1. Simmons, Susan PhD, ARNP-BC

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What are gallstones?

Gallstones are like little pebbles that develop inside the gallbladder-a small, pear-shaped organ located on the right side of your upper abdomen. The gallbladder stores and releases bile, a liquid that helps digest fats. If the bile contains too much cholesterol or waste products, it can harden into gallstones. If the tubes (ducts) carrying bile are blocked by gallstones, the gallbladder may become swollen and painful. Your healthcare provider may refer to gallbladder inflammation as cholecystitis and gallstones as cholelithiasis.


Being overweight or drinking too much alcohol increases your risk of developing gallstones. Prolonged fasting and rapid weight loss, such as from crash diets, also can lead to gallstones.


Some people are more likely than others to get gallstones. In the United States, those at higher risk include American Indians, Mexican Americans, and people with diabetes or liver disease. The risk increases with age. The risk is also higher in people who take cholesterol-lowering drugs and who have a family history of gallstones. Women are at higher risk than men, and the risk increases if they're pregnant, taking birth control pills, or using hormone replacement therapy.


How will my healthcare provider know I have gallstones?

First, your healthcare provider will ask you questions about your health and symptoms. If you have a mild case of gallstone disease, you may notice abdominal pain after you eat, especially after eating a fatty or greasy meal. The pain may go away in a few hours.


If your gallstone disease is more severe, you may notice steady, severe pain on the right side of your upper abdomen, in your right shoulder, or between your shoulder blades. These pains may occur at night and even wake you up.


Your healthcare provider will examine your abdomen. Blood tests may be ordered to check for infection and to see whether your liver and pancreas are working properly. You may also have to give a urine sample to check for other problems. You'll have ultrasound pictures taken of your abdomen, which may show your gallstones.


How are gallstones treated?

If you have gallstones but your symptoms are mild, your healthcare provider will give you medicine for pain, nausea, and vomiting. You may be told to drink only clear liquids for a few days to give your gallbladder a rest. You should also avoid fatty or greasy foods. If you're in a lot of pain, you may be admitted to the hospital so you can get I.V. fluids, pain medicine, and antibiotics.


Removing the gallbladder is usually the cure for gallstones that cause persistent problems. This can often be done with laparoscopic surgery. Because the incisions needed for laparoscopic surgery are tiny, you should have less pain and your recovery should be faster with fewer activity restrictions than with open surgery. You'll probably go home from the hospital the same day or the next day.


If the surgeon doesn't think your gallbladder can easily be removed with laparoscopic surgery, you may need open surgery, which involves a larger abdominal incision. Afterward, you'll need to stay in the hospital for a few days and restrict your activities (such as lifting) for longer than you would after laparoscopic surgery.


Can I prevent gallstones?

To reduce your risk of developing gallstones, maintain a normal body weight, exercise regularly, and eat three well-balanced meals every day. Eat plenty of foods containing fiber and calcium, and avoid alcohol and foods high in saturated fat. If you're overweight, reduce your weight, but don't try to lose weight too fast. Your healthcare provider can help you come up with a plan for healthy weight loss.