Jejunitis" title="Jejunitis">Jejunitis</a></li> <li><a href="/wiki/Ileitis" title="Ileitis">Ileitis</a></li></ul></li> <li><a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">Peptic (duodenal) ulcer</a> <ul><li><a href="/wiki/Curling%27s_ulcer" title="Curling's ulcer">Curling's ulcer</a></li></ul></li> <li><a href="/wiki/Malabsorption" title="Malabsorption">Malabsorption</a>: <a href="/wiki/Coeliac_disease" title="Coeliac disease">Coeliac</a></li> <li><a href="/wiki/Tropical_sprue" title="Tropical sprue">Tropical sprue</a></li> <li><a href="/wiki/Blind_loop_syndrome" title="Blind loop syndrome">Blind loop syndrome</a></li> <li><a href="/wiki/Small_intestinal_bacterial_overgrowth" title="Small intestinal bacterial overgrowth">Small intestinal bacterial overgrowth</a></li> <li><a href="/wiki/Whipple%27s_disease" title="Whipple's disease">Whipple's</a></li> <li><a href="/wiki/Short_bowel_syndrome" title="Short bowel syndrome">Short bowel syndrome</a></li> <li><a href="/wiki/Steatorrhea" title="Steatorrhea">Steatorrhea</a></li> <li><a href="/wiki/Milroy_disease" class="mw-redirect" title="Milroy disease">Milroy disease</a></li> <li><a href="/wiki/Bile_acid_malabsorption" title="Bile acid malabsorption">Bile acid malabsorption</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Large_intestine" title="Large intestine">Large intestine</a> <br /> (<a href="/wiki/Vermiform_appendix" class="mw-redirect" title="Vermiform appendix">Appendix</a>/<a href="/wiki/Colon_(anatomy)" class="mw-redirect" title="Colon (anatomy)">Colon</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Appendicitis" title="Appendicitis">Appendicitis</a></li> <li><a href="/wiki/Colitis" title="Colitis">Colitis</a> <ul><li><a href="/wiki/Pseudomembranous_colitis" class="mw-redirect" title="Pseudomembranous colitis">Pseudomembranous</a></li> <li><a href="/wiki/Ulcerative_colitis" title="Ulcerative colitis">Ulcerative</a></li> <li><a href="/wiki/Ischemic_colitis" title="Ischemic colitis">Ischemic</a></li> <li><a href="/wiki/Microscopic_colitis" title="Microscopic colitis">Microscopic</a></li> <li><a href="/wiki/Collagenous_colitis" title="Collagenous colitis">Collagenous</a></li> <li><a href="/wiki/Lymphocytic_colitis" title="Lymphocytic colitis">Lymphocytic</a></li></ul></li> <li><a href="/wiki/Dysentery" title="Dysentery">Dysentery</a></li> <li><a href="/wiki/Functional_colonic_disease" class="mw-redirect" title="Functional colonic disease">Functional colonic disease</a> <ul><li><a href="/wiki/Irritable_bowel_syndrome" title="Irritable bowel syndrome">IBS</a></li> <li><a href="/wiki/Intestinal_pseudoobstruction" class="mw-redirect" title="Intestinal pseudoobstruction">Intestinal pseudoobstruction</a> / <a href="/wiki/Ogilvie_syndrome" title="Ogilvie syndrome">Ogilvie syndrome</a></li></ul></li> <li><a href="/wiki/Megacolon" title="Megacolon">Megacolon</a> / <a href="/wiki/Toxic_megacolon" title="Toxic megacolon">Toxic megacolon</a></li> <li><a href="/wiki/Diverticulitis" title="Diverticulitis">Diverticulitis</a>/<a href="/wiki/Diverticulosis" title="Diverticulosis">Diverticulosis</a>/<a href="/wiki/Segmental_colitis_associated_with_diverticulosis" title="Segmental colitis associated with diverticulosis">SCAD</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Large and/or small</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Enterocolitis" title="Enterocolitis">Enterocolitis</a> <ul><li><a href="/wiki/Necrotizing_enterocolitis" title="Necrotizing enterocolitis">Necrotizing</a></li></ul></li> <li><a href="/wiki/Gastroenterocolitis" title="Gastroenterocolitis">Gastroenterocolitis</a></li> <li><a href="/wiki/Inflammatory_bowel_disease" title="Inflammatory bowel disease">IBD</a> <ul><li><a href="/wiki/Crohn%27s_disease" title="Crohn's disease">Crohn's disease</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i>: <a href="/wiki/Abdominal_angina" title="Abdominal angina">Abdominal angina</a></li> <li><a href="/wiki/Mesenteric_ischemia" class="mw-redirect" title="Mesenteric ischemia">Mesenteric ischemia</a></li> <li><a href="/wiki/Angiodysplasia" title="Angiodysplasia">Angiodysplasia</a></li> <li><a href="/wiki/Bowel_obstruction" title="Bowel obstruction">Bowel obstruction</a>: <a href="/wiki/Ileus" title="Ileus">Ileus</a></li> <li><a href="/wiki/Intussusception_(medical_disorder)" title="Intussusception (medical disorder)">Intussusception</a></li> <li><a href="/wiki/Volvulus" title="Volvulus">Volvulus</a></li> <li><a href="/wiki/Fecal_impaction" title="Fecal impaction">Fecal impaction</a></li> <li><a href="/wiki/Constipation" title="Constipation">Constipation</a> <ul><li><a href="/wiki/Functional_constipation" title="Functional constipation">Functional</a></li></ul></li> <li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a> <ul><li><a href="/wiki/Infectious_diarrhea" class="mw-redirect" title="Infectious diarrhea">Infectious</a></li></ul></li> <li><a href="/wiki/Adhesion_(medicine)" title="Adhesion (medicine)">Intestinal adhesions</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Rectum" title="Rectum">Rectum</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Proctitis" title="Proctitis">Proctitis</a> <ul><li><a href="/wiki/Radiation_proctitis" title="Radiation proctitis">Radiation proctitis</a></li></ul></li> <li><a href="/wiki/Proctalgia_fugax" title="Proctalgia fugax">Proctalgia fugax</a></li> <li><a href="/wiki/Rectal_prolapse" title="Rectal prolapse">Rectal prolapse</a></li> <li><a href="/wiki/Anismus" title="Anismus">Anismus</a></li> <li><a href="/wiki/Solitary_rectal_ulcer_syndrome" title="Solitary rectal ulcer syndrome">Solitary rectal ulcer syndrome</a></li> <li><a href="/wiki/Rectal_stricture" title="Rectal stricture">Rectal stricture</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anal_canal" title="Anal canal">Anal canal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anal_fissure" title="Anal fissure">Anal fissure</a>/<a href="/wiki/Anal_fistula" title="Anal fistula">Anal fistula</a></li> <li><a href="/wiki/Anal_abscess" class="mw-redirect" title="Anal abscess">Anal abscess</a></li> <li><a href="/wiki/Hemorrhoid" title="Hemorrhoid">Hemorrhoid</a></li> <li><a href="/wiki/Anal_dysplasia" title="Anal dysplasia">Anal dysplasia</a></li> <li><a href="/wiki/Pruritus_ani" title="Pruritus ani">Pruritus ani</a></li> <li><a href="/wiki/Anal_stricture" title="Anal stricture">Anal stricture</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gastrointestinal_bleeding" title="Gastrointestinal bleeding">GI bleeding</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blood_in_stool" title="Blood in stool">Blood in stool</a></li> <li><a href="/wiki/Upper_gastrointestinal_bleeding" title="Upper gastrointestinal bleeding">Upper</a> <ul><li><a href="/wiki/Hematemesis" title="Hematemesis">Hematemesis</a></li> <li><a href="/wiki/Melena" title="Melena">Melena</a></li></ul></li> <li><a href="/wiki/Lower_gastrointestinal_bleeding" title="Lower gastrointestinal bleeding">Lower</a> <ul><li><a href="/wiki/Hematochezia" title="Hematochezia">Hematochezia</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Accessory_digestive_gland" class="mw-redirect" title="Accessory digestive gland">Accessory</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Liver_disease" title="Liver disease">Liver</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hepatitis" title="Hepatitis">Hepatitis</a> <ul><li><a href="/wiki/Viral_hepatitis" title="Viral hepatitis">Viral hepatitis</a></li> <li><a href="/wiki/Autoimmune_hepatitis" title="Autoimmune hepatitis">Autoimmune hepatitis</a></li> <li><a href="/wiki/Alcoholic_hepatitis" title="Alcoholic hepatitis">Alcoholic hepatitis</a></li></ul></li> <li><a href="/wiki/Cirrhosis" title="Cirrhosis">Cirrhosis</a> <ul><li><a href="/wiki/Primary_biliary_cirrhosis" class="mw-redirect" title="Primary biliary cirrhosis">PBC</a></li></ul></li> <li><a href="/wiki/Fatty_liver" class="mw-redirect" title="Fatty liver">Fatty liver</a> <ul><li><a href="/wiki/Metabolic_dysfunction%E2%80%93associated_steatotic_liver_disease" title="Metabolic dysfunction–associated steatotic liver disease">MASLD</a></li></ul></li> <li><i><a href="/wiki/Vascular_disease" title="Vascular disease">Vascular</a></i> <ul><li><a href="/wiki/Budd%E2%80%93Chiari_syndrome" title="Budd–Chiari syndrome">Budd–Chiari syndrome</a></li> <li><a href="/wiki/Hepatic_veno-occlusive_disease" title="Hepatic veno-occlusive disease">Hepatic veno-occlusive disease</a></li> <li><a href="/wiki/Portal_hypertension" title="Portal hypertension">Portal hypertension</a></li> <li><a href="/wiki/Nutmeg_liver" class="mw-redirect" title="Nutmeg liver">Nutmeg liver</a></li></ul></li> <li><a href="/wiki/Alcoholic_liver_disease" title="Alcoholic liver disease">Alcoholic liver disease</a></li> <li><a href="/wiki/Liver_failure" title="Liver failure">Liver failure</a> <ul><li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Acute_liver_failure" title="Acute liver failure">Acute liver failure</a></li></ul></li> <li><a href="/wiki/Liver_abscess" title="Liver abscess">Liver abscess</a> <ul><li><a href="/wiki/Pyogenic_liver_abscess" title="Pyogenic liver abscess">Pyogenic</a></li> <li><a href="/wiki/Amoebic_liver_abscess" title="Amoebic liver abscess">Amoebic</a></li></ul></li> <li><a href="/wiki/Hepatorenal_syndrome" title="Hepatorenal syndrome">Hepatorenal syndrome</a></li> <li><a href="/wiki/Peliosis_hepatis" title="Peliosis hepatis">Peliosis hepatis</a></li> <li><a href="/wiki/Metabolic_disorder" title="Metabolic disorder">Metabolic disorders</a> <ul><li><a href="/wiki/Wilson%27s_disease" title="Wilson's disease">Wilson's disease</a></li> <li><a href="/wiki/Hemochromatosis" class="mw-redirect" title="Hemochromatosis">Hemochromatosis</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Gallbladder_disease" title="Gallbladder disease">Gallbladder</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cholecystitis" title="Cholecystitis">Cholecystitis</a></li> <li><a class="mw-selflink selflink">Gallstone / Cholelithiasis</a></li> <li><a href="/wiki/Cholesterolosis_of_gallbladder" title="Cholesterolosis of gallbladder">Cholesterolosis</a></li> <li><a href="/wiki/Adenomyomatosis" title="Adenomyomatosis">Adenomyomatosis</a></li> <li><a href="/wiki/Postcholecystectomy_syndrome" title="Postcholecystectomy 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