Gallstones symptoms and treatment

Gallstones are a common ailment that can lead to severe pain and other complications if left untreated. This article provides an in-depth look, discussing the symptoms of gallstones, the available treatment options, and if it’s possible to live without a gallbladder.

What are gallstones?

Gallstones are solid particles that form in the gallbladder, which is a small, pear-shaped organ located below the liver. The main function of the gallbladder is to store bile, a digestive fluid produced by the liver that helps to digest fats in the small intestine.

Gallstones form when there is an imbalance in the substances in bile, particularly cholesterol and bilirubin, resulting in the formation of solid particles. There are two primary types: cholesterol gallstones and pigment gallstones.

What are the symptoms of gallstones?

Many people with gallstones are asymptomatic, a condition referred to as silent gallstones. However, if the gallstones obstruct the bile ducts, symptoms may arise suddenly. The most common of these is severe, intermittent pain known as a biliary colic, which is often accompanied by nausea or vomiting.

In addition to biliary colic, other symptoms may include jaundice, fever and chills, as well as dark urine and pale stools.

What are the treatment options for gallstones?

Treatment options will depend on the severity of symptoms and the presence of any complications.

Watchful waiting

If gallstones are asymptomatic, your surgeon may recommend a “watchful waiting” approach. This involves regular check-ups and monitoring.

Medications

In some cases, medications can be prescribed to dissolve cholesterol-based gallstones. These medications work by reducing the cholesterol levels in bile, gradually breaking down the stones.

Surgery

The most common and effective treatment for symptomatic gallstones is surgical gallbladder removal. This procedure, called a cholecystectomy, can be performed using two different techniques:

• Laparoscopic cholecystectomy: A minimally invasive surgical procedure that involves making small incisions in the abdomen and using a camera (laparoscope) to guide the removal of the gallbladder. Most people can go home the same day as the procedure or after a short hospital stay, and recovery is usually quick.
• Open cholecystectomy: If the gallbladder is severely inflamed or infected, open surgery may be necessary. This method requires a larger incision and typically results in a longer recovery period.

Endoscopic procedures

If gallstones have migrated into the bile ducts, your surgeon might suggest an endoscopic retrograde cholangiopancreatography (ERCP) procedure. This procedure involves inserting a thin tube through the mouth and into the digestive tract to locate and remove gallstones from the bile ducts, without needing to remove the gallbladder.

Can you live without a gallbladder?

Yes, it’s entirely possible to live without a gallbladder. Following a cholecystectomy, the liver will still produce bile; however, instead of being stored in the gallbladder, the bile will flow directly from the liver into the small intestine.

Some people may experience mild digestive changes, particularly when eating fatty or greasy foods, while the body adjusts to the change. To reduce any digestive discomfort, your surgeon may recommend the following:

• Eating smaller, more frequent meals.
• Gradually reintroducing fatty foods to assess tolerance.
• Staying hydrated and maintaining a high-fibre diet to support digestion.