What causes gallstones?
Most gallstones form when bile contains too much cholesterol. Others form from bilirubin. Risk is higher in women, people over 40, during or after pregnancy, with obesity or rapid weight loss, and in people with a family history of gallstones.
Symptoms
A gallbladder attack, also called biliary colic, happens when a stone blocks the outlet of the gallbladder. Typical features include:
- Steady pain in the upper right or upper middle abdomen, often after a fatty meal or at night
- Pain that lasts from 30 minutes to several hours
- Pain spreading to the back or right shoulder blade
- Nausea or vomiting
- Bloating and indigestion
Talk with Dr. Arsenous about your options.
When symptoms need urgent care
Stones can cause complications such as inflammation of the gallbladder (cholecystitis), a blocked bile duct, or pancreatitis.
Go to the emergency room for pain lasting more than a few hours, fever or chills, yellowing of the skin or eyes, dark urine, pale stools, or severe pain with vomiting.
Evaluation
An abdominal ultrasound is the main test for gallstones and is quick and painless. Blood tests check liver function and signs of infection. In some cases a HIDA scan, CT scan or MRI is used to look at gallbladder function or the bile ducts. Dr. Arsenous reviews these results with you and explains what they mean.
When is surgery considered?
Surgery is usually recommended when gallstones cause symptoms, because attacks tend to come back and complications become more likely over time. Gallstones found by chance that cause no symptoms usually do not need treatment.
The operation is a laparoscopic cholecystectomy, removal of the gallbladder through small incisions. Most patients go home the same day. Medicines that dissolve stones work slowly, only for certain stones, and the stones often return, so they are rarely used.