Gallstones

Overview

Depending on the composition of the blood, stones can form in the gallbladder over time. Most patients don't have any symptoms, but pain can occur in the right upper abdomen, in particular after meals. Preventive measures include a balanced diet and sufficient exercise.

Symptoms

Main symptoms

Around one-quarter of people with gallstones have the following symptoms (the rest don't have any symptoms).

• Pain in the right upper abdomen
  • In particular after eating greasy or fatty foods
• Feeling of fullness, bloating
• Nausea, vomiting
• Intolerance to fatty foods
  

Complications

• Gallstone colic: a stone enters the bile duct
  • Attacks of severe stabbing pain that waxes and wanes
  • Jaundice
  • Pancreas inflammation
• Gallbladder inflammation
  

Causes and treatment

Causes

• Changes to composition of blood: bile is formed from several components. If there is too much of one, a stone will form (precipitation).
  • Cholesterol (often)
  • Calcium carbonate
  • Bilirubin

Risk factors:

Statistically speaking, women suffer more frequently from gallstones.

• Imbalance in cholesterol metabolism
• Obesity
• Improper nutrition (not enough fibre, large quantities of carbohydrates)
• Fasting, losing weight quickly
• Age > 40 years
• Pregnancy
• Family members with gallstones
• General disorders (e.g. Crohn’s disease, ulcerative colitis, cystic fibrosis, sickle cell anaemia)
  

Further treatment by your doctor / in hospital

Possible tests

• Ultrasound (sonography)
• Blood test
• MRI (magnetic resonance imaging)
• CT scan (computed tomography)
• Biliary tract endoscopy via the stomach and small intestine (ERCP)
  

Possible therapies

• Change in diet, sufficient exercise
• Antispasmodic painkillers
• Antibiotics (for bacterial infections)
• Operation (removal of gallbladder)
  • Sometimes gallstones can be removed during a biliary tract endoscopy

What can I do myself?

• Balanced, high-fibre, low-fat diet
• Weight control and sufficient exercise
• For pain: warmth and exercise, possibly antispasmodic painkillers
  

When to see a doctor?

• Repeated cramping pain in the upper abdomen (in particular after meals)