Another complication associated with sickle cell anemia is the development of gallstones, which occur when certain substances harden in the gallbladder. A healthy gallbladder is responsible for storing and releasing a compound that aids in digestion, called bile. Bile is produced in the liver and travels via the bile duct to the gallbladder. In individuals who have sickle cell anemia, most gallstones are formed from an excess of bilirubin. Bilirubin is a compound in bile that is a byproduct of the process the liver uses to breakdown old red blood cells. The body has no use for it after the process is complete, and it is excreted by the body through the stool. In individuals with sickle cell anemia, there is an excess of red blood cell breakdown, which creates excessive amounts of bilirubin, which is then stored in the gallbladder and attempts to follow the normal process of excretion. However, it ends up sitting in the gallbladder longer than normal. This happens because the body cannot keep up with the liver's bilirubin production. Gallstones then form in the gallbladder from the bilirubin.
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