Gallstones

Once stones are formed in the gall bladder, they can either stay silent for a while or cause problems. In the presence of large stones, when the gall bladder tries to empty the bile into the small intestine for the digestion of a fatty meal, the stone can get stuck at the neck or mouth of the gall bladder causing blockage and pain. This can also lead to symptoms of indigestion, bloating and vomiting. If the stone gets released spontaneously, the pain subsides. However, if the stone gets impacted causing persistent blockage it can lead to constant severe pain, fever and infection called cholecystitis. If the stones are small they can escape into the bile duct and cause blockage of the bile duct leading to pain, jaundice and sometimes causing pancreatitis. Patients who have gall bladder stones are strictly advised to take fat free diet until they get their gall bladder removed.

An Ultrasound scan of the abdomen can confirm the presence of stones in the gall bladder. It can also detect the size and number of stones. The presence of stones in the bile duct and enlargement of the size of bile duct due to blockage may be seen on an ultrasound scan. Confirmation of complications such as the presence of stones in the bile duct, jaundice and pancreatitis will need additional investigations such as CT scan, MRI scan (MRCP) and certain blood tests.

Diagnostic Tests

Gallstones are diagnosed using various tests, depending on the severity of symptoms:

• Ultrasound: A common, non-invasive imaging test to detect stones in the gallbladder.
• CT Scan or MRI: Used for more detailed imaging, especially to locate stones in the bile ducts.
• Blood Tests: To check for signs of infection or issues with bile flow.
  Accurate diagnosis is essential for tailoring the appropriate treatment plan.

Treatments for Gallstones

The presence of gallstones in a patient suffering with abdominal pain, bloating, indigestion or the presence of gallstone complications such as acute cholecystitis (infection of gall bladder), pancreatitis (inflammation of pancreas) will need surgery to remove the gall bladder. Nowadays gall bladder removal is performed by laparoscopic surgery by making three to four small holes to completely remove the gall bladder. The operation can take between 1-2 hours.

Treatment for gallstones varies based on their severity:

• Watchful Waiting: For silent gallstones without symptoms.
• Medications: Used to dissolve cholesterol gallstones, though this is less common.
• Surgery:
  • Laparoscopic Cholecystectomy: A minimally invasive procedure to remove the gallbladder, widely preferred due to its quick recovery time.
  • Open Surgery: Reserved for complicated cases or when minimally invasive methods are not viable.
    Early treatment minimizes the risk of complications and ensures a smooth recovery.

Post-treatment follow-up ensures long-term recovery and prevents recurrence:

• Regular check-ups after surgery to monitor healing and address any residual symptoms.
• Maintaining a healthy lifestyle with:
  • A balanced diet rich in fiber
  • Regular exercise to maintain a healthy weight
  • Avoiding rapid weight loss
    Most individuals recover fully after treatment, but adherence to preventive measures is key to avoiding future gallstone formation.

Life after gall bladder removal

After gall bladder removal, the bile duct takes up the function of storage of bile. Patients who had their gall bladder removed will have normal digestion and can lead an entirely normal life. There are no dietary restrictions that need to be followed after gall bladder removal. However, in the interest of general health we advise them to take a healthy diet