HealthInfo Waitaha Canterbury
Gallbladder & gallstones
Kouawai me kÅhatu kouawai
Your gallbladder is a small organ that sits near your liver in the right upper part of your tummy (abdomen). It stores bile, a fluid that is made by your liver. Bile is released from your gallbladder into your intestine when you eat to help you digest fat.
Gallstones
Gallstones are common. They form in the gallbladder from bile salts, fat (mainly cholesterol) and calcium. They can range from a single large stone to many small stones. They are more common in women than men and occur more often as people get older.
Most people have no symptoms, and the stones are often only found on a scan arranged for other reasons.
There are a several risk factors for developing gallstones including:
- age
- family history
- being overweight or having rapid weight loss (for example, after stomach reduction surgery)
- diabetes
- pregnancy
- oral contraceptives.
Gallstones cause a problem when they block the gallbladder's exit. This causes a pain called biliary colic, which is the most common problem caused by gallstones.
If the gallbladder gets inflamed due to this blockage, it is called cholecystitis.
Sometimes, the gallstones can move out into the main bile drainage pipe that also drains the liver. This may cause no symptoms at all, but it sometimes causes pain. If there is a complete blockage of the bile duct by a stone, bile can back up into your bloodstream. This can cause a yellowing of your eyes and skin known as jaundice. If there is an infection, it is called cholangitis. This can be life-threatening.
Because the main bile drainage pipe also joins the pancreas drainage pipe, a stone lodged there can upset the pancreas gland too. This is called pancreatitis and can be life-threatening.
Symptoms of gallstones
Most people with gallstones have no symptoms at all.
Biliary colic usually happens after a meal, especially a fatty meal. It usually causes a moderately severe pain in the upper right-hand side of your tummy that may go through or around to your back. It may come and go in intensity and can last for several hours. You may feel bloated and sick (nauseated) or it may make you vomit.
If you develop cholecystitis or cholangitis (with infection), you may have a more steady and severe pain that can radiate to the back or right shoulder. You may develop a fever and have nausea and vomiting.
Diagnosing gallstones
If your general practice team suspects that you may have gallstones, they will refer you for an ultrasound scan. This will show up stones in your gallbladder if they are present. The ultrasound may show a stone in your main bile drainage pipe.
It is not uncommon to find out you have gallstones when you have an abdominal ultrasound or CT scan for another reason.
If you end up in hospital and initial investigations suggest there may be a blocked bile duct, you may have an investigation called an MRCP (magnetic resonance cholangiopancreatography). This is another way to image your gallbladder and bile ducts.
Self-care and reducing the risk of gallstone attacks
There are several things you can do to reduce the chance of having more gallstone attacks.
- Eat well with plenty of vegetables, fruit and wholegrains. There is no special diet for preventing or treating gallstones, but low-fat eating may help to reduce your symptoms.
- Drink plenty of fluids. Water is best.
- Go easy on alcohol. If you drink alcohol keep within safe drinking levels.
- Avoid foods and drinks that make your symptoms worse. It may help to keep a food and symptom diary. You can then avoid your "trigger foods".
- Stay a healthy weight. If you are overweight, it is best to lose weight slowly – up to 1 kg per week. Losing weight quickly can increase your risk of having gallstone attacks.
Treating gallstones
If you have no symptoms from your gallstones, you do not need any treatment. If this is the case for you, your general practice team may suggest following a diet that reduces your chances of forming more gallstones.
If you develop biliary colic, your doctor will give you pain relief medicine. Occasionally, the pain can be severe, and you will need hospital treatment.
If you develop cholecystitis or cholangitis, you will need to be treated in hospital with antibiotics and fluids through a drip. You will be given pain relief as needed.
If you have a gallstone in your main bile drainage pipe, you may undergo an ERCP (endoscopic retrograde cholangiopancreatography). It is a specialised camera test, where an instrument is used to remove the stones.
If doctors decide that you need to have your gallbladder removed, this may be done while you are in hospital, especially if you are unwell. If your symptoms go away while you are in hospital, you may be put on a waiting list to have an elective operation.
The most common operation to remove your gallbladder is a laparoscopic cholecystectomy. This involves removing the gallbladder using keyhole surgery. You have three or four holes made in your tummy (abdomen) and a telescope and light inserted to find and remove your gallbladder. Occasionally (if the operation is more difficult than expected), the surgeon may need to switch to an open operation, which will need a bigger cut. This will give you a bigger scar and you will need a longer recovery time.
If you have your gallbladder removed, you should continue to eat well but do not need to follow a low-fat diet.
HealthInfo recommends the following pages
- Gastroenterological Society of Australia – Gallstones
Information about gallstones including why they form, how they are diagnosed and how they are treated.
- Patient.info:
Information about gallstones, including a useful diagram.
Cholecystitis is inflammation of the gallbladder and is usually caused by gallstones. This page gives more information about causes, diagnosis and treatment.
Written by HealthInfo clinical advisers. Last reviewed July 2022.
Sources
Review key: HIGAL-14121
