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Gallstones

Gallstones: Frequently Asked Questions

Last modified: 
22/03/2012 - 15:58

Contributing Author: Guy Slowik FRCS

Here are some frequently asked questions related to Gallstones.

Q: I had an ultrasound scan of the abdomen for another medical problem. It showed several big stones in my gallbladder. Should I have my gallbladder removed?

A: About 60% of people with gallstones never have any symptoms and never get sick. They're just like you. Most might never even know they had gallstones. Their stones are discovered by accident, during tests for other diseases. If you do start having abdominal pain after fatty meals, indigestion, gas, bloating, or other symptoms, make sure to remind the doctor about the ultrasound scan results.

Q: Two friends went on crash diets, and lost a lot of weight real fast. Within a few months, both developed gallstones and needed surgery. How could dieting cause gallstones?

A: Rapid weight loss diets and fasting do increase the risk for gallstones. Both tend to increase the amount of cholesterol in bile. The increase occurs as the body burns stored fat tissue. Sometimes, there is so much cholesterol, that it can no longer remain dissolved in bile, so it turns into a solid crystal, which form gallstones. Dieting and fasting also slow the rate at which the gallbladder squirts bile into thesmall intestine. With less food to digest, there is less need for bile. Bile remains in the gallbladder longer, and becomes strong, or more concentrated. That also makes it more likely for cholesterol and other dissolved material to form stones.

Q: Will I need to stay on a special diet after having my gallbladder removed?

A: People can live normally without a gallbladder. Your liver will still make the bile needed to digest fats. After surgery it will flow directly into the small intestine, rather than being stored in the gallbladder. Years ago doctors routinely told patients to avoid fatty foods after surgery. Most no longer make any special dietary recommendations.

Q: Ever since gallbladder surgery, I've had looser bowel movements. I also have bowel movements more often now. Could removal of my gallbladder have caused digestive problems?

A: Almost 1 in every 3 people have looser and more frequent bowel movements after gallbladder surgery. A few develop more troublesome diarrhea. Scientists think that gallbladder removal decreases the amount of time that food remains in the large intestine. The large intestine removes water from digested food and stores feces for elimination from the body. When digested food moves through the large intestine faster, diarrhea-like symptoms may occur. Often just avoiding certain foods can solve the problem. If not, check with your doctor to see if your digestive problems need treatment.

Q: Two months ago, my wife went to the emergency room in the middle of the night with severe abdominal pain. The doctor said it was a gallstone attack, and recommended removal of her gallbladder. She's had no more problems since then. Could the disease have just gone away?

A: Some people do have just one gallbladder attack. But one attack carries about a 70% risk of having another. Your wife may be having symptoms, but confusing them with ordinary indigestion. If tests show that her gallbladder is infected or inflamed, immediate surgery may be necessary. Surgery also may be wise if there are more stones in her gallbladder or she does a lot of foreign travel, which could complicate a sudden need for surgery. Your wife should discuss her own situation with the doctor and find the best approach for her.

Q: Why should I have my gallbladder removed when non-surgical treatments are available?

A: Non-surgical treatments have plenty of disadvantages. One is that they usually are not a permanent cure. Drugs that dissolve gallstones, for instance, must be taken every day for months or years. They work for only certain kinds of gallstones. If you stop the medicine, gallstones usually start to form again. Shockwave therapy can break gallstones into pieces small enough to pass from the body. But it often doesn't work, and patients may have to take drugs for the rest of their life to keep new stones from forming.

Q: When my mom had gallbladder surgery, she stayed in the hospital for a week. It took her weeks at home to get back to normal. The doctor says modern surgery is a lot easier on patients. He says I need to stay just overnight, and can go back to work in about a week. Does that sound right?

A: Today, most gallbladder operations are done with a "Band-Aid" method. It is called "minimally invasive" surgery because it uses small incisions, instead of the 6-inch to 8-inch incision used in the past. The doctor operates through a laparoscope, a pencil thin instrument with a mini-camera. Patients have less discomfort after surgery, heal faster, and resume normal activities sooner.

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.