Gallstones are stones formed within the gallbladder. In most cases, they arise from the gallbladder
and can go in other parts of the bile duct or in other parts of the bowel. Gallstones
are mainly composed of cholesterol, bile salts, and bile pigments and rarely of other materials
such as calcium. Gallstones are formed mainly in women but can happen in men. But they are
usually in middle ages but can happen in youth or in old age.
Gallstones are very, very frequent condition. If we were to scan people on the street, five
out of a hundred people in the age of 20-60 would have gallstones. It is not clear what
causes gallstones. However, we do know that it is common in women mainly in the child-bearing
age groups so from the ages of 15-45. However, they can happen in men and they can happen
in very young ages or in older people. We think gallstones form because a gallbladder
is not working properly. As a result, the crystals within the bile which is normally
stored in the gallbladder managed to crystallize. Once they crystallize, they can sediment.
It’ll just like lemonade which if left alone, you will see a sediment forming at the bottom.
If this sediment is not cleared by a normally functioning gallbladder, then it can crystallize
to form stones. Stones usually start in very small sizes, a few millimetres across but
can grow up to three to four centimetres. Gallstones are composted of things which are
common in biles such as cholesterol, bile salts or bile pigments. Very rarely, gallstones
can also contain calcium that is rare and therefore gallstones cannot be broken down
by a lithotripter which is common with kidney stones.
Surprisingly, most gallstones are asymptomatic. That means they cause no problems whatsoever.
However, gallstones can give rise to pain at the top part of the tummy or on the right
hand side. These pains are usually colicky in nature. That means they come and go in
waves and they may move towards the right shoulder tip. Sometimes, gallstone symptoms
can be very severe. This happens when gallstones are complicated, for example, cholecystitis
which is inflammation or infection within the gallbladder. Rarely, gallstones can cause
other severe symptoms such as pancreatitis where the pain is severe, unremitting, and
goes to the back. Gallstones very rarely can block the bowel in which case vomiting can
be profuse, accompanied by severe central tummy pain.
Most gallstones are not dangerous. But gallstones can become dangerous. The dangers posed by
gallstones are when they remain in the gallbladder and get stuck in the part of gallbladder such
as they block the flow of the gallbladder. In this instance, you can get infection within
the gallbladder or what’s called cholecystitis. This can be acute or chronic. That means longstanding.
When gallstones get out of the gallbladder, they usually go via the bile duct. If they
get stuck in the bile duct, then they can get jaundice. Jaundice means yellowing of
the eyes and dark yellow urine. Gallstones can also irritate the pancreas and cause pancreatitis.
This pancreatitis and jaundice can be serious life-threatening illnesses. Rarely, gallstones
can go to the bowel and cause blockage in the bowel such that the food cannot pass through.
Then the patient would present with abdominal pain and vomiting. This can also be a serious
condition. Which gallstones should be treated has to be decided with your specialist who will
take into account your symptoms, scan results, and blood test results.
Surgery is required for some conditions where gallstones are causing problems. It is most
commonly required to prevent future problems which the gallstones may cause. Surgery is
required when the person gets symptoms from gallstones like pain, vomiting, or intolerance
to fatty foods. Gallstones surgery is required also when gallstones may cause complications
such as pancreatitis or obstructive jaundice. Gallstones are not removed on their own. They
are removed along with the gallbladder. If one does not remove the gallbladder, gallstones
are likely to form again as the gallbladder is unable to expel all the sedimented bile. Therefore,
gallstone surgery is accompanied by removing of gallbladder.
Gallstone surgery is commonly performed by keyhole. That means small cuts on the abdomen
or tummy. This is called laparoscopic cholecystectomy. Laparoscopy cholecystectomy is usually done
as a day case procedure. You may be required to stay in longer than a day depending on
your physical condition and other health problems as well as complications if any from the gallstones.