4 Things You Should Know About Gallstones

Do you have severe abdominal pain? You could have gallstones. Learn more about the signs and symptoms.

Tucked beneath your liver, the gallbladder is a seemingly inconsequential organ that stores bile from your liver. When this bile passes to your small intestine, it helps digest fatty foods. However, when gallstones occur, the pain can be debilitating. 

1. What are gallstones and their symptoms? 

Gallstones form when small bits of crystalized bile clump together.  

“This happens from a chemical imbalance,” says Sujit Kulkarni, MD, a hepatobiliary and pancreatic surgeon with USC Surgery, part of Keck Medicine of USC. “Bile is juice made by the liver, which contains fat. Normally, this fat is stabilized in liquid form because of the balance of certain chemicals. And when that balance gets disturbed, that’s when the fat deposits inside the gallbladder and hardens to form stones.” 

These stones can be as small as a grain of salt or as large as an egg. When they stay put in the gallbladder, these “silent” gallstones go unnoticed and do not require treatment. When they try to pass through the tiny bile duct to the small intestine, inflammation and severe pain set in. Lasting from a few minutes to a few hours, the pain can feel like indigestion or similar to a feeling of fullness. 

Additional symptoms include: 

• Severe abdominal pain, with no relief from pain relievers 
• Pain that worsens after eating a meal, particularly foods high in fat 
• Chest pain 
• Excessive gas and heartburn 
• Tenderness in the abdomen, especially on the upper right side 
• Jaundice 
• Nausea 
• Pancreatitis 

“Many times, these symptoms are transient, meaning people will have a big meal and experience symptoms, and then after two to three hours the symptoms resolve,” Dr. Kulkarni says. “But sometimes if they don’t get better, a person might end up in the emergency room.”  

2. Who is at risk for gallstones? 

Gallstones have become increasingly common, and all age groups can be affected. 

Factors that contribute to gallstones include: 

• Obesity 
• Being a woman 
• An increase in estrogen, from pregnancy or hormone therapy 
• A diet high in fat and refined carbohydrates, and a decrease in fiber 

A family history of gallstones, as well as multiple pregnancies, can increase risk. Likewise, there is a higher percentage in older people; up to 20% of American women will develop them by the age of 60. 

3. How are gallstones treated? 

An ultrasound will confirm whether you have gallstones. If you don’t have any symptoms, most likely you’ll simply live with them until you do. After treating your gallstones, changing to a low-fat diet or one that includes preventive factors, like polyunsaturated fat, monounsaturated fat, fiber and caffeine, is suggested. 

Modifying your diet will help prevent gallstones. But, if you have already been diagnosed with gallstones, it’s best not to change your diet suddenly. A rapid shift from the gallbladder being very active and frequently digesting animal fats to not being used at all can aggravate your condition and produce more gallstones. Losing too much weight rapidly can also produce or aggravate gallstones. 

If your doctor decides to remove your gallbladder, a cholecystectomy might be suggested. For this procedure, a surgical incision is made, and then the gallbladder may be removed by laparoscopic or robotic surgery. Most patients experience a quick recovery with little pain and discomfort. 

“Many people can be afraid of surgery and put off coming in to treat their symptoms, but oftentimes this procedure is not complicated, and patients get to go home the same day,” Dr. Kulkarni says. “If you know you have gallstones, and if you get surgery and help in timely fashion, then you can avoid some of these complications.” 

4. Are there complications with gallstones? 

Even if you aren’t in pain from your gallstones, they may still present a health risk. Jaundice, where your skin itches and appears yellow, is one side effect. The most common complication is acute cholecystitis, where the stone blocks the cystic duct, preventing the gallbladder from emptying bile into the bile duct, Dr. Kulkarni says. Nausea, vomiting and severe pain are usually present. In the most serious cases, patients may develop acute pancreatitis. Usually, patients return to normal lives after having their gallbladder removed. 

The best way to prevent gallstones is to eat foods that are low in fat and simple carbohydrates, such as fresh whole foods and stay hydrated. Losing weight can also help keep gallstones away. 

“It is hard to prevent gallstones, because most of the time when you find out about them, you already have them,” Dr. Kulkarni says. “So, the best advice in this situation is, if you are experiencing symptoms, to not be afraid and to see a physician for treatment so that you can find relief.” are low in fat and simple carbohydrates, such as fresh whole foods and stay hydrated. Losing weight can also help keep gallstones away.

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