Learning About Gallstones

What are gallstones?

Gallstones are stones that form in the gallbladder. The gallbladder is a small sac located just under the liver. It stores bile released by the liver. Bile helps you digest fats.

Gallstones form when cholesterol and other substances found in bile make stones. They can also form if the gallbladder doesn't empty as it should.

Gallstones can also form in the common bile duct or cystic duct. These tubes carry bile from the gallbladder and the liver to the small intestine.

Sometimes a thick material called "sludge" forms instead of stones. This can cause the same problems as gallstones.

If stones or sludge block a duct, treatment is usually needed.

What happens when you have gallstones?

Most people with gallstones have no symptoms and do not need treatment.

The most common problem caused by gallstones occurs when a gallstone blocks the cystic duct that drains the gallbladder. It often causes bouts of pain that come and go as the gallbladder contracts and expands. The bouts of pain are often severe and steady. Pain can last 15 minutes to 24 hours. Continuous pain for 1 to 6 hours is common. The pain may get worse after a meal. Symptoms usually improve within a few days.

If the pain is severe or if you have had gallbladder pain before, you may need to have your gallbladder removed.

In rare cases, gallstones can cause pancreatitis, an inflammation of the pancreas. Gallstones back up the flow of digestive enzymes made by the pancreas. Pancreatitis may cause sudden, severe belly pain, loss of appetite, nausea and vomiting, and fever.

What are the symptoms?

Most people who have gallstones don't have symptoms. When symptoms occur, they can include:

• Pain in the pit of your stomach or in the upper right part of your belly. It may spread to your right upper back or shoulder blade area.
• Pain that may come and go or be steady. It may get worse when you eat.
• Fever, chills, nausea, or vomiting if a gallstone is blocking a bile duct and causing an infection.
• Yellowing of your skin and the whites of your eyes.

Pain can last 15 minutes to 24 hours. Continuous pain for 1 to 6 hours is common. The pain may begin at night and be severe enough to wake you. Pain often starts after eating food that is high in fat. The pain usually makes it hard to get comfortable. Moving around doesn't make the pain go away.

How can you prevent gallstones?

You can try to reduce your risk of forming gallstones.

• Stay at a weight that's healthy for you. If you need to lose weight, your doctor and a dietitian can help you make a plan. Losing weight too quickly can increase the risk of gallstones.
• Eat a variety of foods that give you the nutrients you need to stay healthy.
• Get 30 minutes of exercise on most days of the week. For many people, walking is a good choice.

How are gallstones treated?

• If you don't have symptoms, you probably don't need treatment.
• For mild symptoms, your doctor may have you take pain medicine and wait to see if the pain goes away.
• For severe pain or infection, or if you have more than one gallstone attack, your doctor may suggest surgery to have your gallbladder removed. The body works fine without a gallbladder.
• If you have small gallstones and can't have surgery, you may be able to try medicines that break down gallstones.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.