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Gallstones

Description

Gallstones are stones that develop in the gallbladder. In Australia, gallstones are extremely common with up to 30% of people developing them. Fortunately, the majority of people remain without symptoms from their gallstones and will never know that they have them. Asymptomatic gallstones do not need treatment in most cases.

Causes

The liver produces bile that is stored in the gallbladder. Upon eating, the gallbladder contracts and sends bile down through the bile duct into the small intestine to break down fats in the meal to aid digestion and absorption. It essentially works like a detergent. Bile is composed of bile salts, cholesterol and phospholipids. When these components are not in the correct concentrations, stones can precipitate. A Western diet seems to be a major risk factor for this to happen. Other risk factors include obesity, age, some ethnic groups, rapid weight loss and multiple pregnancies.

Complications

Once a person becomes symptomatic from gallstones, it is highly likely that further attacks will occur (even with a very strict low fat diet). Complications include

  • Biliary colic – This is severe pain that occurs in the upper abdomen usually after a meal. It is caused by a gallstone temporarily blocking the outlet of the gallbladder.
  • Acute cholecystitis – This is severe upper abdominal pain that continues and is associated with fever. It is when a stone blocks the gallbladder for long enough for it to become inflamed/infected.
  • Obstructive jaundice – This is when a stone travels out of the gallbladder and blocks the bile duct. Symptoms include jaundice (becoming yellow) and if not fixed, a severe infection can arise.
  • Pancreatitis – This is when a stone blocks the pancreatic duct leading to inflammation of the pancreas, the gland that aids in digestion and regulates blood sugar. This is extremely serious and is potentially life-threatening.

Treatment

Once symptomatic, the usual recommendation is to have your gallbladder removed surgically. Fortunately, one can survive very well without a gallbladder. In fact, most people do not notice any difference without a gallbladder and there are no serious long term effects. In some people, diarrhoea and bloating can occur after a fatty meal.The standard surgery is a laparoscopic (keyhole) cholecystectomy. Non surgical approaches to dissolve gallstones by medications or other means have not proven to be successful.

  • Prince of Wales Private Hospital
  • The Royal Hospital For Women Foundation
  • Colorectal Surgical Society of Australia and New Zealand
Randwick Rooms

Prince of Wales Private
Suite 17, Level 7
Barker Street
Randwick NSW 2031

Phone: 1300 553 347
Fax: (02) 9650 4924

Double Bay

Double Bay Day Hospital Specialist Suites
Suite 3.01, Level 3, commercial
451 New South Head Road
Double Bay

Phone: 0290 863 133
Fax: (02) 9086 3123

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