It is estimated that 10% or more of adults in the UK have gallstones, however most people will show no symptoms.
The risk of developing gallstones increases for:
- People who are overweight, or obese
- Women, particularly if you have had children
- People who are 40+
Gallstones can be harmless but if symptoms arise then it is vital to see a doctor, as treatment to remove the gallstones may be necessary.
Consultation with a specialist, who can conduct the necessary diagnosis tests, is the first step to better understanding your symptoms.
The main symptom of gallstones is called bilary colic, and is typical of these factors:
- A sudden and severe pain in your abdomen, which isn’t relieved by going to the toilet, passing wind or being sick
- Pain is usually constant
- Pain is usually located in the centre of your tummy, or one the right-hand side of your body, just under the ribs
- Occasionally the pain will move to your shoulder blade
- The pain may last for up to five hours
- You may experience an episode of bilary colic and then feel fine for several weeks, or even months before another episode occurs
Whilst these symptoms can be painful, they are generally considered to be “uncomplicated”.
On occasions the gallstone can permanently block a bile duct, resulting in a significant build-up of bile inside the gallbladder.
The gallbladder may become infected and inflamed. Symptoms can include:
- Abdominal pain that travels to shoulder blade, but lasts longer than 5 hours
- A fever, with a temperature over 38C
- A raised and rapid heartbeat
Here, antibiotics are usually required to treat the infection and in almost all cases the gallbladder needs to be removed.
Jaundice can occur when a gallstone escapes the gallbladder into the bile duct, blocking the flow of bile.
- Symptoms include:
- Yellow coloured skin and eyes
- Dark brown urine
- Pale stools
- Itchy skin
If the stone doesn’t pass through the bile duct on it’s own accord, then surgery is required to remove it.
Bacteria can easily infect blocked bile ducts. Symptoms may include:
- Abdominal pain that travels to your shoulder blade
- A high temperature, fluctuating to chills
Here, antibiotics are usually required to treat the infection but there is also usually a requirement for treatment to drain the excess bile that built-up in the liver. This procedure is known as endoscopic retrograde cholangio-pancreatography (ERCP).
If the gallstone escapes the gallbladder and blocks the opening to the pancreas, this can cause an inflammation called acute pancreatitis.
The most common symptoms include:
- Sudden, severe dull pain in the upper abdomen
- Pain usually gets progressively worse until it aches persistently
- The pain may cause backache
- Eating may make the pain worsen
- Other symptoms may include:
- Feeling sick, or being sick
- Loss of appetite
- A fever over 38C
- Abdominal tenderness
- Jaundice, in some cases
There is no cure for acute pancreatitis so hospital admission is typically necessary to support the various body functions until the inflammation passes.
Cancer of the gallbladder is very rare but can be a serious complication of gallstones.
Four out of five people that develop gallbladder cancer will have had a history of gallstones, showing an increased risk. However, there is less than 1,000 cases of gallbladder cancer diagnosed each year in the UK, and even if you have a history of gallstones, there would be an estimated one in 10,000 chance of it developing into cancer of the gallbladder.
Other risk factors include:
- Family history of gallbladder cancer
- High calcium levels inside your gallbladder
Symptoms are similar to other complications of gallstones so it is important to seek diagnosis from a specialist to determine the exact nature of your symptoms.
If surgery is required to remove your gallbladder there are a number of types of procedure:
Keyhole surgery called laparoscopic cholecystectomy
Here 3-4 small incisions are made in your abdomen. In one incision, a laparoscope is inserted that makes it possible for the surgeon to see inside your body with a light and camera. Using special surgical instruments the gallbladder can be removed through the other incisions.
This procedure is performed under a general anaesthetic and usually takes 60-90 minutes. It is usually possibly to go home the same day, although recovery may take up to 10 days.
Single incision keyhole surgery
Here only one incision is required for surgery, resulting in just one small scar following the procedure. It is a new technique and isn’t widely available as it requires expertise from the surgeon.
Meet the GI Doctors – we offer single-incision laparoscopic cholecystectomy.
Sometimes using keyhole surgery techniques isn’t applicable and open surgery is required. This can include if you are pregnant, overweight or have an unusual gallbladder for any reason.
Open surgery typically requires a longer hospital stay and recovery times can increase to six weeks.
Endoscopic retrograde cholangio-pancreatography (ERCP)
ECRP isn’t a surgery to remove the gallbladder, but it is a procedure used to remove gallstones from the bile duct.
This procedure usually only requires sedation, so you will be awake but will not feel any pain. An ERCP may take 30 minutes, on average but can be as quick as 15 minutes with an experienced surgeon.