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What Are Gallstones?

Gallstones are solid deposits of cholesterol and other substances in bile that develop because the levels of these chemicals become unbalanced. The gallbladder is a small sack located underneath the liver. It stores bile that the liver makes and squirts the bile into the bowel (intestine) when a meal is eaten. Bile helps digest fats in the food. Under certain conditions, the gallbladder can form gallstones (cholelithiasis).

Gallstones are common: up to 20% of men and 40% of women get gallstones. More women get gallstones because of the effects of estrogen (a female hormone) on bile. Being overweight, aging, and fasting for a long time increase the risk of getting gallstones.

What Are the Symptoms of Gallstones?

Most gallstones produce no symptoms and may never lead to trouble, but they can cause intense pain. If a gallstone gets stuck in the tube (duct) that takes bile to the bowel, the gallbladder will squeeze harder, and the duct may tighten around the stone. Severe cramps in the belly (abdomen), or maybe between the shoulder blades, will result. Feeling sick to the stomach and vomiting are likely. Symptoms go away if the stone falls back into the gallbladder or moves through the bile duct into the bowel. A gallstone stuck at the end of the duct may cause swelling (inflammation) in the pancreas, and the skin and eyes may turn yellow (jaundice) if the bile ducts are blocked and there is a backup of bile.

How Are Gallstones Diagnosed?

Ultrasound (a special x-ray machine that uses sound waves to get pictures of body organs) can be used to find almost all gallstones and is usually the first test ordered. When ultrasound shows unclear results, the health care provider can use a special x-ray test (HIDA scan) or a CT scan to rule out other diseases that cause similar symptoms.

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How Are Gallstones Treated?

Gallstones can be cured by surgically removing the gallbladder and gallstones (cholecystectomy). This is usually done with a laparoscopic method using only tiny cuts, instead of one large cut, for the health care provider to insert instruments into the belly to remove the gallbladder. This operation allows a shorter recovery time and can be an outpatient surgery.

Treatment of gallstones in people without symptoms (asymptomatic) remains unclear. Some doctors recommend avoiding surgery unless symptoms are present. Others suggest surgery because of possible complications and the risk of complications from surgery is generally small. You should discuss the situation with your health care provider, because you may have a higher risk (e.g., if you have diabetes, heart disease, emphysema).

In rare cases when surgery is too dangerous, your health care provider may suggest drugs to dissolve the gallstones, but medicines may not work and must be used for a long time.

DOs and DON’Ts in Managing Gallstones:
  • DO maintain a normal weight. If you are overweight, ask your health care provider to help you with slow, steady weight loss.
  • DO notify your health care provider if you have pain that you think may be related to gallstones. Call your health care provider immediately if you have a fever with the pain.
  • DON’T eat meals high in fat, extra large meals, and foods that cause stomach upset. Fatty foods make the gallbladder tighten and it may squeeze a stone into the duct. Even more important, avoid high-fat meals after following a low-fat diet.
  • DON’T fast for long periods or go on a crash diet.
FOR MORE INFORMATION

Contact the following sources:

  • American College of Surgeons
    Tel: (312) 202-5000
    Website: http://www.facs.org
  • American College of Gastroenterology
    Tel: (703) 820-7400
    Website: http://www.acg.gi.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor