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Gallstones

What Are The Symptoms Of Gallstones?

Last updated on:
22/03/2013

Contributing Author: Guy Slowik FRCS

Gallstones may cause no symptoms at all or may cause various symptoms, sometimes severe.

Most gallstones don't cause illness and are termed "silent" stones. They often are discovered accidentally, when an individual has medical tests for other health concerns. Silent gallstones may be small enough to pass through the ducts between the liver and small intestines, and out of the body. Silent stones also may be quite large, but they remain in the gallbladder and never move.

 

 

Gallstones cause trouble when they:

  • Irritate the gallbladder, causing a condition called cholecystitis. When gallstones partially block the flow of bile out of the gallbladder, bile remaining in the gallbladder becomes stronger or more concentrated. That irritates the bladder walls, causing inflammation.

     

  • Get stuck in ducts that carry bile from the liver to the small intestine, causing sudden severe pain called biliary colic.

     

 

 

 

Gallstones may get stuck in:

 

 

  • Hepatic ducts, which carry bile out of the liver.

     

  • The cystic duct, which carries bile to and from the gallbladder.

     

  • The common bile duct, which collects bile from the cystic and hepatic ducts and carries it to the small intestine.

    Doctors gave the common bile duct its name because it is shared by several organs, which use it in common. A duct from the pancreas also opens into the common bile duct. It carries digestive juices containing powerful enzymes from the pancreas to the small intestine.

     

  • A gallstone that blocks the opening of the pancreatic duct may cause digestive enzymes to become trapped inside the pancreas. The result can be a very painful and dangerous inflammation of the pancreas called pancreatitis.

     

 

 

 

 

Symptoms of Jaundice

Abdominal pain, nausea, vomiting, and a bloated feeling in the stomach and chest are the most common symptoms of a gallstone attack.

Similar symptoms can occur in a number of serious diseases, including a heart attack. They also can occur in ordinary indigestion. When the symptoms occur, it is important to get medical advice.

A gallstone attack can be very painful.

  • Pain can occur in the upper right part of the abdomen under the ribs. Usually it appears suddenly, sometimes an hour or two after eating a fatty meal. Fat in food signals the gallbladder to contract and squirt bile into the small intestine. If there are stones in the gallbladder or ducts, contraction may cause pain.

     

  • Pain may get worse quickly, and then last for several hours.

     

  • Pain may extend, or radiate, to the back between the shoulder blades or under the right shoulder. Inhaling deeply, or moving, often makes the pain worse.

     

 

Along with the pain there may be other symptoms, including the following.

  • Nausea

     

  • Vomiting

     

  • A bloated sensation in the abdomen

     

  • Gassiness, with belching and passing of intestinal gas

     

  • Indigestion

     

  • Clay-colored stools

     

  • Jaundice, a yellowish color in the skin or whites of the eyes

     

  • Chills, sweating, and fever

     

 

Many people who have a gallstone attack recall similar but less severe symptoms that occurred in the past, but disappeared. Those probably were due to small gallstones that lodged briefly in the ducts and then passed into the small intestine.

 

 

Gallstones And Jaundice

If gallstones pass into the common bile duct, they may become stuck at the lower end of the duct and prevent the free flow of bile into the intestine. When the flow of bile is blocked, it backs up into the liver and spills over into the blood. This results in jaundice.

Jaundice is a yellowing of the skin and the whites of the eyes. The urine turns dark and the stools become a pale clay color, instead of brown. These color changes are due to the high bile pigment concentration in the blood. The condition is called obstructive jaundice because an obstruction in the bile duct - the gallstone - is the cause.

Sometimes a stone will become unstuck and pass into the intestine. Then jaundice improves. Often, however, the stone simply "uncorks" temporarily and stays in the common bile duct, where it may block bile flow again in the future.

If the stone remains stuck in the duct, the jaundice will worsen. This may become life threatening:

  • Individuals with obstructive jaundice often are very ill and need emergency surgery to remove the gallstone reopen the duct.

     

  • Without surgery, they face a high risk of infections, serious complications and death.

     

  • Obstructive jaundice often occurs in elderly people who are less able to cope with the complications.

     

  • The risk of obstructive jaundice is one important reason why people with gallstone symptoms usually should have their gallbladder removed.

     

  • Fortunately, only a very small percentage of people with gallbladder disease develop jaundice.

     

 

 

 
 

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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.