Gallstones are hard deposits of digestive fluid (bile) that develop in the gallbladder (a small, pear-shaped organ located on the right side of the abdomen just below the liver). Gallstones may be as small as grain of sand to as big as a golf ball.
Gallstones develop because of imbalance in the substances that make up bile. It is still unclear why these imbalances occur. However, it is believed that gallstones may form if bile contains unusually high levels of cholesterol, bilirubin, or not enough bile salts.
Many people with gallstones do not have any symptoms or are not aware that they have gallstones unless detected in tests carried out for another reason. If symptoms occur, they may include:
- Constant cramping pain that is sharp or dull which occurs on the right side, under the ribs or middle upper abdomen for at least 30 minutes. It is often described as a band like pain. Gallbladder attacks usually occur in the evening or during the night. The attack usually stops when gallstones pass into the small intestine.
- A high temperature
Other symptoms include nausea, vomiting and clay coloured stools.
You are at higher risk of developing gallstones if you:
- Are female
- Are more than 40 years of age
- Are taking birth control pills or pregnant
- Have a family history of gallstones
- Have diabetes
- Are overweight or obese
- Are on a high calorie and low fibre diet and have recently lost weight very quickly
The diagnosis of gallstones is done primarily with the help of an ultrasound scan of the abdomen. CT scans of the abdomen, magnetic resonance imaging (MRI) scan endoscopic retrograde cholangiopancreatography (locate the affected bile duct and the gallstone), cholescintigraphy (diagnose abnormal contractions of the gallbladder or obstruction of the bile ducts) may also be required if the diagnosis is unclear. Your doctor may also order blood tests to look for signs of infection or inflammation of the bile ducts, gallbladder, pancreas, or liver.
The usual treatment for symptomatic gallstones is surgery to remove the gallbladder. The most commonly used technique is called laparoscopic cholecystectomy (involves small incisions, which allow for a faster recovery). Open cholecystectomy (incision of about 4 to 6 inches long is made in the abdomen and thus requires more time to heal) was the technique used in the past. However, this technique is less common now.
Removing gallstones without removing the gallbladder is an ineffective method of treatment.
Nonsurgical treatments (endoscopic retrograde cholangiopancreatography) may be used to remove stones or let them pass freely into the bowel, if a person cannot undergo surgery to remove the gallbladder.
Medications can be used to try to dissolve gallstones. However, the disadvantage of taking these medicines is that you may need to take them for a period of months or years, may have limited or adverse effects and you may develop complications of your gallstones during this period.