Progress has been made in understanding the process of gallstone formation. Researchers believe that gallstones may be caused by a combination of factors, including inherited body chemistry, body weight, gallbladder motility (movement), and perhaps diet. Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts. Besides a high concentration of cholesterol, two other factors seem to be important in causing gallstones.

Gallstones are solid crystals made of either cholesterol or bilirubin, a pigment material. They can range in size from almost microscopic to over half an inch in diameter.

The gallstones appear due to a precipitation of the crystals. This is due to a malfunction of the liver who produces toxic or fatty bile.

The doctor can try to dissolve the stones, but this is made gradually on a period of several years with the help of medication. Also, keeping a diet low in fats will help your liver more than you think. Sometimes if the gallstone gets stuck in the neck of the gall bladder or in the cystic duct, acute cholecystitis might appear, meaning that the gallbladder got inflamed and distended, creating a localized peritonitis.

Gallstones are the most common risk factor for gallbladder cancer. Between 75% and 90% of people with gallbladder cancer also have gallstones and an inflamed gallbladder. Gallbladder cancer is more likely to happen if your gallbladder has a single large gallstone than several small ones. Doctors believe that large gallstones grow over a long time, irritating the gallbladder wall and increasing the risk for gallbladder cancer.

If the gallstones stay in the gallbladder and do not move there will be no symptoms. As soon as the gallstones move and obstruct the neck of the gall bladder, pain in the upper right abdomen will appear. Most frequent jaundice will appear, due to the accumulated bile pigment.

People with asymptomatic (without symptoms) gallstones usually do not need surgery. However, if you have had a significant gallbladder attack or multiple minor attacks, you may need surgery.

This year, more than 1 million people in the United States will learn they have gallstones. They will join the estimated 20 million Americans--roughly 10 percent of the population--who already have gallstones. Native Americans. They have the highest prevalence of gallstones in the United States. A majority of Native American men have gallstones by age 60. Among the Pima Indians of Arizona, 70 percent of women have gallstones by age 30.

Most people with gallstones do not have symptoms. They have what are called silent stones. Studies show that most people with silent stones remain symptom free for years and require no treatment. Silent stones usually are detected during a routine medical checkup or examination for another illness.

Many times gallstones are detected during an abdominal x-ray, computerized axial tomography (CT) scan, or abdominal ultrasound that has been taken for an unrelated problem or complaint. When actually looking for gallstones, the most common diagnostic tool is ultrasound. An ultrasound examination, also known as ultrasonography, uses sound waves. Pulses of sound waves are sent into the abdomen to create an image of the gallbladder.

Despite the development of nonsurgical techniques, gallbladder surgery, or cholecystectomy, is the most common method for treating gallstones. Each year more than 500,000 Americans have gallbladder surgery. Surgery options include the standard procedure, called open cholecystectomy, and a less invasive procedure, called laparoscopic cholecystectomy. The standard cholecystectomy is a major abdominal surgery in which the surgeon removes the gallbladder through a 5- to 8-inch incision.