- Gallstones are common but they often cause few symptoms.
- They can cause problems such as pain, inflammation, infection, jaundice and pancreatitis.
- Symptomatic gallstones are by surgery to remove the gallbladder. This is a common operation.
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What does the Gallbladder do?
What are gallstones?
Who gets them?
Problems caused by gallstones
Treatments available
What happens after the gallbladder is removed?
What does the gallbladder do?
The gallbladder is located under the liver in the upper right-hand side of the abdomen. It is a 'reservoir' which stores bile that has ben made in the liver. Bile aids in the digestion of fat in our diet. When we eat the gallbladder contracts (squeezes) emptying bile into the duodenum (the first part of the gut after the stomach).
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What are gallstones?
Gallstones occur when bile stored in the gallbladder crystllises or solidifies. They are mainly composed of fat (cholesterol) but can also be made from bile pigments or calcium deposits. When gallstones are formed the gallbladder can contain a few small stones up to several hundred, some people produce a single large stone.
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Who gets them?
Typically 1 in 3 women, and 1 in 6 men, will develope gallstones during their lifetime. They are more common as we get older.
Pregnancy, obesity, and some medicines increase the risk of forming gallstones.
Being vegetarians and alcohol in moderation reduces the risk of forming gallstones.
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Problems caused by gallstones
Often none
Most people aree unaware they have them. They are often found coincidentally on scans of the abdomen during investigation of other conditions.
Problems which can occur
A third of people with gallstones develope symptoms, such as :
Severe pain in the upper abdomen, usually worst on the right-hand side, below the ribs. Pain is caused by a stone obstructing the cystic duct (the tube that allows bile in and out of the gallbladder) which prevents the gallbladder from emptying. The gallbladder squeezing against the blockage causes pain. Pain is relieved by the gallstone passing out into the bile duct, or falling back into the gallbladder. The pain can last for minutes or hours. Severe pain may happen only once, or it may recur intermittently. Ongoing 'niggly' pains may be more frequent and often follow a fatty meal.
- Inflammation/Cholecystitis.
This is usually due to infection in the gallbladder. Symptoms develop rapidly and include abdominal pain, fever, nausea, vomiting and feeling generally unwell. This usually requires admission to hospital for treatment.
This is a less common complication. It occurs if a gallstone passes out of the gallbladder and gets stuck in the bile duct (the tube that connects the liver to the gut (duodenum). Bile gets into the bloodstream and causes you to go yellow (jaundiced). This requires admission to hospital for treatment.
(Note: there are many other causes of jaundice apart from gallstones.)
This is an inflammation of the pancreas. The pancreas makes enzymes which digest the food we eat. The pancreatic duct joins the bile duct just before opening into the gut (duodenum). If a gallstone becomes stuck here it can cause pancreatitis which is a painful and potentially life threatening condition.
- Other rare but serious complications can occur such as severe infection in the bile ducts (cholangitis).
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Treatments available
MOST cases require no treatment
Gallstaones can be left alone if they cause little or no symptoms.
Surgery
An operation to remove the gallbladder is the usual treatment if you have symptoms.
- Laparoscopic Cholecystectomy or 'Key-hole' surgery is the most common way to remove a gallbladder.
- This operation requires very small cuts on the abdomen and leaves only small scars.
- It is not suitable for all people.
- Some people with gallstones need the traditional operation to remove the gallbladder (Open Cholecystectomy).
- Other surgical procedures may be needed if a stone gets stuck in the bile duct.
Medication
Taking a medicine is sometimes an option. The aim is to 'dissolve' the stones. This may take years of treatment, and is not always successful. If the medication is stopped the stones return. It is usually reserved for situations where surgery is not possible.
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AWhat hapens after the gallbladder is removed?
Laproscopic cholecystectomy can be performed as a daycase operation. Most people spend one night in hospital. After 1-2 weeks you should be able to return to your normal daily activities.
The gallbladder is a reservoir for bile, it is not essential for normal digestion of food to take place. Bile continues to flow from the liver to the gut after the gallbladder is removed.
Eating a normal diet usually causes no problems after your gallbladder is removed. 50% of people experience indigestion or bloating from time to time following surgery. Fatty meals may aggrevate these symptoms. Some people notice an increase in the frequency of passing faeces (stools/motions), if troublesome it can be treated with anti-diarrhoeal medication.
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