Gallstones
The gallbladder is a small organ that sits below your liver. It stores a greenish liquid called bile that the liver produces which it secretes via the bile ducts into your small intestine to help you to digest fats.
Gallstones form when small crystals precipitate in the gallbladder. The most common component of these crystals is cholesterol, which is secreted by the liver. Gallstones can be single or multiple, and can vary in size from that of a salt granule to larger than a golf ball.
Gallstones most commonly cause intermittent pain in the upper abdomen, nausea and sometimes fever. These symptoms are related to biliary colic (cramping because the gallbladder is trying to expel the stones) or cholecystitis (inflammation of the gallbladder) and occur when the gallstones are confined to the gallbladder causing obstruction to the outflow into the bile duct. If a gallstone passes out of the gallbladder into one of the bile ducts, it can cause obstruction of the ducts (obstructive jaundice or cholangitis), or inflammation of the pancreas (pancreatitis).
If you have such symptoms, you will have an abdominal ultrasound to confirm or exclude gallstones.
Cholecystectomy
Cholecystectomy is the procedure used to remove the gall bladder (laparoscopic surgery) in a person with symptoms related to gall stones. Some people have gallstones without symptoms and the gallstones have been discovered incidentally – the decision as to whether they have surgery needs to be made on an individual basis. Occasionally, the gallbladder is removed for other indications such as gallbladder polyps.
Frequently Asked Questions
I had an ultrasound scan of the abdomen for another medical problem. It showed several big stones in my gallbladder. Should I have my gallbladder removed?
About 60% of people with gallstones never have any symptoms and never get sick. They're just like you. Most might never even know they have gallstones. Their stones are discovered by accident during tests for other diseases. If you do start having abdominal pain after fatty meals, indigestion, gas, bloating, or other symptoms, make sure to remind the doctor about the ultrasound scan results.
Two friends went on crash diets and lost a lot of weight really quickly. Within a few months, both developed gallstones and needed surgery. How could dieting cause gallstones?
Rapid weight loss diets and fasting do increase the risk for gallstones. Both tend to increase the amount of cholesterol in bile. The increase occurs as the body burns stored fat tissue. Sometimes, there is so much cholesterol, that it can no longer remain dissolved in bile, so it turns into a solid crystal, which forms gallstones. Dieting and fasting also slow the rate at which the gallbladder squirts bile into the small intestine. With less food to digest, there is less need for bile. Bile remains in the gallbladder longer, and becomes strong, or more concentrated. That also makes it more likely for cholesterol and other dissolved material to form stones.
Will I need to stay on a special diet after having my gallbladder removed?
People can live normally without a gallbladder. Your liver will still make the bile needed to digest fats. After surgery it will flow directly into the small intestine, rather than being stored in the gallbladder. Years ago doctors routinely told patients to avoid fatty foods after surgery. Most no longer make any special dietary recommendations.
Ever since gallbladder surgery, I've had looser bowel movements. I also have bowel movements more often now. Could removal of my gallbladder have caused digestive problems?
Almost 1 in every 3 people have looser and more frequent bowel movements after gallbladder surgery. A few develop more troublesome diarrhoea. Scientists think that gallbladder removal decreases the amount of time that food remains in the large intestine. The large intestine removes water from digested food and stores faeces for elimination from the body. When digested food moves through the large intestine faster, diarrhoea-like symptoms may occur. Often just avoiding certain foods can solve the problem. If not, check with your doctor to see if your digestive problems need treatment.
Why should I have my gallbladder removed when non-surgical treatments are available?
Non-surgical treatments have plenty of disadvantages. One is that they usually are not a permanent cure. Drugs that dissolve gallstones, for instance, must be taken every day for months or years. They work for only certain kinds of gallstones. If you stop the medicine, gallstones usually start to form again. Shockwave therapy can break gallstones into pieces small enough to pass from the body. But it often doesn't work, and patients may have to take drugs for the rest of their life to keep new stones from forming.