Is it gallstone disease?

Most gallstones remain confined to the gallbladder and do not produce symptoms. But if you are experiencing unusual abdominal pain, it could indicate gallstone disease. The most typical symptom of the condition is a severe steady pain – lasting from 15 minutes to several hours – in the upper abdomen or right side, and sometimes between the shoulder blades or the right shoulder. Patients may also experience vomiting or sweating. Attacks of gallstone pain may be separated by weeks, months or even years.

Why does it hurt?

It is thought that gallstone pain results from blockage of the gallbladder duct (cystic duct) by a stone. When the blockage lasts more than several hours, the gallbladder may become inflamed. This condition, called acute cholecystitis, may lead to fever, prolonged pain and eventually infection of the gallbladder. Hospitalization is usually necessary for observation, treatment with antibiotics and pain medications, and frequently for surgery.

Is gallstone disease dangerous?

More serious conditions may occur when a gallstone passes out of the gallbladder duct and into the main bile duct. If the stone lodges in the main bile duct, it can lead to a serious bile duct infection. If it passes down the bile duct, it can cause an inflammation of the pancreas, which has a common drainage channel with the bile duct. Either situation can be extremely dangerous. Stones in the bile duct usually cause pain, fever, and jaundice (yellow discoloration of the eyes and skin). Patients with these symptoms should immediately seek treatment.

How do I treat gallstone disease?

Many new approaches to symptomatic gallstone treatment have been tried over the past several years, but surgical removal of the gallbladder (cholecystectomy) remains the most widely used therapy.

Laparoscopic cholecystectomy, used for about 80 percent of all cholecystectomies in the United States, is a technique whereby the surgeon makes several one inch incisions in the abdomen through which a tiny video camera and surgical instruments are passed. Because the abdominal muscles are not cut, patients experience less postoperative pain, quicker healing and better cosmetic results. Patients are typically able to go home from the hospital within a day and resume normal activities within a few days.

When laparoscopic cholecystectomy is not an option because of complications such as a severely inflamed gallbladder, the surgeon removes the gallbladder through a five- to eight-inch incision. This method, known as the open procedure, has been performed for over 100 years and is quite safe, although it usually requires four or five days of hospitalization and several weeks of at-home recuperation.

Can I manage without a gallbladder?

Patients generally do well after surgery and have no difficulty digesting food, even though the gallbladder’s function is to aid digestion.

If you’re suffering from symptoms of gallstone disease, I encourage you to see your physician for a proper diagnosis. Delayed treatment may cause more serious conditions and the need for open surgery rather than the less invasive laparoscopic procedure.

The gallbladder is a storage tank for bile produced in the liver until the body needs it for digestion. Problems occur when the bile hardens into little pebble-like substances called gallstones and block the release of bile into the digestive system. Gallstones can be as big as a golf ball or as small as a grain of sand. Many people with gallstones don’t even know they are there.

When gallstones block the bile ducts, pressure increases in the gallbladder and may result in a gallbladder “attack.” An attack may follow a “fatty” meal, causing pain in the abdomen or in the back either between the shoulder blades or under the right shoulder.

Sometimes the pain subsides after an “attack” because the gallstone has moved. However, infection and rupture can still occur. People with prolonged pain; nausea and vomiting; fever or chills; yellowish coloration of the skin or eyes; or clay-colored stools should see a doctor immediately.

Over one million patients are diagnosed with gallstones each year. The good news is that the gallbladder is one organ you can live without, and surgery to remove the gallbladder is one of the most common surgeries performed on adults in the United States. It can often be done on an outpatient basis and may be performed laparoscopically, or with tiny incisions through the abdomen.

Although anyone can develop gallstones, the following tips can help prevent gallstones or their recurrence once treated.

• Don’t avoid eating or fast. Eating at least three balanced meals each day helps prevent the build-up of bile.
• Watch your diet. A diet that is high in fiber and calcium and low in saturated fats helps prevent the formation of gallstones.
• Maintain your target weight. Obesity increases your risk for gallstones, but so does rapid weight loss. Strive for an overall health plan to achieve a normal weight for your age and height.

Because gallstone symptoms may be similar to those of a heart attack, appendicitis, ulcers, irritable bowel syndrome (IBS), pancreatitis and hepatitis, an accurate diagnosis is very important. Don’t let this little problem become a big issue.