What causes black gallstones?

Black gallstones may be caused by long-term high-fat diet, bile stasis, gallstones with chronic cholecystitis, cholestatic liver disease, or biliary tract infections. These conditions can be improved through dietary adjustments, lifestyle modifications, medication, and symptomatic interventions. If gallstones cause symptoms such as abdominal pain or jaundice, prompt medical attention is necessary.

1. Long-term high-fat diet: Frequent daily consumption of high-fat foods such as fried foods and animal offal increases cholesterol levels in bile, leading to crystal formation and eventually black gallstones. This may be accompanied by indigestion and dull pain in the upper right abdomen. It is recommended to adjust the diet by reducing intake of high-fat foods, increasing fiber-rich foods such as vegetables and whole grains, and controlling daily fat intake.

2. Bile stasis: Prolonged sitting, lack of physical activity, or weakened gallbladder contraction function can cause bile to remain in the gallbladder for too long. Excessive water absorption leads to concentrated bile, which easily forms black gallstones, possibly accompanied by bloating and nausea. It is recommended to increase physical activity, engaging in aerobic exercises such as brisk walking or jogging 3–5 times per week to promote bile excretion and avoid prolonged sitting.

3. Gallstones with chronic cholecystitis: Long-term irritation of the gallbladder wall by gallstones can trigger chronic inflammation. Inflammatory secretions mixing with bile components may darken the stones to black, accompanied by recurrent right upper abdominal pain and postprandial fullness. Patients may take medications such as ursodeoxycholic acid capsules, anti-inflammatory and cholagogue tablets, or belladonna tablets under medical guidance to relieve symptoms.

4. Cholestatic liver disease: Abnormal liver metabolism disrupts bile production or excretion, causing intrahepatic bile stasis. Precipitated bilirubin components may form black gallstones, accompanied by skin itching and jaundice. It is recommended to use medications such as ademetionine enteric-coated tablets, ursodeoxycholic acid capsules, or prednisolone tablets under medical supervision to alleviate discomfort.

5. Biliary tract infection: Infection of the biliary tract by pathogens such as bacteria or parasites causes inflammatory stimulation that alters bile composition, leading to bilirubin deposition and formation of black gallstones. Symptoms may include fever, abdominal pain, and chills. Follow medical advice to use medications such as cefoperazone sodium sulbactam sodium injection, metronidazole injection, or anti-inflammatory and cholagogue tablets to improve symptoms.

Daily care should include maintaining regular meal times and avoiding prolonged fasting; managing body weight to prevent obesity; undergoing regular abdominal ultrasound examinations to monitor stone changes; and maintaining a healthy sleep schedule to avoid excessive fatigue.