Gallstones: symptoms

Silent gallstones

About 70 per cent of people who have gallstones do not have noticeable symptoms and are often unaware of their presence. The gallstones may be discovered only during investigations for other problems. For this reason, they are sometimes called 'silent' gallstones. If you find you have silent gallstones, it is not usually recommended that you have surgical treatment unless you develop pain or other symptoms. It is important that you weigh up the risk, expense and discomfort of having your gallbladder removed (known as a cholecystectomy) against the fact that the stones may never cause any clinical illness.

Symptomatic gallstones

Symptoms of gallstones generally occur when a stone becomes lodged in one of the ducts (tubes) that carry the bile to and from the gallbladder (these include the cystic duct and the bile ducts).

The most common symptom of gallstones is pain in the upper abdomen or the back, known as biliary colic. The pain generally increases quickly and may last from a few minutes to several hours before subsiding. It may be moderate to severe and may be felt in the upper right section or centre of your abdomen, and run through to your back, between the shoulder blades or into your right shoulder.

Attacks of biliary colic are commonly recurrent (repeating). They often occur after a fatty meal, as fat intake stimulates the gallbladder to squeeze its stored bile into the small intestine to help digestion.

Several other conditions can cause symptoms similar to gallstones, so it is important that you seek advice from your doctor to rule out other causes, such as indigestion or peptic ulcer disease. Your doctor will evaluate your symptoms and may refer you to a specialist.

Gallstone symptoms requiring immediate attention

Gallstone signs and symptoms that require immediate medical attention include:

  • fever, sweating and chills;
  • steady, severe abdominal pain that persists for longer than a few hours;
  • abdominal pain that is so intense you cannot sit still; or
  • jaundice — a yellowing of the skin or whites of the eyes.

These signs and symptoms can indicate serious gallstone complications. Fever may indicate infection or inflammation of the gallbladder (a condition known as cholecystitis) or of the bile duct (cholangitis).

A constant severe pain that does not get better after a few hours may also indicate cholecystitis or pancreatitis (inflammation of the pancreas). The pancreas is a digestive gland near the gallbladder that produces insulin and digestive enzymes. These enzymes flow into the small intestine through the same opening as the bile duct and so can be affected by a gallstone. Acute pancreatitis is extremely serious and can be life-threatening.

Jaundice occurs when the main bile duct becomes blocked, leading to the build up of a substance called bilirubin in the bloodstream.

If you have any of these serious symptoms you should seek medical care immediately.


 

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