Health Society of South Africa

GALLSTONES
Finding relief for an uncomfortable problem

Who Gets Gallstones?
Anyone can have gallstones. But some people are more likely to get them:

Women, especially those who have been pregnant
People of American Indian or Hispanic descent
People who are overweight
People who have lost weight quickly
Women who have taken oestrogen birth control pills or hormone replacement therapy (HRT)
People who eat a high-fat diet

Common symptoms
Symptoms of gallstones range from none at all to disabling pain. Common symptoms include the following:

Mild to severe pain in the upper abdomen
Frequent stomach upset, burping or bloating
Fever, nausea, or vomiting
Jaundice (a liver problem that makes the skin yellow)

How Gallstones Form
The gallbladder stores bile, a fluid made by the liver. Ducts carry bile to the small intestine, where bile helps digest fat. If the chemicals making up bile become unbalanced, gallstones can form. When stones remain in the gallbladder, you may or may not have symptoms. If stones move out of the gallbladder, they can cause pain or infection.

Your Evaluation
Gallstones may be found on x-rays done for other reasons. Or, your symptoms may lead your doctor to suspect gallstones. Your doctor will assess your health history and do a physical examination to be sure your symptoms are from gallstones. You may also have some tests.

Possible tests
Ultrasound uses sound waves to create a picture of the gallbladder and ducts.
X-rays may be used to take pictures of the gallbladder and ducts.
ERCP (endoscopic retrograde cholangiopancreatography) is a procedure using an endoscope (a lighted tube that projects a video image). It can locate stones or other blockages in the common bile duct.
Other tests, such as blood tests and electrocardiograms (ECGs), may be done to rule out other health problems.

Treating Gallstones
Gallstones are treated only if you have symptoms. Sometimes your doctor may simply want to monitor your condition. Other types of treatment include medication, ERCP and surgery.

Medication can be taken orally, to dissolve some kinds of small stones. But it takes time for the medication to take effect. Stones may return. Medication is most useful for people who cannot have surgery.

ERCP uses a thin tube with video and x-rays to locate stones and remove them from the common bile duct. ERCP may be done alone. Or it may be followed by surgery to remove the gallbladder.

Surgery is often done to remove gallstones and the gallbladder:
Laparoscopic cholecystectomy uses small incisions to locate and remove the gallbladder.
Cholecystectomy uses a larger incision to remove the gallbladder and is more effective for removing stones in the ducts.

Prevent Future Symptoms
Once gallstones are dissolved or removed from the ducts, you may be able to prevent them from returning. How? By eating a low-fat diet. This means limiting your use of high-fat meat and dairy products and vegetable oils. Also, read labels on prepared foods to be sure they're low in fat.

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