Gallstones Like many people, you may have
gallstones and not know it. In fact, gallstones — solid deposits of
cholesterol or calcium salts that form in your gallbladder or nearby
bile ducts — often cause no symptoms and require no treatment. But up to
about one-fifth of people with gallstones will have a gallbladder attack
that can cause symptoms such as nausea and an intense, steady ache in
their upper-middle or upper-right abdomen. In some cases the pain can be
Like many people, you may have gallstones and not know it. In fact, gallstones — solid deposits of cholesterol or calcium salts that form in your gallbladder or nearby bile ducts — often cause no symptoms and require no treatment. But up to about one-fifth of people with gallstones will have a gallbladder attack that can cause symptoms such as nausea and an intense, steady ache in their upper-middle or upper-right abdomen. In some cases the pain can be severe.
Because about 80 percent of gallstones produce no symptoms, they require no treatment. Doctors often discover these "silent stones" during routine medical checkups or exams for other illnesses and usually recommend taking a wait-and-see approach to treatment. If your gallstones cause symptoms, however, several possible treatments are available.
Most often gallbladder surgery is performed using a laparoscope, a pencil-thin tube with its own lighting system and miniature video camera. A surgeon inserts the laparoscope into your abdomen through a hollow instrument (cannula). Only small incisions are required. The video camera then produces a magnified view on a television monitor of the inside of your abdomen. This allows the surgeon to see the surgery in detail. To remove your gallbladder, he or she uses tiny instruments inserted through several other small abdominal incisions.
Because laparoscopic cholecystectomy uses smaller incisions, you'll likely have less postoperative pain, less scarring and an earlier return to your normal activity — usually within just a few days.
Laparoscopic removal of the gallbladder is effective in the majority of cases. But occasionally an option is open surgery, in which the gallbladder is removed through a large abdominal incision. Your doctor may regard this surgery as the best option in severe cases. It may also be used when the gallbladder walls are thick and hard, the gallbladder is obviously infected, or there is scar tissue from earlier abdominal operations. Recovery from open surgery typically entails up to a week's stay in the hospital, followed by several weeks at home.
After surgery your liver continues to produce enough bile to digest a normal diet. But you may notice you're having more bowel movements than usual and that their consistency is less solid. For some people these changes can be major. In most cases the symptoms usually lessen over time. When diarrhea remains a problem, general self-care measures — such as avoiding dairy products, fats and spicy foods as well as adding more fiber to your diet — may help. If diarrhea persists, see your doctor, as medications can sometimes help.
If you have stones in the bile duct as well as your gallbladder, your doctor may recommend surgical removal of both the duct stones and your gallbladder. But in some cases, your doctor may suggest removing the stones in the bile duct using an endoscope. Your gallbladder also may be removed at a later date. Often, a cutting instrument is inserted through the endoscope, and the entrance of the bile duct is enlarged so the stone can pass through it. The same procedure may be used to remove a stone from a blocked pancreatic duct.
Although you can't entirely prevent gallstones from forming, you may be able to lower your risk by following these suggestions: