Ask the Doctor: What is a gallstone?

Q. My mom was told she has a gallstone. What is that? Will she need an operation?


A. This is a common dilemma.

The mere presence of gallstones doesn’t mean that an operation is needed. In fact, many people have these stones with no symptoms.

liver 225x300 Ask the Doctor: What is a gallstone? Photo

Gallstones can build in the gallbladder, a small sac under the liver.

Surgery is indicated when:

  • Stones are large and block the bile duct (causing obstruction to the liver)
  • The pancreatic duct is blocked causing pancreatitis
  • Gallbladder is inflamed.


Causes and Composition of Gallstones

Bile is a fluid made by the liver to assist in the body’s fat digestion and stored in the gallbladder, a small sac under the liver on the right side.

When a fatty meal is eaten, the gallbladder contracts, spewing the bile into a duct that leads to the intestines where the fat is dissolved.

If there are imbalances in the constituents of bile, little crystals form and can develop in size from a grain of sand to a golf ball over months or years. They are typically formed from cholesterol, but may also be made up of calcium carbonate and other bile pigments like bilirubin.


Symptoms of Gallstones

Most people with gallstones don’t actually have symptoms. However, the signs of gallstone problems include:

  • Pain in the abdomen or upper right part of your tummy (steady or intermittent)
  • Pain in the upper back region or shoulder blades
  • Possible jaundice with yellowing of the whites of the eyes

Abdominal sonogram or x-rays confirm the presence of gallstones.


Risks for Gallstones

There is an increased probability of developing gallstones if you:

  • Are overweight
  • Female
  • Have a family history of gallstones
  • Are over 55 years of age
  • Had gastric bypass surgery or rapidly losing weight
  • Are pregnant
  • Are taking estrogen or certain other medications
  • Have Crohn’s disease or cirrhosis of the liver


Gallbladder Treatment 

If there are no symptoms, no treatment is needed. Many people can control symptoms by maintaining a low fat diet and decreasing milk and other calcium-rich foods.

Having one attack does not mean that a second will ever occur. Pain medication may be all that is warranted. However, if a second pain attack occurs, a repeat incidence is likely and thus removal of the gallbladder is suggested.

Surgery is generally performed as a laparoscopic procedure where small incisions are made into the abdomen. Instruments penetrate into the abdominal cavity through these cuts and the gallbladder is retrieved with sutures and cauterization. Usually, the procedure only requires a one-night hospital stay and recovery is usually rapid.

Bodies function well despite the absence of a gallbladder. Bile circulates from the liver directly to the intestine where the food is digested and absorbed.

By exercising and eating a proper nutritious diet, one can avoid problems with gallstones. Enjoy making some meals with your Mom. You’ll both be healthier and delight in the time spent together.