Gallstones

What are gallstones?

The liver makes bile, a substance that helps to digest fats. If the bile has too much cholesterol, small particles called gallstones form. The stones may be in the gallbladder or bile ducts. The gallbladder is a small sac that lies under the liver and is part of the digestive system. Bile ducts are small tubes that drain bile from the liver into the gallbladder and small intestines.

Biliary colic is the medical term for the extreme cramping pain caused by gallstones. The formation of gallstones in the gallbladder is called cholelithiasis.

How does it occur?

You are more likely to have gallstones if:

• You are female.
• You are overweight.
• You have type 2 diabetes.
• You are Native American.
• You have sickle cell anemia.

What are the symptoms?

Symptoms include:

• pain in your upper abdomen or back, or on the right side of your chest
• stomach pain or nausea after meals, especially after eating heavy or high-fat meals.

The pain may be mild or severe. It may last a few minutes or an hour or more. You may have nausea with the pain. The pain may spread from your chest or abdomen to your right shoulder or back.

How is it diagnosed?

Your health care provider will review your symptoms, ask about your medical history, and examine you. He or she may use the following tests:

• abdominal x-rays
• oral cholecystogram (OCG)
• ultrasound scan
• CT scan
• HIDA scan.

Not all gallstones show up on regular x-rays. The OCG is a special type of x-ray using a dye that you swallow. It is a common way to look for stones and to see if the gallbladder is working properly. Ultrasound can most often show whether stones are present. HIDA scans, which use an injection of radioactive dye, show whether the gallbladder is blocked and inflamed and therefore the cause of pain.

How is it treated?

Gallstones causing mild pain may first be treated with a low-fat diet. Your health care provider may also prescribe pain relievers.

Usually gallstones are treated with surgery to remove the gallbladder. Removal of the gallbladder should cause few, if any, long-term problems because the digestive system can function normally without it.

In some cases, especially if you are not well enough to have surgery, other treatments may be tried. For example, your health care provider may try to dissolve the stones with medicine. Sound waves have also been used to try to break up gallstones. With either of these methods, the stones may return.

How long will the effects last?

The pain caused by gallstones usually continues until the stones are removed.

How can I take care of myself?

To take care of yourself during and after treatment, follow these guidelines:

• Follow the treatment plan prescribed by your health care provider.
• Lose weight if you are overweight and then maintain a normal weight with a healthy diet and physical activity.
• Reduce the amount of fat, especially animal fat (meat and dairy), in your diet.
• Eat healthy foods that are high in fiber, such as whole grains, fresh fruits, and vegetables.
• Avoid foods that have caused pain or nausea in the past.

If you have gallstones and are taking birth control pills, you may want to ask your health care provider if you should use another method of birth control.

What can be done to help prevent gallstones?

To prevent gallstones, follow these guidelines:

• Avoid foods high in fat.
• Read the labels on food packages to learn the ingredients.
• Avoid fasting. Long periods of fasting can cause gallstones because the bile stays in the gallbladder too long.
• Maintain a normal weight with a healthy diet and physical activity.