What are gallstones?

Gallstones

Gallstones are stones that form in the gall bladder. This is a small pear-shaped organ, situated on the right side of the abdomen, just under the liver and the ribs. Its function is to store bile, which is made in the liver and needed to digest fat.

What causes gallstones?
Gallstones form when excess cholesterol in the bile forms crystals in the gall bladder. The gall bladder may also empty too slowly, causing the crystals to stagnate. Stones may also contain calcium and bile salts.

Who is at risk?
Although anyone can get gallstones, they are more common in older people and approximately 10% of people over the age of 40 have them. Women are particularly at risk during pregnancy, or if taking oral contraceptives or hormone replacement therapy.

What are the symptoms?
Most people with gallstones have no symptoms. Symptoms occur when a stone gets lodged in the duct leading from the gall bladder to the bowel. Common symptoms include:
· Severe pain just below the ribs on the right-hand side. This may radiate to the back between the shoulder blades or to the right shoulder.
· Pain triggered by eating fatty foods.
· Nausea and vomiting, sometimes accompanied by flatulence.
· Jaundice may be present, but this is unusual in the absence of other symptoms.

How are gallstones diagnosed?
An ultrasound scan of the abdomen will usually diagnose gallstones. Sometimes, however, special x-rays using contrast media may be required.

How are gallstones treated?
If the stones are not causing any problems no treatment is necessary. Symptoms can often be controlled by a low-fat diet. If, however, symptoms do not improve or there are signs of infection in the gall bladder, surgery may be necessary. Usually this will entail removal of both the stones and the gall bladder either by key-hole or conventional surgery. In elderly people or people unfit for surgery it may be possible to dissolve the stones or break them up using ultrasound (a technique called lithotripsy).

Following removal of the gall bladder, most people find they are able to eat a normal diet without problems.

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