Gallstones are stones that develop in your gallbladder. For most people, they don’t give any symptoms and won’t need treatment.
Gallstones sometimes cause problems such as abdominal (tummy) pain and inflammation of your gallbladder. The usual treatment for gallstones when they cause problems is surgery.
Your gallbladder is a small, pear-shaped pouch in the upper right part of your tummy (abdomen). Between meals, your gallbladder stores bile, a fluid that’s produced by your liver. When you eat, your gallbladder releases bile into your bowel through a channel called the bile duct. Bile helps your body break down food, especially fats.
Gallstones develop if the chemicals that make up your bile become imbalanced and form lumps which then harden. You might form one stone, several or many. Gallstones can vary in size from as small as grains of sand to as big as a golf ball.
If you have gallstones, they may stay in your gallbladder and cause no problems. Small gallstones may occasionally just break up and be passed out. But if gallstones begin to block the flow of bile they can cause pain and inflammation. See our section on symptoms below for more information.
There are three main types of gallstone:
Most people with gallstones don’t have any symptoms. Sometimes, gallstones are found if you have a scan to investigate something else.
The most common symptom of gallstones is pain in the middle or right side of your upper abdomen, just under your ribs. This is known as biliary colic. It can happen when a gallstone blocks the flow of bile out of the gallbladder.
The pain may be severe, and is constant – it doesn’t come and go. It may spread to the centre of your back and the tip of your right shoulder blade. You may develop this pain after a heavy meal, especially in the evening or during the night. The pain usually lasts for at least 30 minutes and may go on for up to eight hours. You may also sweat, feel sick and vomit.
Sometimes an episode of biliary colic leaves you with a dull ache or discomfort over the gallbladder area for several days afterwards.
Gallstones may block the flow of bile for a long time, or leave the gallbladder to cause problems in the bile duct and nearby pancreas. See our section on complications below for more information about what can happen. Symptoms may then include the following.
If you have severe pain in your tummy which does not resolve by itself or after taking over-the-counter painkillers, contact your doctor.
If you become very unwell and develop a high fever, jaundice or any of the other symptoms listed above, seek medical attention as soon as possible because you may need urgent hospital treatment.
You may only discover you have gallstones when you have a test such as an ultrasound of your abdomen for some other reason.
If you do have symptoms, your doctor will ask about these and about your medical history. This will help to identify possible causes and any other conditions. They’ll feel your tummy area to see if it’s tender or swollen.
You might have blood tests to check for any inflammation or infection, a problem with your liver or a blocked bile duct.
Your doctor may refer you to your local hospital for more tests, some of which are described below. If your doctor thinks you have complications that need immediate treatment, you may have to go to hospital straightaway.
If gallstones aren’t giving you any symptoms, your doctor may suggest leaving them alone. If your gallstones start to cause problems, your doctor may refer you for further investigations and treatment.
You may be able to manage your symptoms by taking over-the-counter painkillers like paracetamol or ibuprofen. Your doctor may prescribe stronger painkillers if you need them.
If your gallstones have caused an infection, your doctor may prescribe antibiotics. These may be given intravenously (into a vein) in hospital.
There is no special diet for gallstones, but your doctor may advise you to avoid any food or drinks that you notice make your pain worse. For more information, see our FAQ: Should I change my diet if I have gallstones? below.
The main treatment for gallstones which give symptoms is an operation to remove your gallbladder. Your gallbladder isn’t essential, and most people don’t notice any difference without it.
The decision to remove your gallbladder may depend on how often you get symptoms, how severe they are and what problems your gallstones are causing. Your decision should also take into account your age and general health. Your doctor or surgeon can explain your options and answer any questions you may have.
An operation to remove the gallbladder is called a cholecystectomy. There are two main ways this can be done.
If your doctor thinks you might have gallstones in your bile duct, they may suggest having an endoscopic retrograde cholangiopancreatography (ERCP). This uses a combination of endoscopy and X-rays to find and treat your gallstones. Your doctor passes an endoscope through your mouth down to where the bile duct opens into your intestine. They can then widen the end of the bile duct and take out the gallstones.
If an ERCP isn’t possible, your doctor may recommend a procedure called a percutaneous transhepatic cholangiogram (PTC). In a PTC, the gallstones in the bile duct are removed by passing a tube through the skin below your ribs, and into the liver.
Most people will still need to have an operation afterwards to remove their gallbladder because there may be more gallstones in it.
Your chance of getting gallstones increases as you get older, especially once you’re over 40.
You’re also more likely to get gallstones if you:
Most gallstones stay in your gallbladder; occasionally they can pass out of your system without any problems. But sometimes they can move and cause complications. They may block ducts to your internal organs, like your gallbladder, liver, pancreas and small intestine and cause inflammation, swelling or infection.
Some of the most common complications are as follows.
Other complications, including those listed here, are much less common but can be more harmful.
If you have one of the complications of gallstones, your doctor will explain any tests and treatments they recommend.
If you have gallstones, you don’t need to follow a special diet unless you identify any foods that trigger symptoms. If so, avoid or cut back on those. Some people find avoiding spicy and fatty foods, caffeine and dairy products helpful. Large and heavy meals may also bring on biliary colic, so you may choose to avoid these.
Being overweight can increase the risk of developing more gallstones but if you need to lose weight, do it gradually. You’re more likely to get gallstones if you fast for long periods or follow a liquid-only or low-calorie diet.
Try to eat a healthy balanced diet. Generally, this means:
avoiding salty foods and those high in saturated fat
Doing more physical activity can help you to stay a healthy weight and is good for your general health.
Not necessarily. You may still have gallstones even if your blood tests and ultrasound scan come back normal.
It depends on the type and size of the stones, and where they’re causing problems. An ultrasound scan may not spot very small gallstones, or those that are in the bile duct. You may need another sort of scan that will show if small stones are inside your bile duct.
Your doctor will explain what’s involved with any tests they recommend, and how they might help in finding the cause of your symptoms.
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