Gallstones

Understanding Gallstones

The gallbladder is a small, pear-shaped organ tucked under the liver. It stores bile — a fluid the liver makes to help digest fat. When the chemistry of bile is out of balance (too much cholesterol or bilirubin), tiny crystals form and gradually clump into stones. These can range from a single stone the size of a golf ball to hundreds of tiny, gravel-like stones.

Gallstones themselves are not cancerous. The problem begins when a stone moves and blocks the outflow of bile — causing pain, inflammation, or infection.

Symptoms

• Sudden, intense pain in the upper-right or centre of the abdomen (biliary colic)
• Pain that spreads to the right shoulder or between the shoulder blades
• Nausea or vomiting, often after fatty or heavy meals
• Bloating, indigestion and belching
• Pain lasting from 30 minutes to several hours
• Fever, chills or yellowing of the skin/eyes (a sign of a serious blockage)

Causes & risk factors

• Bile with too much cholesterol
• Being female, especially with previous pregnancies
• Age over 40
• Being overweight or rapid weight loss / crash dieting
• A diet high in fat and low in fibre
• Diabetes or a family history of gallstones

Possible complications

• Acute cholecystitis — a painful, infected gallbladder
• Blockage of the bile duct (obstructive jaundice)
• Acute pancreatitis if a stone blocks the pancreatic duct
• Infection of the bile ducts (cholangitis), which can be life-threatening

How it is diagnosed

Gallstones are usually confirmed with a simple abdominal ultrasound — a quick, painless scan that detects most stones. Blood tests check for infection and liver involvement. If a stone is suspected in the main bile duct, an MRCP scan or endoscopic evaluation may be advised before surgery.

Treatment options

Gallstones that cause no symptoms usually need only observation. Once they cause pain or complications, medicines and dietary changes may ease an episode but cannot dissolve the stones or stop them recurring. For symptomatic gallstones, the reliable, long-term solution is to remove the gallbladder.

Surgical treatment

The standard treatment is laparoscopic cholecystectomy — keyhole removal of the gallbladder through a few small (5–10 mm) cuts, using a camera and fine instruments. Dr. Sujan Shrestha performs this as a minimally invasive, often day-care procedure. Because the gallbladder only stores bile, life and digestion continue normally without it.

Compared with traditional open surgery, the keyhole approach means far less pain, tiny scars, a shorter hospital stay and a quicker return to work.

Recovery & aftercare

Most patients go home the same day or the next morning and return to light activity within a few days. You may be advised to ease back into fatty foods gradually. Full recovery after keyhole surgery typically takes one to two weeks, compared with several weeks for open surgery.

When to see a doctor

See a doctor promptly if you have repeated upper-abdominal pain after meals. Seek urgent care if you develop fever, persistent severe pain, or yellowing of the skin or eyes — these can signal infection or a blocked bile duct that needs immediate treatment.