The majority of gallbladder disease in the UK is related to the formation of gallstones. These are made from a mixture of cholesterol and bile pigment and take several years to evolve. Predisposing factors include a family tendency and a diet particularly rich in fatty food. The old adage of “fair, fat, fertile, females of forty” has some truth but young, thin males can also be affected!

Gallbladder Syndromes


Recurrent mild attacks

Often called “biliary colic”, this is the commonest way gallstones make themselves known. The typical symptoms are abdominal pain, mainly upper and right-sided, under the right ribs, which may last several hours. There may be nausea or vomiting and the sufferer cannot find a comfortable position, often pacing around during an attack.
Attacks are generally provoked by fatty foods such as chips, cream or cheese.

Severe acute attack

Often called “acute cholecystitis”, in this syndrome there is unrelenting pain frequently resulting in hospitalisation.

Jaundice

The appearance of yellow skin occurs when a stone from the gallbladder slips into the bile duct and impedes the flow of bile. It is very unpleasant and requires specialist treatment.

Rare serious complications

These include abscess formation, perforation and gallstone-related pancreatitis. Very rarely, malignant change can occur.

Diagnosis

The diagnosis is usually made from the typical symptoms and an ultrasound scan. Other types of scan are available depending on the clinical situation.

Gallstones may be diagnosed incidentally during the course of tests for other conditions. It is a point of debate as to whether these stones warrant an operation and this can be discussed in an out-patient consultation.

What are the available treatments?

If you have been found to have gallstones or a diseased gallbladder and you are having symptoms, then some form of treatment will be required. Staying on a strictly low-fat diet will keep the symptoms at bay as much as possible.

It is possible to dissolve some types of gallstones using medication. However, this can take a considerable period of time (over 1 year) and the medication frequently causes chronic diarrhoea. Furthermore, the gallstones may reform over time. The problem is that it is the gallbladder and not the gallstones that are diseased. Any method of treatment that leaves the gallbladder intact will inevitably be prone to recurrence. This includes stone destruction by external shock wave machines. For this reason, surgery is by far the most effective treatment option.


Unopened gallbladder (size, about 10cm)



Opened gallbladder with a large stone





Ultrasound showing 2 large stones casting a shadow

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