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About one in ten people in Britain have gallstones. It is more common in women, overweight people and those who are middle-aged and older. This information sheet has been developed for you, to give you the opportunity to understand this common complaint.

What are Gallstones?
Gallstones are solid lumps or ‘stones’ which form in the gallbladder or bile ducts. These ‘stones’ are usually made of cholesterol (a fat), but can include calcium salts (similar to chalk). They may be the size of a grain of rice, or as big as a golf ball. Some people get a single large stone whilst others may have hundreds of tiny ones.

Usually gallstones cause no symptoms at all. These are referred to as ‘silent’ and require no treatment. Symptoms that can be caused by gallstones are:

• Abdominal pain that can become severe, lasting as little as 15 minutes or several hours. Some patients have back and shoulder pain.
• Nausea with or without vomiting.
• Abdominal bloating, wind and indigestion.
• Dark urine and pale clay-coloured stool.
• Sweating, chills and a high temperature.
• Yellowing of the skin or whites of the eye.

Diagnosis and Treatment
Your doctor will:
• Ask you to describe your symptoms.
• perform a physical examination
• take a blood sample
• and will probably arrange for you to have an ultrasound scan. This examination is where a microphone is used to’ bounce’ sound waves against hard objects like stones, these sound waves are displayed as a picture on a screen. A Radiographer will perform this scan.

If your consultant suspects a stone has become ‘lodged’ within the common bile duct, an ERCP (endoscopic retrograde cholangiopancreatography) may be recommended. A long, flexible, telescope with a light source is guided into the duodenum to enable the Doctor to view the ducts and find any stones. People can live without a gall-bladder; the most common treatment for symptomatic gallstones is the surgical removal of the gall-bladder, known as cholecystectomy, (pronounced co-lee-sist-ect-omy).

This operation is commonly performed using the keyhole method, (laparoscopic choleycystectomy) which generally means having a number of tiny cuts (usually four in the abdomen).

Surgical instruments and a miniature camera, with light source are use to remove the gall-bladder. Laparoscopic surgery is not possible for all patients and an ‘open’ cholecystectomy may be necessary – this involves removing the gallbladder through a larger cut in the abdominal wall. When a person’s gall-bladder becomes inflamed, a condition referred to as cholecystitis (pronounced co-lee-sist-it-is) you will usually be kept in hospital for a few days with antibiotics. You may be offered surgery during thi stage or at the later date. You will be advised not to eat as this will make your symptoms worse.

The Nurses and Doctors will advise you when to re-commence food.

What Should I Eat?
Many people with gallstones find some foods (especially those that are fatty or oily) make them feel sick and give them pain. A low fat healthy diet is recommended including steamed or boiled vegetables, fruit, pasta, steamed or poached fish, skinless chicken, grilled lean meat, skimmed milk, brown bread, and various types of beans and pulses. After a cholecystectomy, you could re-introduce fats in to your meals, although it is healthier to avoid them as much as possible.

Common Bile Duct
Cystic duct Duodenum
Gallbladder with stones

Further Information
Send a SAE stating what information you require to: The Digestive Disorders Foundation, PO Box 251, EDGWARE, Middlesex, HA8 6HG.