Gall stones

Gallstones are very common, however only some people develop symptoms

If you start to experience symptoms, specialist healthcare is available to remove the gallstones and help you to feel better again.

On occasions, when gallstones are not treated sufficiently, more serious problems can arise so early diagnosis and specialist treatment is vital.

What causes gallstones?

Bile is a liquid produced by the liver to help digest fats. When needed, the gallbladder releases bile into the digestive system however, when in storage it becomes more concentrated, preparing to be more effective at breaking down fat.

It is believed that gallstones are caused by an excess build-up of cholesterol in the gallbladder, which in turn forms into stones due to a chemical imbalance.

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.

Symptoms of gallstones

Symptoms arise when a gallstone blocks a bile duct, one of the tubes that connect the liver to the gallbladder. Or, in worst cases a gallstone can block another part of the digestive system.

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”.

Complications of gallstones may include:

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
  • Jaundice
  • Confusion
  • Itching

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
    • Diarrhoea
    • 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.

Treatment of gallstones

There are many treatments for gallstones, depending on the nature and severity.

If gallstones are not causing significant pain they can sometimes be left alone, and monitored to ensure they don’t grow or worsen.

Or, if they are small and don’t contain calcium then it is sometimes possible to take ursodeoxycholic acid tablets to dissolve them, although this isn’t always effective.

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.

Open surgery
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.

Your health is our goal

Whether your symptoms are recent or you have been suffering with a gastrointestinal condition over the longer term, specialist healthcare is available to help reduce, or relieve the pain and discomfort you are experiencing.

To arrange a consultation, please contact our specialist team.