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Gallstones
Medical Questions » Gallstones
| Name: Gallstones |
| Also known as: Biliary Colic; Cholelethiasis |
| The development of one or more stones in the gall bladder. |
Causes of Gallstones
The liver produces bile which is stored in the gall bladder. Bile is required to help in the digestion of food, and when this is required in the gut, the gall bladder contracts to squeeze out the bile. If the bile becomes too concentrated it may precipitate out as a stone. Up to 10% of men over 60 years of age, and 20% of women over 60 have some gallstones. |
Symptoms of Gallstones
Larger stones block the bile duct, and when the gall bladder contracts with eating, the movement of the stone in the duct causes severe intermittent pain (colic) in the upper right side of the abdomen. The pain can also be felt in the back at the lower end of the shoulder blade. Indigestion, burping and passing wind rectally (farting), are common. If the stone becomes stuck, constant severe pain results, and an emergency operation is required to clear it. |
Tests for Gallstones
The presence of gallstones is confirmed by an ultrasound scan, or special X-rays (cholecystograms) taken after a dye which concentrates in the bile has been swallowed or injected. In difficult cases, X-rays of the gall bladder can be performed by passing a gastroscope into the small intestine and then injecting dye through the opening into the bile duct (endoscopic retrograde cholecystopancreatography — ERCP). Blood tests to check liver function are usually normal unless a gallstone is blocking the bile duct and preventing waste products leaving the liver. |
Treatment for Gallstones
A low fat diet will reduce demands on the gall bladder for bile and reduce painful spasms. Most effective treatment is surgery to remove the gall bladder. The operation can be performed by open exposure of the gall bladder or by laparoscopic surgery. If stones are very low in the common bile duct they may be removed by an instrument that is passed through the mouth and stomach into the intestine (an endoscope). Patients who are too ill for an operation may use a drug that slowly dissolves some gallstones over many months. Lithotripsy is a treatment in which the stones are shattered by a high-frequency sound wave, but it is only suitable for a small number of cases.
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Complications of Gallstones of its treatment
Infection of the gall bladder (cholecystitis) when its drainage is blocked by a stone. The patient is feverish, nauseated and in constant pain. In extreme cases, an infected gall bladder will rupture and cause peritonitis. |
Likely Outcome of Gallstones
Surgery is completely successful in the vast majority of patients. |
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