Information From Your Health Care Provider

GALLSTONES

(Cholelithiasis)

Basic information

description

Gallstones are hard objects (stones) that form in the gallbladder and its ducts. The gallbladder is a body organ that stores bile. Gallstones affect young people and adults, and are more common in women.

FREQUENT SIGNS & SYMPTOMS

No symptoms in about 40% of cases.
Sharp pain in the upper-right stomach area, between the shoulder blades, or in the right shoulder.
Nausea, vomiting, bloating or belching.
Fever (sometimes).
Fatty foods cause indigestion.
Jaundice, which causes yellow skin and eyes.

causes

Bile is a liquid made by the liver and stored in the gallbladder. Its use in the body is to help with digestion. Gallstones form when substances in the bile liquid harden. This may be due to too much cholesterol or bilirubin, or not enough bile salts, or the gallbladder not emptying as it should. Stones may be small like a grain of sand or as large as a golf ball. There may be one or hundreds of tiny stones.

risk increases with

People over age 60 and women more than men.
Disorders such as cirrhosis of the liver, blood disorders, Crohn's disease, cystic fibrosis, sickle-cell anemia, biliary tract infection, or high levels of triglycerides.
Stomach reduction surgery.
Some ethnic groups are more likely to have gallstones (e.g., Hispanics and Native Americans).
Overweight.
Diabetes.
Too much estrogen in the body. It may be from pregnancy, birth control pills, or hormone replacement.
Rapid weight loss or fasting.
Drugs that lower cholesterol can actually increase the cholesterol in the bile, which can lead to gallstones.

PREVENTIVE MEASURES

There are no specific preventive measures.

expected outcomes

Gallstones that cause no symptoms can safely be left alone. They are unlikely to cause problems. For those who do have symptoms, treatment is available.

possible complications

A stone becomes lodged in a duct. Ducts are tubes that carry bile to and from the gallbladder. A lodged stone can cause serious problems with the gallbladder, pancreas, or liver.
Gallstones may recur if treatment does not include removing the gallbladder.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms. Medical tests may include blood tests and an ultrasound, which can detect the stones by sound waves. Other tests may be done to confirm the diagnosis or check for complications.
There are several ways to treat gallstones that are causing symptoms. They include surgery, shockwave treatment, and sometimes drugs or diet changes.
Some people try diet changes to help symptoms. This may work for a while, but not permanently.
Cholecystectomy is surgery to remove the gallbladder. For most people, this will relieve the symptoms. Surgery options include:
- Laparoscopic procedure. This procedure uses tiny incisions through the skin and a special instrument to remove the gallbladder.
- Open surgery. A more serious procedure that requires a longer incision to remove the gallbladder.
Less often, treatment involves shockwave (lithotripsy) to break up (shatter) the stones or chemicals passed into the gallbladder via a catheter to dissolve the stones.
To learn more: National Digestive Diseases Information Clearinghouse, 2 Information Way, Bethesda, MD 20892; (800) 891-5389; website: www.digestive.niddk.nih.gov.

medications

Less common treatment is the use of drugs taken by mouth to dissolve stones. It is used for certain types of stones and can require up to 2 years to be effective.

activity

You will be advised of limits depending on the type of treatment. Get extra rest while you recover.