Gallstones

  • Medical Author:
    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

  • Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.

Gallbladder Attack Symptoms

Symptoms of a gallbladder attack include:

  • pain in the upper right side or middle of the abdomen;
  • the pain may be dull, sharp, or cramping;
  • the pain typically starts suddenly;
  • the pain is steady and may spread to the back or the area below the right shoulder blade.

Gallstones facts

  • Gallstones are "stones" that form in the gallbladder or bile ducts.
  • The common types of gallstones are cholesterol, black pigment, and brown pigment.
  • Cholesterol gallstones occur more frequently in several ethnic groups and are associated with female gender, obesity, pregnancy, oral hormonal therapy, rapid loss of weight, elevated blood triglyceride levels, and Crohn's disease.
  • Black pigment gallstones occur when there is increased destruction of red blood cells, while brown pigment gallstones occur when there is reduced flow and infection of bile.
  • The majority of gallstones do not cause symptoms.
  • The most common symptoms of gallstones are biliary colic and cholecystitis. Gallstones do not cause intolerance to fatty foods, belching, abdominal distention, or gas.
  • Complications of gallstones include cholangitis, gangrene of the gallbladder, jaundice, pancreatitis, sepsis, fistula, and ileus.
  • Gallbladder sludge is associated with symptoms and complications of gallstones; however, like gallstones, sludge usually does not cause problems.
  • The best single test for diagnosing gallstones is transabdominal ultrasonography. Other tests include endoscopic ultrasonography, magnetic resonance cholangio-pancreatography (MRCP), cholescintigraphy (HIDA scan), endoscopic retrograde cholangio-pancreatography (ERCP), liver and pancreatic blood tests, duodenal drainage, oral cholecystogram (OCG), and intravenous cholangiogram (IVC).
  • Gallstones are managed primarily with observation (no treatment) or removal of the gallbladder (cholecystectomy). Less commonly used treatments include sphincterotomy and extraction of gallstones, dissolution with oral medications, and extra-corporeal shock-wave lithotripsy (ESWL). Prevention of cholesterol gallstones also is possible with oral medications.
  • Symptoms of gallstones should stop following cholecystectomy. If they do not, it is likely that gallstones were left in the ducts, there is a second problem within the bile ducts, or there is sphincter of Oddi dysfunction.
  • Many dietary recommendations have been made for the prevention or treatment of gallstones and to prevent their symptoms, but none of them have been shown to be effective.
  • Many home remedies have been suggested for eliminating gallstones, but none have been shown to be effective
  • Continuing research is directed at uncovering the genes that are responsible for the formation of gallstones. Continue Reading
Reviewed on 4/18/2016
References


UpToDate. Gallstones (Beyond the Basics).

Thistle, J. et al. Factors That Predict Relief From Upper Abdominal Pain After Cholecystectomy. Clinical Gastroenterology and Hepatology, Vol. 9, Issue 10, p891–896. Published online: May 23, 2011.

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