Gallstones

Illustration showing the gallbladder and common bile duct that is situated below the liver. Gallstones in the common bile duct can block the flow of bile and cause inflammation, infection and jaundice.

What is the function of the gallbladder?

The gallbladder is a pear-shaped sac that sits just underneath the liver. The function of the gallbladder is to store the bile produced by the liver. The liver produces about 500-700 ml of bile each day, which helps digest fat in the food. Following food consumption, the gallbladder receives a signal. It then contracts and squeezes the bile out to the first part of the small bowel to help with digestion. Removing the gallbladder usually has no significant side effects. However, a small percentage of patients may experience fatty diarrhoea after eating a fatty meal. Even though the liver makes the same amount of bile, the lack of storage in the gallbladder means that there may be insufficient bile delivered in the small bowel following a fatty meal to fully digest the fat. This can lead to the fatty diarrhoea (steatorrhoea). In most cases, the body adapts itself over time and these symptoms resolve.

What causes gallstones?

Gallstones are a common problem and can affect up to 25% of the population, mostly women. Gallstones are caused by an imbalance in the substances within the bile, which can lead to a build-up of sediment and subsequently stone formation. There are known risk factors for gallstones, such as female gender, genetic predisposition, obesity, pregnancy or other hormonal factors, rapid weight loss, diabetes and certain medications.

What problems can be caused by gallstones?

Occasionally gallstones can be found  when undergoing  imaging for other conditions. If they are asymptomatic, they may not require specific treatment.

The most common symptom of gallstones is biliary colic, which typically manifests as pain in the right upper part of the abdomen and can travel through to the back. Usually this happens after eating a fatty meal, sometimes in the middle of the night. Nausea and vomiting may accompany the pain.

More serious complications of gallstones include:

  • Cholecystitis (inflammation/infection of the gallbladder)

  • Pancreatitis (inflammation of the pancreas, due to a (temporary) blockage by gallstones)

  • Cholangitis (infection in the bile ducts due to blockage by gallstones)

What is the treatment for gallstones?

The recommended treatment for symptomatic gallstones is to have the gallbladder removed. This operation is one of the most common surgeries performed in Australia. Dr Bell will be able to explain the risks and benefits of a laparoscopic cholecystectomy (keyhole surgery to remove the gallbladder) with you.