Gallstones are hard, pebble-like masses that form in your gallbladder, which is a small pear-shaped organ on the right side of your abdomen, below your liver.
Gallstones can be made of undissolved cholesterol (called cholesterol gallstones) or the digestive fluid bile (pigment gallstones). The stones can be as small as a grain of sand or as large as a golf ball. It is possible to develop one gallstone or many.
The stones can block the tubes that carry the digestive fluids from the gallbladder to the bowel. If you experience pain or other symptoms that you think may be due to gallstones, visit your doctor.
Gallstones are also called cholelithiasis.
What are the symptoms of gallstones?
Many people with gallstones never experience any symptoms, but some people do get symptoms such as:
- sudden severe pain in the abdomen, back or right shoulder
- yellowing of the skin or eyes
- clay-coloured poo
Seek urgent medical attention if you have a fever or pain that doesn't go away if you take simple pain relief, that 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 as you get older, if you are pregnant, if you are taking the contraceptive pill, or if you lose weight quickly. Being overweight and inactive, having diabetes and having a close family relative who has had gallstones also puts you at higher risk.
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When should I see my doctor?
If you are experiencing severe and ongoing abdominal pain, make an appointment to see your doctor. If your doctor thinks gallstones may be causing your symptoms, and this is confirmed by doing investigations, then you will be referred to a gastroenterologist or a surgeon.
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How are gallstones diagnosed?
Your doctor or specialist might order tests to detect any gallstones. You will probably have blood tests to check your liver function and various tests to check your bile ducts for gallstones.
The most common imaging test to detect gallstones is an abdominal ultrasound.
Other tests may include:
- a computed tomography (CT) scan
- magnetic resonance imaging (MRI)
- a hepatobiliary iminodiacetic acid (HIDA) scan, in which a radioactive tracer is injected into the body, allowing the gallbladder function to be assessed
- an endoscopy, which involves a doctor inserting a thin, flexible, lighted tube into the mouth and guiding it down through the oesophagus (throat), stomach and small intestine so they can observe the biliary system
You may also be asked to have a specific type of endoscopy that enables your doctor to remove any gallstones detected during the procedure.
How are gallstones treated?
Some people with gallstones will not require any treatment. They recover from whatever caused the gallstones and don’t experience any more problems. Some people discover they have gallstones during an unrelated medical scan but again, they won’t necessarily experience health problems.
Other people, however, may need treatment.
Changes to your diet
For some individuals, the symptoms of gallstones can be managed by simply limiting how much fatty food and dairy products they consume. If you have gallstones, you should eat plenty of fruit and vegetables, drink a lot of fluids and aim to lose weight gradually if you are overweight.
Cholecystectomy is the most common method of curing gallstones. It does not affect your ability to digest food. You can live a healthy life without your gallbladder — it just means that after surgery, the bile flows directly from the liver to the small intestine.
The most common type of surgery is keyhole or laparoscopic cholecystectomy. The surgeon will make a few small incisions in the abdomen, insert a miniature video camera and instruments, remove the gallbladder and stitch up the incisions. The trapped gallstones can be removed at the same time.
If your gallbladder is very inflamed you may need open surgery, which requires a larger cut.
Keyhole surgery is better for most people because recovery is usually faster. You may be able to go home the day after your operation. If you have open surgery, on the other hand, you may need to stay in hospital for several days.
Medicines for gallstones
Medicines can be used to dissolve gallstones, but they are not very effective and some have side effects. The gallstones return after treatment, so using medicines to treat gallstones is not commonly recommended.
Can gallstones be prevented?
Although diet doesn't directly cause gallbladder problems – or cure them – choosing a diet that’s low in fat and cholesterol and high in fibre, and maintaining a healthy weight may help prevent a gallstones from forming. It may also help you avoid discomfort if gallstones develop.
Some studies have shown that eating a lot of fruit and vegetables, and drinking coffee or tea, can also lower your risk of gallstones.
Complications of gallstones
If one of the stones moves or gets stuck in the bile duct, it can cause a severe pain called biliary colic. This can last from a few minutes to several hours and can make you vomit.
Gallstones can also cause thickening or inflammation of the gallbladder, known as cholecystitis. This causes pain and often a fever. Cholecystitis is a serious condition and needs to be treated in hospital. If cholecystitis is not treated, the gallbladder can burst, which is a life threatening condition.
Sometimes gallstones cause blockages elsewhere in the body and can lead to jaundice (a yellowing of the skin), an infection or pancreatitis (inflammation of the pancreas). These are all serious conditions which also need to be treated in hospital.
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Last reviewed: November 2020