Types of Gallstones: Understanding Cholesterol, Pigment, and Mixed Stones

What Are Gallstones?

Gallstones are tiny stones formed due to the solidification of the bile juice, a digestive juice produced by your liver. When these stones block your bile duct (the pipeline through which bile moves out of the gallbladder), it can cause severe pain. It can also cause obstructive jaundice. 

Although your gallstones form from solidified bile juice, they combine with other toxins produced in your body from some unhealthy choices.

Depending on these factors of gallstone composition, the gallstones come in different forms - cholesterol, pigment, and mixed.

Let's look deeper into each type of stone.

Cholesterol Gallstones

As the name suggests, these gallstones are composed of hardened cholesterol. This type is the most common type of gallstone. 80% of the population with gallstones have the cholesterol type.

But where does this cholesterol come from?

You already know that bile is the main culprit which forms these stones. So, the bile in your gallbladder contains a small amount of fat, which is 0.5% of cholesterol. This amount is the average range. Things change when the bile in your body becomes imbalanced and contains too much cholesterol. Bile, which should always be liquid, hardens into cholesterol gallstones. 

There are ways to identify cholesterol gallstones based on their appearance. Want to know how?

Distinctive Features of Cholesterol Stones

If you remove your gallstones through surgery and get to see them, the cholesterol stones will have the following features:

• Cholesterol stones are yellowish-green in colour, just like how actual cholesterol looks like.
• The size can be as small as a dot or as large as a lime. Cholesterol stones are usually the largest of the three types of gallstones.
• As these large stones need space inside your gallbladder, they are usually less in number.
• Cholesterol gallstones often have a round shape. Sometimes, they also appear with flat surfaces.
• Compared to other gallstones, cholesterol gallstones are smooth with a soft texture.

Why Do the Size and Shape of the Stone Matter to You?

Since cholesterol gallstones are large, they often block the bile duct and cause severe pain. (Imagine pushing a large stone through a small pipeline!)

What Gave You Cholesterol Stones?

The factors that make you a high-risk person for getting cholesterol stones are;

• One, as understood from the name itself - high cholesterol.
• Other risk factors include obesity, rapid weight loss and certain medications. 

PS: Are you considering getting an X-ray to determine if you have cholesterol stones? Then wait! 

No one can see cholesterol stones in an X-ray! Not even your doctor. These fat-filled stones are not visible in an X-ray film.

Now, let's move on to know about pigmented gallstones.

Pigment Gallstones

As the name suggests, they are pigmented, usually in black or brown. What gives them these colours? The red blood cells in your liver break down, producing the colour. Don't worry; breaking down your red blood cells is a normal body process, and this coloured bilirubin is regularly found in your gallbladder.

So, how do these form stones?

Again, the answer is the composition of your bile itself. Bilirubin accounts for 0.2% of bile composition. Bilirubin content in bile increases, resulting in the formation of pigment gallstones.

Distinctive Features of Pigmented Stones

Bilirubin and calcium salts give pigmented gallstones their colour. Some of the distinctive features of these types of stones are;

• Pigmented gallstones vary in size. Generally, black-pigmented stones are smaller and brown-pigment stones are more prominent. 
• Black pigmented stones are more ragged, faceted or have jagged edges, while brown pigment stones are less regular.
• These are comparatively harder and more brittle than cholesterol gallstones.
• Pigmented gallstones usually form as multiple stones than cholesterol gallstones.

Do You Need to Worry if You Have Pigment Stones?

Yes, a little bit. Black-pigmented gallstones are generally associated with chronic liver diseases, while bacterial infections mainly cause brown-pigmented stones.

Another exciting feature of these pigmented stones is that you can find them if you get an X-ray done!

Let's learn about the third type - the mixed gallstones.

Mixed Gallstones

As you guessed, a combination or mixture of cholesterol and pigment gallstones make up a mixed gallstone. They account for only 5% of total gallstone cases. That's right; the chance that you may have a mixed type of gallstone is very slim. 

Distinctive Features of Mixed Gallstones

• Mixed gallstones have a variegated appearance with different zones and layers of colours.
• Size and shape are also varied and mixed. It depends on the percentage of cholesterol or bilirubin present in them.
• These stones have a mixed texture. Some parts may feel softer, and some parts may feel harder. 

What Differences Do These Features Make?

This mixed composition makes these gallstone symptoms somewhat unpredictable. Treatment and diagnosis are all dependent on the percentage of composition.

Conclusion

It is essential to have a comprehensive knowledge of the different types of gallstones and their associated risk factors. This knowledge can help you better understand your health status and empower you to take proactive measures to prevent or manage their occurrence.

By being aware of the types of gallstones and their underlying causes, you can make informed decisions about your health and well-being. Stay informed, stay healthy.