What are Gallstones?

Gallstones are pebble-like deposits that form in the gallbladder. The gallbladder is a small, pear-shaped sac in the right upper part of abdomen just below the liver. Gallbladder stores liquid called bile (it helps the body digest fats). Bile is made in the liver, the transported through ducts and stored in the gallbladder until the body needs it. When the bile hardens into pieces of stone-like material gallstones are formed. The size of the gallstones can vary from as small as a grain of sand or as large as a golf ball

The two types of gallstones that are formed in the gallbladder are:

• Cholesterol stones—these are yellow-green in colour and are made primarily of hardened cholesterol. They are the most common types of gallstones (about 80 percent of gallstones).
• Pigment stones—these are dark stones made of bilirubin

Symptoms of gallstones

Gallstones do not cause symptoms in everyone who has them. According to estimates about eight in 10 people with gallstones have no symptoms and hence are not aware that they have gallstones.  They cause symptoms if stone blocks the flow of bile out of the gallbladder or it gets caught in ducts that carry bile from the liver to the small intestine.

Sites where the gallstone can get stuck include:

• Hepatic ducts—the duct which transports bile out of the liver.
• Cystic duct—the duct carries bile to and from the gallbladder.
• Common bile duct—the duct that collects bile from the cystic and hepatic ducts and carries it to the small intestine.
• Pancreatic duct –the duct that carries digestive enzymes from the pancreas to the intestine.

Acute pain the abdomen is a common presentation of gallstones. The pain usually starts after eating a heavy fatty meal, and may occur during the night. Other symptoms which may be associated with pain in biliary colic are:

• feeling unwell
• nausea and vomiting
• bloating sensation of the abdomen
• passing excessive gas and belching
• profuse sweating.

Some people with gallstone disease may have repeated episodes of abdominal pain, indigestion, feeling unwell, nausea and vomiting, bloating sensation of the abdomen and passing excessive gas and belching.

Treatment

Treatment of gallstones is decided based on if you have or do not have symptoms. If you have no symptoms, then treatment is not needed. Treatment for people with symptomatic gall bladder disease includes:

• Cholecystectomy (surgical removal of the gallbladder)
• Medications such as ursodeoxycholic acid
• Lithotripsy

Cholecystectomy is the curative treatment for gallstones. After a first attack of gallstone pain (which was mild and not associated with complications such as blocked bile duct) the doctor may recommend watchful waiting. If you have severe symptoms or any symptom suggestive of complication then you will be advised surgery (if there are no contraindications for it).