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Gallstones

Gallstones are solid formations of bile that sit in the gallbladder. They don’t always cause symptoms, but when they do, they can be painful and sometimes lead to an infection.

  1. Gallstones are asymptomatic in most cases
  2. Occur due to a chemical imbalance in bile
  3. Can result in the removal of the gallbladder

It may not be easy to notice if you have gallstones, as it will only produce symptoms in around a third of cases. However, if you feel unwell or have severe pain in the abdomen, it could be a sign. If you are unsure or concerned that you may have gallstones, you can speak to one of our UK doctors using our online video consultation service.

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Description

What are gallstones?

Gallstones occur when small crystals form in bile, and develop into stones. When these stones move and block the bile ducts, it can cause pain and inflammation, and in some cases lead to an infection. It’s fairly common for people to have gallstones and not require treatment due to an absence of symptoms, but symptomatic cases should be seen by a doctor. 

Cholecystolithiasis refers to the presence of gallstones in the gallbladder, whereas choledocholithiasis refers to the presence of gallstones in the bile duct. In symptomatic cases, they can lead to jaundice (where the skin and eyes become yellow), inflammation of the pancreas and severe abdominal pain.

Gallstones form when a chemical imbalance develops in bile fluid. Bile is a substance produced by the liver to help us digest food. It is stored in the gallbladder, before passing through the bile ducts to the intestine. It’s when levels of cholesterol or bilirubin, which is a waste product from the blood, become too high in bile that small crystals form. These crystals may then grow into stones. 

Who gets gallstones?

There are several risk factors for developing gallstones. Obesity is a prevalent factor, and the condition is more likely to occur as we get older. It’s also more common in women who have had children.

Infections caused by gallstones are usually treated with antibiotics. When gallstones cause persistent problems, such as inflammation of the gallbladder, surgery to remove the gallbladder is an option, as the gallbladder is not required for the storage of bile. Once it’s removed, bile will still flow from the liver but it will not be stored anywhere, and flow into the gut. 

What complications can gallstones lead to?

If gallstones do result in problems and aren’t treated, they can cause further issues. Biliary colic is a common complication of gallstones, and it’s due to a gallstone obstructing the bile duct that drains the gallbladder. It’s a regular occurrence for people with gallstones and by far the most common complication. After biliary colic, acute cholecystitis is the second most common complication, and refers to an inflammation and infection of the gallbladder. This is usually due to an obstruction of the cystic duct. Jaundice can also occur when the bile duct becomes blocked, which allows bile to enter the bloodstream. This occurs when a stone moves from the gallbladder to one of the bile ducts.

People who have stomach pain or discomfort and would prefer to speak to a doctor online can do so quickly and easily, with our secure video consultation service. Click below to book an appointment at a time that suits you.

Page last reviewed:  15/06/2020
Diagnosis and treatment

What are the causes of gallstones?

Gallstones occur when the chemical makeup of bile changes. Bile is a substance the gallbladder stores and the body uses to help digest food. When there is too much cholesterol or bilirubin (a waste substance) in bile, it causes small crystals to form. These crystals can then grow, and turn into gallstones.

Gallstones don’t always cause symptoms, and it’s thought that about 10% of the UK adult population has them. But when they do, it’s called cholelithiasis. This occurs when the stones block small tubes that lead out from the gallbladder called bile ducts. It’s characterised by abdominal pain, jaundice and sometimes a fever. 

The presence of gallstones can also lead to infection of the gallbladder, when waste products become trapped (because they can’t exit through the bile ducts) or an inflamed gallbladder (known as cholecystitis). 

How are gallstones diagnosed?

Someone experiencing any of the above symptoms should see a doctor. They will feel your stomach for signs of tenderness, and also take into account any factors that increase your risk. For example, obesity and metabolic syndrome can often be contributing characteristics.

Will I need tests?

Typically, yes. An abdominal ultrasound may be able to confirm if a gallstone is present in the gallbladder. Tests to assess liver function will also be undertaken. This involves a full blood count (FBC) and liver biochemistry tests. If you have inflammation, this will show up in your results. Some people may also be sent to have an endoscopy, however this is less common as it cannot always detect smaller stones.

How are gallstones managed?

They’ll normally only need treatment if they’re causing problems.

Where treatment is required, gallbladder removal through keyhole surgery is usually the recommended course of action. This involves making a number of small cuts in the abdomen and using very thin equipment to take out the gallbladder. The procedure is known as a laparoscopic cholecystectomy. It’s conducted in a hospital under general anaesthetic.

Page last reviewed:  15/06/2020
Questions and Answers

How are gallstones treated?

Gallstones are either left alone and monitored (in the event that they become symptomatic), or they can be treated with surgery if they are causing problems. Some people may have gallstones for the duration of their lives, without any need for treatment. 

When gallstones do cause issues however, gallbladder removal surgery is an option. Keyhole surgery is the most common way to remove the gallbladder. The specific procedure is called a laparoscopic cholecystectomy. It involves making small incisions in the abdomen and inserting a small camera, which allows a surgeon to see the gallstones. The gallbladder is then removed with very small instruments. 

How long will it take for me to recover?

Most people will be able to recover and return to normal activities within two weeks of the operation, if it is done by keyhole surgery. Open procedures require longer periods of recuperation. Usually, you can follow a normal diet relatively soon after your operation, but you should avoid heavy lifting until your surgery site has completely healed.

Can I consult a doctor about gallstones online?

It’s advisable to speak to a clinician if you think you may have gallstones. Book an appointment for our online private video consultation service at a suitable time for you. Our doctors will be able to discuss your symptoms with you, and refer you to a specialist for further examination where required.

Page last reviewed:  15/06/2020

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