Understanding the gallbladder and bile
The gallbladder is a small pear-shaped organ that is attached to the underside of the liver. It functions as a storage reservoir for bile. With meals, the gallbladder contracts and empties the stored bile through a long tube (bile duct) into the small bowel.
Bile is a fluid that helps digestion by breaking down fats in food. It contains various substances, including bile pigments, bile salts, cholesterol and lecithin. It is produced by the liver and passed through the bile duct into the small bowel.
When the gallbladder is removed, bile will still flow from the liver to the small bowel to aid digestion but there is no longer a storage area for bile between meals.
What are gallstones?
Gallstones are literally small stones, often the size of a marble (but can vary from as small as a grain of sand to as big as a golf ball) that form in the gallbladder. When the substances within bile becomes unbalanced, some of the chemicals solidify and form gallstones. Most gallstones are made mainly of cholesterol.
Who gets gallstones?
About 1 in 10 adults develop gallstones.
Certain factors increase the risk of developing gallstones:
- Increasing age
- Female gender
- Some ethnic groups
- Multiple pregnancies
- Obesity or rapid weight loss
What problems can gallstones cause?
About 1 in 3 people with gallstones develop symptoms and complications. These include:
This is severe pain in the upper abdomen which can extend towards the right-hand side and to the back. It typically occurs after meals and lasts from minutes to hours. It may be associated with bloating, nausea or vomiting.
This is inflammation of the gallbladder which can progress to an infection. Symptoms usually develop quickly and include abdominal pain, fever and being generally unwell.
This is yellowing of the skin or the whites of eyes. It occurs if gallstones escape into the bile duct and cause a blockage. Bile cannot pass into the small bowel and instead seeps into the bloodstream. Cholangitis, a severe infection of the bile duct, may develop.
This is inflammation of the pancreas (another digestive organ). It occurs if small gallstones escape into the bile duct and pass beyond the pancreas resulting in inflammation.
This is a rare form of bowel obstruction. Large gallstone(s) can erode through the gallbladder into the adjacent bowel and cause a blockage.
How are gallstones diagnosed?
Gallstones are diagnosed by an ultrasound scan.
What are the treatments for gallstones?
Symptoms due to gallstones tend to recur if left untreated. Complications due to gallstones (e.g. cholecystitis, cholangitis, pancreatitis) require urgent treatment.
The recommended treatment for gallstones that have caused troublesome symptoms and/or complications is surgery to remove the gallbladder. The standard modern technique is through keyhole surgery, an operation called laparoscopic cholecystectomy.