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Gallstones
8-minute read
Key facts
- Gallstones (cholelithiasis) are hard, pebble-like masses that form in your gallbladder, below your liver.
- If you have gallstones, you may not have any symptoms, or you may have pain from time to time in your tummy area, back or right shoulder.
- You're more likely to get gallstones if you're female, aged over 40 and living with overweight or obesity.
- Many people with gallstones do not need treatment.
- If you do need treatment, this may involve changing your diet to cut out fatty foods or having an operation.
What are gallstones?
Gallstones (cholelithiasis) are hard, pebble-like masses. They form in your gallbladder. Your gallbladder is a small pear-shaped organ on the right side of your abdomen (tummy). The gallbladder is found below your liver.
Gallstones can be made of undissolved cholesterol (called cholesterol gallstones). Some gallstones are made of bile (a liquid that helps your body digest fat). Bile gallstones are called pigment gallstones
Gallstones may be as small as a grain of sand. Some can be as large as a golf ball. You can get one gallstone or many of them.
Gallstones can block the tubes that carry digestive fluids from your gallbladder to your bowel. This blockage can cause pain and other symptoms.
What are the symptoms of gallstones?
Some people with gallstones never have any symptoms.
Other people have pain in the abdomen, back or right shoulder. The pain happens from time to time. It can come and go. It might not happen often, but can be severe. The pain may come after you eat a fatty meal.
Gallstones can sometimes cause other problems such as:
- jaundice — yellowing of your skin and of the whites of your eyes
- cholecystitis — severe pain in the upper right abdomen, nausea and vomiting
- pancreatitis — upper abdominal pain which can move to your back as well
- fever — raised temperature, sometimes with sweating or shivering
Seek urgent medical attention if you have a fever or pain that doesn't go away after you take simple pain relief. Seek urgent medical attention if the pain lasts a few hours, or that stops you from eating and drinking normally.
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What causes gallstones?
It is not fully understood why gallstones form. However, you are more likely to get gallstones if you're:
- female
- aged over 40 years
- living with overweight or obesity, or are inactive
- pregnant or taking the contraceptive pill
- if you lose weight quickly
- if you have diabetes
- have a family history of gallstones
How are gallstones diagnosed?
Your doctor will talk to you about your symptoms and examine you. There are several tests that can be used to diagnose gallstones.
The most common imaging test used to see gallstones is an abdominal ultrasound.
Other tests may include:
- a computed tomography (CT) scan
- magnetic resonance imaging (MRI) scan
- a hepatobiliary iminodiacetic acid (HIDA) scan, in which a radioactive tracer is injected into your body, letting doctors see how well your gallbladder works
- an endoscopy, which involves a doctor putting a thin, flexible, lighted tube into your mouth and guiding it down through your oesophagus (throat), stomach and small intestine so they can see your biliary system. Some types of endoscopy also let your doctor to take out any gallstones found.
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You will usually also have blood tests to check your liver function.
When should I see my doctor?
If you are having severe and ongoing abdominal (tummy) pain, seek medical attention as soon as possible.
Your doctor may refer you to a gastroenterologist (specialist in problems with the digestive tract) or a surgeon.
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How are gallstones treated?
The main ways gallstones are treated are dietary changes and surgery.
Not everyone who has gallstones will need treatment. You may find out that you have gallstones just by chance. This can happen if you are having a scan for another health issue. You may not have any symptoms.
If your gallstones are causing symptoms, your doctor may recommend dietary changes, taking medicines or having an operation.
Dietary changes
You may be able to manage your symptoms by not eating as much fatty foods and dairy products as normal. You should eat plenty of fruit and vegetables and drink a lot of fluids. It is a good idea to aim to lose weight gradually if you are overweight.
Medicines for gallstones
There are medicines to dissolve gallstones. They are not very effective. Some of these medicines have side effects. Gallstones often come back after treatment. For these reasons, most doctors do not recommend taking medicines to treat gallstones.
Surgery
The most common treatment for gallstones is surgery. This means having an operation. Your surgeon may take out your whole gallbladder (called having a cholecystectomy). Sometimes the surgeon will take out just the stones that are in your bile ducts.
Cholecystectomy does not affect how you digest food. You can live a healthy life without your gallbladder. After surgery, the bile flows straight from your liver to your small intestine. Bile works to help digest fatty food.
The most common type of surgery to take out your gall bladder is called keyhole or laparoscopic cholecystectomy. The surgeon will make a few small cuts in your tummy area. They will then put in a very small video camera and instruments. They can use these instruments to take out your gallbladder. Then they will stitch up the small cuts.
You may have some trapped gallstones in tubes around your gallbladder. These will be taken out at the same time.
Sometimes the gallbladder is very inflamed (red and swollen). In this case, you may need open surgery. The doctor will make a larger cut to get the gallbladder out.
Recovery is usually faster after keyhole surgery. You may be able to go home the day after your operation. If you have open surgery, you may need to stay in hospital for a few days.
Can gallstones be prevented?
Choosing a healthy diet may help prevent gallstones from forming. It may also help you have less pain if you get gallstones.
Your diet doesn't cause gallbladder problems, and a healthy diet cannot make them go away. Having a healthy diet in the first place is the best way to prevent them.
Choose a diet that's low in fat and cholesterol and high in fibre. This will give you the best chance of avoiding gallstones.
Some studies have shown that eating a lot of fruit and vegetables can lower your chance of getting gallstones. Drinking coffee or tea may also lower your chance of gallstones.
What are the complications of gallstones?
Sometimes a gallstone can move or get stuck in your bile duct. If this happens, it can cause severe pain. This is known as biliary colic. The pain can last from a few minutes to several hours. The pain may make you vomit.
Gallstones can also cause thickening or inflammation of your gallbladder. This is called cholecystitis. This causes pain and often a fever. Cholecystitis is a serious condition. You will need to be treated in hospital. If your cholecystitis is not treated, your gallbladder can burst. A burst gallbladder can be fatal (cause death).
Sometimes, gallstones can lead you to get jaundice (yellowing of the skin), or pancreatitis (inflammation of your pancreas). These are also serious conditions and need to be treated in hospital.
Resources and support
The Gastroenterological Society of Australia (GESA) provides information about gallstones, including various treatment options.
You can also call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.