Am Fam Physician. 2000;61(6):1687-1688
See related article on gallstones.
What are gallstones?
The gallbladder is a small “bag” just under your liver. It stores digestive juices that are made by the liver. Sometimes these juices become solid and form stones, called gallstones.
What problems can gallstones cause?
About 60 percent of people with gallstones never get sick from them. They might never know they have gallstones. However, a gallstone can leave your gallbladder and go into the passageway from your gallbladder to your intestine. It might get stuck in that passageway. If the stone completely blocks the passageway, you will have severe pain in the right upper part of your belly. You may also feel pain in your upper back. The pain usually starts suddenly and lasts for as long as three hours. This is known as an “attack.”
Complete or partial blockage can also cause your gallbladder to get irritated and inflamed. If this happens, you will usually have pain for more than three hours. You may also get a fever. Your skin may turn a yellowish color, known as jaundice (say “john-diss”).
Who gets gallstones?
You're more likely to get gallstones if:
You are a woman
You have diabetes
Your mother had gallstones
You are pregnant or taking birth control pills
You have high blood triglycerides (a type of fat)
You are fasting or have lost a lot of weight quickly
You are of Native American (especially Pima Indian) or Scandinavian background
You are middle-aged
You are overweight
How are gallstones usually treated?
If you have gallstones but no pain, chances are good the stones won't be a problem for you. Your doctor might suggest you leave them alone.
Once you have one attack of pain, the chance of having another one is high—about 70 percent. Many doctors will suggest you have your gallbladder removed in surgery to prevent a future attack. You and your doctor should talk about your situation and decide what is right for you. If your gallbladder is irritated or inflamed, most doctors will want to take it out right away. The surgery is safe and effective. Without surgery, the gallbladder can get infected. It might even burst open, causing further problems.
Are there other treatments?
Yes, there are other treatments. They are usually for people who would have a high risk in surgery because they are old, or have heart problems or lung disease. Your doctor might be able to use sound wave therapy to break up the stones so they can move into the intestine without problem. However, only one of five people can have this treatment. People who have this treatment often form new gallstones after a few years.
Or you might take a pill called Actigall to dissolve the stones. This pill only works in a few people, and it can be very expensive. Surgery is still the best way to cure gallstones for many people. Talk with your doctor about what is right for you.