Gallbladder Stones

What is the gallbladder and what are gallstones?

The gallbladder is a small sac that sits beneath the liver and stores bile, the fluid the liver makes to help digest fat. Gallstones are solid pieces that form within that bile. They are common, and many people carry them for years without knowing. Trouble starts when a stone blocks the outlet of the gallbladder.

What are the symptoms?

Gallstones cause colicky pain, typically after a meal which is rich in fat (dairy products). The pain can be severe and is frequently confused with heart attack. It is situated below the breast bone and travels to the right, under the ribs and also to the back. Vomiting is a feature and tends to relieve the pain.

How are gallstones diagnosed?

Once the symptoms have been assessed, an ultrasound examination is performed. An ultrasound shows the stones in most cases and is a definitive test. Rarely, an MRI scan or endoscopic ultrasound may be necessary, this decision is best made by a doctor.

Can gallstones cause complications?

Yes, the commonest complications are inflammation or infection of gallbladder which causes continuous pain, pain and jaundice, or infection in bile (cholangitis) and acute pancreatitis (inflammation of pancreas). Less common complications are pus in gallbladder (empyema), gallbladder perforation, bowel obstruction or abscess in the liver.

How are gallstones treated?

The best treatment is to have the gallbladder removed with surgery, ideally the key hole approach (laparoscopic). Whilst awaiting surgery, it is best to maintain low fat diet and avoid food which aggravates the pain.

What happens if nothing is done?

Gallstones that have never caused symptoms can often be left alone and kept under review. Once they have caused pain or a complication, symptoms tend to return, and that is the usual reason surgery is advised. The decision is made case by case, and not operating is always one of the options we discuss.