Learning About Gallstones

What are gallstones?

Gallstones form when cholesterol and other substances in the bile make crystals that become hard stones in the gallbladder. The gallbladder is a small sac located just under the liver that stores bile, a fluid that helps the body digest fats. Gallstones also can form in the bile duct. This is the tube that carries 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 don't need treatment.

The most common problem caused by gallstones occurs when a gallstone blocks the cystic duct that drains the gallbladder. It often causes pain that comes and goes as the gallbladder contracts and expands. The pain is often severe and steady. Pain can last from minutes to hours. Continuous pain for several hours is common. The pain may get worse after a meal. The pain is usually in the right upper belly. Or it may be felt in the right shoulder or spread to your back or shoulder blade area. Symptoms usually improve within a few days.

You may need to have your gallbladder removed if the pain is severe with other symptoms (such as nausea, vomiting, a fever, or yellow skin or eyes) or if you've had gallbladder pain before.

Sometimes 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 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.
• Pain that often starts after you eat food that's high in fat.
• Fever, chills, nausea, or vomiting if a gallstone is blocking the bile duct and causing an infection.
• Yellowing of your skin and the whites of your eyes.

Pain can last from minutes to hours. Continuous pain for several hours is common. The pain may begin at night and be severe enough to wake you. 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 heart-healthy foods. These foods include vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit high-fat foods, sodium, alcohol, and sugar.
• Be as active as you can every day. For many people, walking is a good choice. Or you may want to swim, bike, or be active in other ways. Housework and yard work count too.

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 contact 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.