Gallstones

Gallstones are hardened deposits that form in the gallbladder, a small organ that stores bile used in digestion. Many gallstones cause no symptoms, but some can lead to significant pain or complications if they block the flow of bile.

• Many gallstones cause no symptoms and are found incidentally
• Sudden, intense pain in the upper right or central abdomen, often after a fatty meal, which can radiate to the back or right shoulder blade (biliary colic)
• Nausea and vomiting during an episode of pain
• Fever, jaundice (yellowing of the skin and eyes), or persistent severe pain can indicate a complication, such as infection or a blocked bile duct, requiring urgent care

• Form when substances in bile, such as cholesterol or bilirubin, become imbalanced and crystallise into stones.
• Risk is increased by female sex, increasing age, obesity, pregnancy, rapid weight loss, a diet high in fat and low in fibre, and family history of gallstones.

• Often diagnosed incidentally on abdominal ultrasound performed for another reason, since many gallstones are silent.
• In someone with typical symptoms, abdominal ultrasound is the standard test to confirm the presence of gallstones and assess the gallbladder.
• Blood tests and further imaging may be used if a complication, such as infection or bile duct blockage, is suspected.

Gallstones that cause no symptoms generally do not need treatment and may simply be monitored.

Symptomatic gallstones causing recurrent pain are usually treated with surgical removal of the gallbladder (cholecystectomy), which is a common and generally safe procedure that resolves symptoms in most people.

Pain relief and, if needed, anti-nausea medicine are used to manage an acute episode of biliary colic while arranging further care.

Gallstones complicated by infection of the gallbladder (cholecystitis), blockage of the bile duct, or inflammation of the pancreas (pancreatitis) require urgent hospital-level treatment, which may include antibiotics and, often, surgery.

• Maintain a healthy body weight and avoid rapid weight loss, which can increase gallstone risk.
• Follow a balanced diet with moderate fat intake and adequate fibre.
• Seek prompt medical care for sudden, severe abdominal pain, particularly if accompanied by fever or yellowing of the skin or eyes.
• Discuss gallstone risk with a health worker if there is a strong family history or other known risk factors.