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Gallstones are formed in the gallbladder. Gallbladder is a small pouch-like organ under the liver. It collects bile secreted by the liver and releases it as and when necessary for digestion. Bile contains cholesterol, and bilirubin formed when red blood cells are broken down, in addition to digestive enzyme. If you have cholelithiasis, it means you have gallstones. They are formed when cholesterol or bilirubin crystalises. Cholesterol stones are yellowish green in colour and are more common than bilirubin stones that are smaller and darker. The size of the stones can vary. They can be as small as a grain of sand or, rarely, as large as a golf ball. Gallstones do not cause problems initially. When they grow in size and start moving down the bile duct, you will have severe pain and other symptoms. If they get too big to pass through the duct, then they can block the duct and cause complications. Complications of gallstones include: • Gallbladder inflammation • Blocked bile duct • Blocked pancreatic duct • Pancreatitis caused by blocked pancreatic duct Symptoms of gallstones • Sudden pain in the upper right abdomen under the ribs or in the centre of the abdomen below the breast bone that gets worse with time • Right shoulder or back pain • Stomach upset • Nausea or vomiting • Heartburn, indigestion, gas Symptoms may last for a few minutes or a few hours till the stones pass out of the bile duct and into the small intestine. Symptoms that require immediate medical assistance • Pain that persists for hours • Fever and chills • Yellow skin & eyes • Dark urine & pale stool Causes of gallstones Gallstones may form due to three reasons. When cholesterol content in bile is too high to be dissolved by bile chemicals, the excess cholesterol forms gallstones. When bilirubin content in bile is too high due to liver problems, it can form gallstones. If gallbladder doesn’t empty completely, the stagnating bile will concentrate to form gallstones. Risk factors of gallstones • A family history of gallstones • People over 40 years of age • Women • Pregnancy • Obesity • Not being active • Eating a high fat and cholesterol diet • Eating a low fibre diet • Using birth control pills • Taking hormone therapy • Losing weight rapidly • Having diabetes • Having certain digestive diseases • Having certain blood and liver disorders • Taking cholesterol medication • Fasting often Treatment options for gallstones People with no symptoms may not need treatment for gallstones. Your doctor will recommend surgical removal of gallbladder if you have recurrent gallstones or if the gallstones block ducts leading to complications and severe symptoms. Open and laparoscopic cholecystectomy Cholecystectomy is the surgery performed to remove the gallbladder. In open surgery the abdomen is opened with a major incision. The gallbladder is removed and the abdomen sutured closed in layers. Laparoscopic cholecystectomy uses minimally invasive laparoscopic procedure to remove gallbladder using special surgical instruments that are inserted into the abdominal cavitythrough a few tiny incisions. There is very little tissue damage and blood loss. It is less painful and the recovery is much faster than after the open procedure. Surgery is the only option for providing permanent relief. Removal of gallbladder will not affect digestion and you can get back to normal life. If you cannot undergo surgery for any medical reason, medications will be prescribed to dissolve the stones. This is a slow process and may take months or years. The stones may form again when treatment is stopped. Prevention of gallstones A little effort on your part may decrease the risk of gallstones. • Eat at regular mealtimes without skipping meals • Be active and exercise regularly • Manage obesity and try to get back to ideal weight • Lose weight gradually and not rapidly • Eat high fibre diet filled with fruits, vegetables and whole grains Consult our expert surgeon for gallbladder removal surgery. We offer both conventional open cholecystectomy and laparoscopic cholecystectomy.