Gallstones are one of the most common digestive problems seen by general surgeons. Many people have gallstones without knowing it, while others develop severe pain or serious complications.
What are gallstones?
The gallbladder is a small organ beneath the liver. It stores bile, a fluid that helps digest fats. Gallstones form when substances in bile, mainly cholesterol or pigments, become solid and form stones.
Who is at risk?
The chance of developing gallstones may increase with:
- age above 40 years;
- female gender;
- obesity;
- pregnancy;
- diabetes;
- rapid weight loss; and
- a family history of gallstones.
Gallstones can still occur in anyone, including people without these factors.
Symptoms of gallstones
Many people have no symptoms. When symptoms develop, they may include:
- pain in the upper right side of the abdomen;
- pain after eating fatty meals;
- pain spreading to the back or right shoulder;
- nausea and vomiting; and
- indigestion.
When is it an emergency?
Fever with abdominal pain, yellow eyes or skin, severe pain lasting more than several hours, or persistent vomiting may indicate infection or blockage of the bile ducts.
How are gallstones diagnosed?
Ultrasound is the preferred first investigation because it is accurate, safe and painless. Blood tests may also be required if complications are suspected.
Treatment
Gallstones without symptoms often do not require surgery. Surgery may be recommended when gallstones cause pain or complications, depending on the patient’s clinical assessment.
Laparoscopic gallbladder removal
Laparoscopic surgery is widely used because it can offer:
- smaller incisions;
- less pain;
- minimal blood loss;
- earlier recovery;
- a shorter hospital stay;
- a faster return to work; and
- better cosmetic results.
Individual recovery and suitability vary. A surgeon must assess whether this approach is appropriate for a particular patient.
Can medicines dissolve gallstones?
Medicines are useful only in selected patients and are generally much less effective than surgery for symptomatic gallstones.
Reducing the risk
Healthy eating, regular exercise, maintaining an appropriate weight and avoiding rapid weight loss may reduce the risk of gallstones.
If you experience repeated pain after meals, do not ignore it. Early diagnosis and timely medical assessment can help prevent serious complications.