Gallstones are one of the most common reasons patients are referred to a surgical gastroenterologist. Many people carry gallstones without knowing it, while others experience pain that brings them to a doctor for the first time. This article explains what gallstones are, why they form, how they're diagnosed, and when surgery is typically recommended.
What Are Gallstones?
The gallbladder is a small, pear-shaped organ beneath the liver that stores and concentrates bile, a fluid that helps digest fat. Gallstones are hardened deposits that form inside the gallbladder when substances in bile — usually cholesterol or bilirubin — crystallize. They can range from as small as a grain of sand to as large as a golf ball, and a person may have one stone or several.
Common Causes and Risk Factors
Gallstones form when bile contains too much cholesterol or bilirubin, or when the gallbladder doesn't empty completely or often enough. Several factors are associated with a higher likelihood of developing gallstones, including:
- Being female, and increasing age
- Obesity or rapid weight loss
- A diet high in fat or cholesterol and low in fibre
- A family history of gallstones
- Certain underlying medical conditions affecting the liver or blood
Symptoms to Watch For
Many gallstones cause no symptoms at all and are found incidentally on a scan done for another reason. When symptoms do occur, they typically include:
- Sudden, intense pain in the upper right or centre of the abdomen, often after a fatty meal
- Pain that spreads to the right shoulder or back
- Nausea or vomiting
- Bloating or indigestion
If a stone blocks a bile duct, it can cause more serious symptoms such as jaundice (yellowing of the skin or eyes), fever, or persistent severe pain — these require urgent medical attention.
How Gallstones Are Diagnosed
An ultrasound scan of the abdomen is usually the first and most reliable test to detect gallstones. Blood tests may also be used to check liver function and look for signs of infection or bile duct blockage. In some cases, additional imaging is used to assess the bile ducts more closely before planning treatment.
Treatment Options
Not every gallstone requires treatment. Stones that are not causing symptoms are often simply monitored. When gallstones are causing recurrent pain or complications, surgical removal of the gallbladder — a procedure called cholecystectomy — is the standard treatment.
Today, this is most commonly performed as a laparoscopic cholecystectomy, using small incisions and a camera rather than a single large incision. This minimally invasive approach is suitable for the majority of patients and, depending on the individual case, may offer benefits such as a smaller scar and a potentially shorter recovery compared with open surgery. If a stone has also moved into the bile duct, a related procedure — laparoscopic common bile duct exploration — may be required to clear it.
Living Without a Gallbladder
The gallbladder is not an essential organ. After it is removed, bile flows directly from the liver into the intestine instead of being stored first. Most people adjust to this without significant dietary restriction, though some may notice mild changes in digestion, particularly with very fatty meals, in the initial period after surgery.
The right time to treat gallstones depends on the individual — the presence of symptoms, stone size, and overall health all factor into that decision.
If you have been told you have gallstones, or are experiencing symptoms that concern you, a consultation can help clarify whether treatment is needed and what approach is most suitable for your situation.
Leave a Comment