Description, causes, prevention, treatment and medicines

Gallstones can occur with or without producing symptoms.

Silent gallstones

About 70 per cent of people who have gallstones do not have noticeable symptoms and are often unaware that they have them. Gallstones may be discovered only during investigations for other problems. For this reason, they are sometimes called ‘silent’ gallstones.

Symptomatic gallstones

Symptoms of gallstones generally occur when a stone becomes lodged in one of the ducts (tubes) that carry the bile to and from the gallbladder (these include the cystic duct and the bile ducts).

The most common symptom of gallstones is known as biliary colic, which is described as pain that:

  • is felt in the upper right section or centre of your abdomen and may run through to your back, between the shoulder blades or into your right shoulder;
  • often comes on suddenly, increases quickly and may last from a few minutes to several hours before subsiding; and
  • may be moderate to severe.

Biliary colic usually settles when the gallstone moves, unblocking the affected bile duct(s) and releasing the pressure on the gallbladder. If the duct remains blocked, complications can result.

Attacks of biliary colic are commonly recurrent (repeating). They often occur after a fatty meal, as fat intake stimulates the gallbladder to squeeze its stored bile into the small intestine to help digestion.

Symptoms such as belching, bloating, fat intolerance and indigestion are not usually caused by gallstones, and are unlikely to be improved by removing them.

Symptoms requiring immediate attention

Gallstone signs and symptoms that require immediate medical attention include:

  • fever, sweating and chills;
  • steady, severe abdominal pain that persists for longer than a few hours;
  • abdominal pain that is so intense you cannot sit still;
  • nausea and vomiting associated with the abdominal pain; or
  • jaundice — a yellowing of the skin or whites of the eyes.

These signs and symptoms can indicate serious gallstone complications.

Fever and severe abdominal pain (with or without nausea and vomiting) that does not get better after a few hours may indicate infection or inflammation of the:

  • gallbladder (a condition known as cholecystitis);
  • bile duct (cholangitis); or
  • pancreas (pancreatitis).

The pancreas is a digestive gland near the gallbladder that produces insulin and digestive enzymes. The digestive enzymes flow into the small intestine through the same opening as the bile duct, so can be affected by a gallstone.

Jaundice occurs when the main bile duct becomes blocked, leading to the build-up of a substance called bilirubin in the bloodstream. Jaundice can be a symptom of cholangitis.

If you have any of these serious symptoms you should seek medical care immediately.

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