Gallstones are solid deposits that develop inside the gallbladder, which can lead to severe pain and/or block your bile duct.

A medical diagram showing gallstones

The gallbladder makes up part of the digestive system by storing bile, a digestive fluid, and then releasing it into the small intestine. Gallstones occur when hardened material forms within the organ. 

Ranging in size from as tiny as a grain of sand to several centimetres across, there are two types of gallstones, distinguished by their composition: 

  • Cholesterol gallstones (composed mainly of cholesterol) 
  • Pigment gallstones (comprising largely of bilirubin, a chemical made in the breakdown of aged red blood cells)

The causes of gallstones are not fully understood but it’s thought that diet, genetics and body weight play a part. They are also more common in women.

What are its symptoms?

It’s not unusual for symptoms of gallstones to be absent – often they are only discovered accidentally during another procedure. 

However, if a gallstone manages to become lodged in a duct, symptoms may develop, including:

  • Sudden, intense pain in the right upper half of the abdomen or sometimes in the centre of the abdomen, lasting at least half an hour. It may be experienced as a sharp pain or a dull ache and may either come in cramps or be constant
  • Nausea and vomiting
  • Pain below the right shoulder or between the shoulders (known as “referred pain”)
  • If gallstones are present in the bile duct (a condition called choledocholithiasis), jaundice may be a symptom.

How is it diagnosed? 

Diagnosis of gallstones usually relies on imaging tests such as ultrasound or CT (computerised tomography) scans of the abdomen to create a picture of the gallbladder and its surrounding structures that can then be analysed for gallstones and signs of inflammation. 

The bile ducts can be highlighted on imaging tests using a special dye, showing if there are any blockages present. Your doctor may also order blood tests to search for signs of infection, jaundice or other possible complications.

What are your treatment options? 

In cases where gallstones are asymptomatic, medical intervention is not necessary. Your doctor may simply caution you to be aware of the signs of possible complications. 

Treatment for gallstones showing symptoms may involve either medication taken orally to dissolve the stones or a surgical procedure called a cholecystectomy, which removes the gallbladder entirely. 

Treating gallstones with medication can take months, so usually this route is reserved for those who are not suitable candidates for surgery. 

In most people, the removal of the gallbladder has no negative consequences later on because the liver simply releases bile directly into the small intestine.

Can it be prevented? 

The key to gallstone prevention is minimising those risk factors that medical science has been able to pinpoint. This means staying within a healthy weight range or losing weight if you are overweight. 

However, rapid weight loss has also been identified as a potential risk factor, so take it slowly. Diets high in fat and cholesterol and low in fibre may also increase your risk of developing gallstones, so talk to your doctor or dietician for guidelines on the best eating plan to follow.

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in June 2016