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Gallstones

Gallstones occur when digestive fluids stored in the gallbladder form into hardened deposits. These gallstones are formed in the gallbladder, which is a small pear-shaped organ that helps with digestion and is located below the liver on the right side of the abdomen. The sizes of gallstones may vary from tiny-sized, like a grain of sand, to large, like a golf ball.

When the gallstones are tiny, you may not even notice any symptoms. But if they become larger and travel, they may disrupt the normal digestive process by blocking pathways. As a result, you may experience sudden, sharp pain, especially after eating. If you frequently experience pain in your right upper abdominal area, especially after eating, you should seek advice from a healthcare professional.

Signs & Symptoms

The signs and symptoms of gallstones may vary. If the gallstones are present but very small, you may not notice anything unusual. Once they become bigger in size, they may move around and be able to block certain areas, which is when you may begin to notice the following symptoms:

  • Upper right abdominal pain
  • Sudden, rapid, intense pain in the centre of your abdomen just below your breastbone
  • Fast heart rate
  • Nausea
  • Vomiting
  • Back pain between your shoulder blades
  • Right shoulder pain
  • Fever and chills
  • Intolerant of fatty foods
  • Indigestion
  • Yellowing of the skin and whites of your eyes (jaundice)

The pain from gallstones can last a few minutes to several hours. If your abdominal pain becomes so severe that you have difficulty sitting or finding a comfortable position, you should seek emergency care to avoid more serious complications.

Causes & Risk Factors

It is thought that gallstones are formed when bile contains too much cholesterol or bilirubin or when the gallbladder does not empty as it should normally. Excess cholesterol may crystalize and form into stones at some point. Excess bilirubin from certain liver conditions may contribute to forming gallstones. When the gallbladder does not function properly and empty itself, bile may become more concentrated and form gallstones. The following are risk factors that may increase the chances of having gallstones:

  • Obesity
  • Diabetes
  • Older than 40 years old
  • Female (related to hormones)
  • Family history of gallstones
  • Blood disorders
  • Liver disease
  • Diet (high fat, high cholesterol, low fibre)
  • Native American or Mexican

Diagnosis

The condition of gallstones is diagnosed by blood tests and imaging. Blood tests will be done to check for signs of infection, inflammation, and jaundice. An abdominal ultrasound, an MRI, or a CT scan may be ordered. These imaging tests are non-invasive and can help show if gallstones are present and where a blockage might be.

An invasive diagnostic test, endoscopic retrograde cholangiopancreatography (ERCP), is a procedure that involves inserting a tube with a camera down your throat into the upper GI area. With the help of a special dye that gives better visualization, ERCP may show gallstones where bile ducts may be blocked.

Treatment & Management

Treatment for gallstones will likely depend on the severity of your condition, your age and medical history, or even your own preferences. Your healthcare provider will help you determine what the best course of action might be. If you are not having pain associated with gallstones, treatment is usually not necessary. When pain continues or is frequent, several different treatment methods may be advised.

Surgery to remove your gallbladder

Dissolution therapy (injecting a solution into the gallbladder to dissolve the stones)

Oral medication therapy (using medications/drugs to dissolve the stones)

Extracorporeal shockwave lithotripsy (ESWL) (using shock waves to help break stones to smaller pieces to pass through)

To help manage gallstones, your healthcare provider may advise that you make dietary changes such as decreasing fried and fatty foods, losing weight slowly, and eating fish and high fibre foods which help to increase “good” cholesterol and get rid of excess cholesterol.

 
 
 

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