Gallstones

Sometimes with gallstones, symptoms are absent and require no treatment, or they may be very painful and require surgery to remove the gallbladder. Gallbladder surgery is one of the most common operations performed on adults in the U.S.

What is a gallstone?

Gallstones are hard formations that form when a fluid called bile accumulates and solidifies in the gallbladder or bile duct. Bile is necessary for digestion, produced by the liver, and stored in the gallbladder. When you have gallstones, they may block the bile duct or pancreatic duct. Your gallbladder or pancreas may also become inflamed.

What causes gallstones?

Gallstones are caused by bile crystallization within the gallbladder or bile duct. Bile, a crucial digestive fluid, is produced in the liver and stored in the gallbladder.

Bile fluid includes the pigment bilirubin. If the liver can’t process bilirubin or there’s an increase in its production, it can build up in the body and contribute to gallstone formation. This buildup can lead to jaundice, characterized by yellowing of the skin and eyes. Gallstones can trigger intense pain.

Gallstones symptoms

One of the most noticeable symptoms of gallstone is when you have pain in the upper right or center of your abdomen that gets worse after a meal – particularly a meal of fatty or greasy foods. Other symptoms of gallstones may include:

• Bloating
• Nausea or vomiting
• Sweating
• Fever
• Chills
• Pain in the right shoulder
• Pain between the shoulder blades
• Jaundice (yellowing of the skin and eyes)

If you have possible gallstones symptoms that concern you, especially abdominal pain that lasts longer than a few hours, pain that is severe and accompanied by fever and chills, or if your skin or eyes look yellowish, schedule an appointment with your doctor.

Diagnosing gallstones

Your doctor will perform a physical exam and ask about your possible gallstone symptoms. Gallbladder symptoms can be similar to those for other conditions, such as appendicitis, pancreatitis, gastroesophageal reflux disease (GERD) and ulcers. To rule out other causes for your symptoms, your doctor may order tests such as:

• Blood tests
• Liver function tests
• Ultrasound
• CT scan
• MRI
• Hepatobiliary iminodiacetic acid (HIDA) scan: Radioactive material is inserted into your veins, which allows your doctor to examine the system that handles bile.
• Endoscopic retrograde cholangiopancreatography (ERCP): A tube with a light and camera is inserted through your throat and into the stomach and small intestine. Dye is injected to view bile ducts. Gallstones can be removed during this test.
• Endoscopic ultrasound (EUS): A small ultrasound device in a tube is inserted down your throat. Sound waves from the ultrasound create images for your doctor to review.

Gallstones treatment & services

If you don’t have any symptoms, your doctor may have you come in for regular physical exams to watch for concerns that require gallstones treatments.

In some cases, medications can be used to dissolve gallstones, but they may take months or years to work and are not commonly used. These medications are typically reserved as gallstones treatments for those who can't undergo surgery.

If you must have surgery, your doctor may perform one of two surgeries to remove the gallbladder:

• Laparoscopic gallbladder removal: A minimally invasive procedure where surgeons make several small incisions in the abdomen to remove the gallbladder. Recovery time is typically shorter compared to open surgery.
• Open gallbladder surgery: A traditional surgery method where a larger incision is made to remove the gallbladder.

Gallstone prevention

Simple lifestyle changes could go a long way with gallstone prevention. Some ways to help reduce your risk of gallstones are:

• Get more exercise
• Eat a healthy diet of whole fruits and vegetables, lean proteins and whole grains
• Moderate coffee consumption if you drink coffee
• Eat less fatty and fried foods

These practices can reduce your risk but may not prevent gallstones from forming. Keep up with regular physical exams and talk with your doctor about any symptoms you have.