Gallstones and Related Conditions

Gallstone disease is a very common problem in Australia, with around 25% of the population developing gallstones before the age of 50 years. There is no universal cause for gallstones however there a number of known risk factors which include:

• Female gender
• Obesity
• Rapid weight loss
• Family history
• Oral contraceptive pill
• Hormone replacement treatment

Most people with gallstones, approximately 90%, do not develop symptoms. The remaining 10% develop symptoms which vary in severity and seriousness (see below).

The treatment of gallstone disease is surgery. Cholecystectomy is the removal of the gallbladder, usually by laparoscopy (keyhole surgery). Complications are uncommon, and most people are able to go home after one night in hospital for elective surgery.

Biliary colic is pain from gallstones and typically comes on after eating, especially after rich or fatty meals. The pain usually comes on minutes to hours after the meal and resolves on its own, usually within 4 hours of starting. Biliary colic is benign, it won’t cause any harm, but can be very uncomfortable for the sufferer. Some people are able to minimise symptoms by avoiding any fatty foods in their diet, however the definitive treatment is having your gallbladder removed via surgery.

Cholecystitis is inflammation of the gallbladder. The triggering event is usually a gallstone getting stuck in the outlet of the gallbladder which causes a chemical change in the bile and an inflammatory response. This inflammation may subsequently develop a secondary bacterial infection. Symptoms of cholecystitis are similar to biliary colic but tend not to improve with time. These patients may get initially get better with antibiotics, but ultimately will need surgery to remove their inflamed gallbladder.

Cholangitis is an infection in the bile duct which is the main drainage duct that connects the liver (where bile is made) to the first part of the small bowel, the duodenum, where bile is used for digestion. This infection is usually caused by a gallstone in the bile duct that blocks the drainage of the liver. This blockage allows bacteria to multiply in the bile duct and is often associated with jaundice (turning yellow). Cholangitis is a potentially life-threatening emergency that needs urgent treatment in a hospital.

Pancreatitis is inflammation of the pancreas caused by pancreatic digestive juices attacking the pancreas itself. The most common cause of pancreatitis is gallstones. Once a person has developed pancreatitis from gallstones, it is strongly recommended that their gallbladder be removed by surgery.