By Thomas Strigle, MD
General Surgery
Surgical Associates of Northwest Ohio
Gallstones are precipitations (collections) of bile that form into stones that range in size from sand crystals to golf balls.
They usually form in the gallbladder which is a sac-like organ sitting beneath the liver on the right side of the abdomen. The gallbladder’s purpose is to store the bile that the liver creates.
Bile travels through ducts to empty into the intestine and helps digest the fatty foods we eat. Gallstones occur from an unbalanced collection of cholesterol, lecithin and bile salts in the bile.
Some diseases can also cause gallstones such as sickle cell anemia. About 10 percent of the population (25 million Americans) have gallstones.
Unfortunately, the gallstones can block the outlet of the gallbladder or ducts, giving rise to inflammation and infection of the gallbladder, liver, bile ducts or pancreas. Rarely do gallstones cause gallbladder cancer, which is rare in the first place.
Usually, only symptomatic gallstones need to be treated. Asymptomatic gallstones are typically watched and observed.
Gallstones can cause moderate to severe pain on the right upper portion of the abdomen as well as below the breastbone at the top of the stomach. The pain can go to the right shoulder or to the back.
They can be associated with nausea, vomiting, belching and even sometimes jaundice. They are predominately found in females (65%). Other risk factors are being over 40 years of age, being overweight, having a sedentary lifestyle, undergoing rapid weight loss, being pregnant, using female hormones, as well as having a family history. Gallstones are commonly diagnosed with an ultrasound though other modalities can be used as well.
Treatment usually requires the removal of the gallbladder (cholecystectomy). The body still functions well since the liver can make an abundant supply of bile to help with digestion.
Occasionally after gallbladder surgery, people can have looser stools. This usually resolves over time but can be treated with medicine. A cholecystectomy is performed most of the time using a laparoscope thru small incisions.
This generally allows patients to go home the same day and recover faster. Gallstones blocking the ducts may require an endoscopy (scope down your throat) to remove the stones as well. Some gallstones can be treated with medicine if the patient is not a surgical candidate, but it can take months or up to a year to dissolve the stones with a frequent recurrence rate.
Prevention of gallstones includes maintaining a healthy weight, regular meals and exercise, a high fiber diet with less red meat and if overweight a slow weight loss. If you have any questions or concerns about your gallbladder you should have a discussion with your primary care provider about it.
