Gallstones and Sickle Cell Disease

Gallstones are a common problem for people with sickle cell disease. They form in the gallbladder and can cause pain and discomfort.

The gallbladder is a pear-shaped organ that is located behind the liver. It stores and releases bile. Bile is a fluid used in digestion. The liver produces it, and the gallbladder stores it.

What are gallstones?

Gallstones are hard rock-like deposits that form in the bile duct or in the gallbladder. They are solid and can vary in size. Some are the size of a grain of salt. Others are the size of a golf ball. Different substances in the body can form gallstones.

Gallstones are more common in people with sickle cell disease than in people without sickle cell disease. This is because most gallstones in sickle cell disease are caused by excess bilirubin. Bilirubin forms when red blood cells break down. People with sickle cell disease often have excess bilirubin because of how quickly their red blood cells break down.

Biliary sludge (when excess bile settles in the duct) can also lead to gallstones in people with sickle cell disease.

Gallstones and your child’s health

Gallstones are usually not harmful. Your child might have discomfort when gallstones settle in the bile duct or collect in the gallbladder. But sometimes gallstones can lead to serious health problems.

Some of the symptoms of gallstones are:

• Pain
• Fever
• Nausea
• Vomiting
• Yellowing of the skin and eyes (also called jaundice)
• Dark urine
• Clay-colored stool
• Fever
• Pain in the abdomen
• Severe pain in the upper abdomen that can move to the shoulders and back

Diagnosis of gallstones

Your child’s doctor will do an exam on the stomach to check for pain or discomfort. The doctor may draw blood for tests or order an imaging test to diagnose gallstones.

Treatment of gallstones

If your child is not having problems from the gallstones, the care team may choose to watch and wait.

If your child is having pain, their doctor may choose to treat the symptoms with

• IV fluids to keep your child from becoming dehydrated
• Medicines to relieve nausea and vomiting
• Pain medicine
• Antibiotics for fever
• Removing the gallbladder through surgery

Prevention of gallstones

Your child may not be able to prevent gallstones. Some 30-50 % of people with sickle cell disease will develop them.

But you can take steps to help your child lower their risks for gallstones. Risks for gallstones include:

• A diet high in fatty foods and low in fiber
• Lack of exercise
• Smoking
• Not drinking enough fluids
• Obesity

You can ask your care team if working with a nutrition professional such as a dietitian or nutritionist could help. Your care team may be able to offer other tips as well.