Black Pigment Gallstones Symptons,Causes &Treatment

Black Pigment Gallstones

Black Pigment GallstonesBlack pigment gallstones are a type of bile pigment gallstones which are black in colour and hard. Pigment is a waste product formed in hemoglobin. The chemical that is formed  when old red blood cells are destroyed is called bilirubin. This bilirubin is released into the blood which is removed by the liver through bile by modifying it. In the case of excess amounts of bilirubin it combines with other constituents of bile like calcium and forms pigment. This pigment is like cholesterol which does not dissolve in the bile easily. It sticks together to form particles which finally grow in size into gallstones.

Composition, Color and Consistency

The color may be due to the amount of calcium salts, like calcium bilirubinate, and cholesterol which also affects the consistency. Mucin glycoprotein present is responsible for binding the stone. Black stones have lesser amount of cholesterol. They have high concentration of bilirubin. These are firmer and can easily crumble.

Size and Quantity

Pigments stones are usually smaller than 1.5 centimters. The black stones are formed in large numbers.


These stones are found in the gallbladder and are mostly caused due to hemolytic anemia.


Most black pigment stones are radiopaque and can be detected using an x-ray.


The symptoms generally are the same for all types of Gallstones. These include Abdominal pain, Abdominal swelling, distension or bloating, Abdominal symptoms that occur within minutes after a meal, Abdominal tenderness, Clay-colored stools, Fever and chills, Loss of appetite, Nausea with or without vomiting, Pain that radiates from the abdomen to the right shoulder or back, Sweating and Yellowing of the skin and whites of the eyes. If you see any of these symptoms it is better to consult a doctor right away.


The main causes for Black pigment gallstones are Hemolytic anemia, Sickle cell anemia, Liver Cirrhosis, Round worm infection and Escherichia coli infection. In Hemolytic anemia there is a deficiency of red blood cells because of the destruction of the cells. This produces more bilirubin. In sickle cell anemia the blood cells are deformed and are easily broken and destroyed resulting in excess bilirubin. In the round worm infection the bile builds up in the gallbladder because of the round worms. All these increase the content of bilirubin in the liver and hence result in the formation of Pigment stones.


Generally the treatment for gallstones is of two types. Surgical treatment and non- surgical treatment. The non surgical treatments like Oral dissolution therapy, Contact dissolution therapy and Extracorporeal Shock Wave Lithotripsy are suitable for cholesterol stones.

Surgical treatment:

This surgery can be done in two ways. Laproscopy and Open surgery.

Laproscopic surgery: In this type of surgery  several tiny incisions of 5 to 10 mm size are made in the abdomen and these incisions are used to send medical instruments and a camera and the gallbladder is removed by monitoring through a computer. This is very simple surgery when compared to the traditional open surgery and the patients can get back to their normal daily life within 3 to 5 days..

Traditional Open Surgery: In this surgery an incision of 5 inch to 8 inch is made and the gallbladder is removed. This surgery is also called Cholecystectomy. This is usually not opted as it takes time for recovery and is done only if there is a gallbladder infection or some other complications which make laproscopy unsuitable.

Natural treatment is also available in addition to the above treatments which dissolve the gallstones without any medications or surgery by home remedies .