Gallstones are common in the population and may cause no symptoms. Symptoms can occur when stones move and block the bile ducts. The quality and severity of symptoms vary greatly, but there are common patterns. Classic gallbladder attacks occur shortly after a fatty meal that has stimulated the gallbladder to do its job and contract to eject bile into the intestine. Normal post-meal gallbladder contraction causes no perceptible sensation and stones normally cause no interference with gallbladder function. Keep in mind that the only function of the gallbladder is to store bile, which is a liquid used for the digestion of fat.
Occasionally, however, a contracting gallbladder can squeeze a gallstone into the outflow channel of the gallbladder. When this happens, that channel, called the cystic duct, becomes plugged and the gallbladder spasms in a futile effort to empty its bile. A spasming gallbladder, like other spasms, can be very painful. People who fall victim to this cycle of gallbladder blockage and spasm understand the term “gallbladder attack,” or what doctors call “biliary colic.”
Biliary colic is typically felt in the right upper abdomen and radiates around to the back. Associated nausea, vomiting, and bloating are common. Variations in the pattern of symptoms include location (with some patients feeling the attack in the upper mid-abdomen and others in the lower chest) and severity. Some attacks produce only mild discomfort while others cause excruciating pain. Some victims of a severe gallstone attack actually fear that they are having a heart attack.
Regardless of the location or severity of pain, and the presence of absence of nausea, most gallbladder attacks end just as abruptly as they began. The actual physiology is complex, but think of the culprit gallstone tumbling out of the way and allowing the bloated, spasming gallbladder to decompress. Ahhh. Relief. The attack is over, usually after 30 minutes to several hours. What to do now?
Those who survived a severe attack are often motivated to take immediate action to avoid any repeat. If your attack was mild you may be inclined to be conservative and simply avoid fatty food – and surgery. But bigger problems can lurk.
But, let’s back up for a moment.
What Are Gallstones?
Gallstones form within the gallbladder, which is basically a storage bag attached to the underside of the liver in the right upper abdomen. Liquid bile is secreted by the liver, through the bile duct and into the gallbladder. If the chemical composition of the bile is out of balance, gallstones precipitate out in clumps, like fat globules appearing in a cooling pot of home-made chicken soup.
Gallstones come in infinite varieties, from solitary to heaping piles, jet black to pale yellow, tiny pebbles to big rocks, and jagged to smooth. Surprisingly, none of these features determine symptoms or treatment.
Who Is Most at Risk for Developing Gallstones?
Metabolism and hormones have a big impact on the chemistry of the bile. So does your family tree. Because of this, some people are prone to developing gallstones, including Native Americans, Hispanics, and those with multiple close blood relatives with gallstones. Additionally, pregnant women, those who have quickly lost weight, and those taking cholesterol reducing drugs are at increased risk of gallstones.
Early Warning Signs of Gallstones and When to See a Doctor
Pay attention to sharp cramping pains in the right side of your abdomen along with pain between the shoulder blades in your back. Association with fatty food, fluctuating symptoms, and waves of nausea are additional clues. Complicated gallbladder attacks come in three varieties – cholecystitis (gallbladder infection), cholangitis (bile duct and liver infection), and pancreatitis (inflammation of the pancreas). These are serious complications and require hospitalization and emergency treatment. Many patients with these potentially life-threatening complications require emergency surgery. Fortunately, these conditions are almost always preceded by warning attacks of “simple” biliary colic and can therefore be prevented by removing the gallbladder when indicated.
If complications do occur, prompt treatment is important. Symptoms of cholecystitis,cholangitis, or pancreatitis include::
- Persistent nausea and vomiting (beyond several hours)
- Persistent pain in your abdomen, back or right shoulder (beyond several hours)
- Fever and chills
- Yellowing of the skin and eyes known as jaundice
- Dark (coca cola colored) urine
These more severe symptoms should alert you to a possible complicated gallbladder attack and the need for visiting the emergency room.
Treatment Options
Asymptomatic gallstones do not usually require treatment beyond observation. Symptomatic gallstones typically require surgery. This can usually be done laparoscopically, with or without robotic assistance. This minimally invasive approach is typically done outpatient and allows for quick recovery.
Experimental treatments from the past, including shock wave lithotripsy and dissolution medication, are associated with bad outcomes and are no longer recommended.
Gallbladder Surgery at SEM Surgical
If you’ve experienced the warning signs of gallstones, it’s important to address the issue before it leads to more serious complications. At SEM Surgical, we specialize in gallbladder surgery, offering both traditional and minimally invasive options to safely remove the gallbladder when necessary.
Our team in Royal Oak, MI uses the latest techniques in gallbladder surgery to ensure a smooth procedure and a quick recovery, helping you get back to your daily life as soon as possible. Whether your condition requires immediate surgery or you’re exploring your options, we are here to provide personalized care and expert guidance every step of the way.
Call SEM Surgical today at (248) 985-8060 to schedule your consultation and take the next step toward relief with professional gallbladder surgery.
Sources:
Gallstones – Symptoms & causes – Mayo Clinic
Seven Things You Should Know About Gallstones and Gallbladder Removal | Jefferson Health
