Professor Aali J Sheen
Gallstones can cause pain when the gallbladder contracts against a gallstone or the gallstone is impacted in the neck of the gallbladder, this is called ‘biliary colic’. The pain experienced is typically in the upper part of the abdomen and can move to the right hand side as well as into the right side of the back and right shoulder tip. On consumption of rich or fatty food the pain can be more pronounced as the gallbladder has to release extra bile into the bowel and so will contract more often. On occasion the bile can be prevented from being secreted (passed) out of the gallbladder as a result of a stone blocking its passage and bacteria can then colonise/grow in the stagnant bile and cause an infection; this condition is called acute cholecystitis. Sometimes a small stone can pass down the ducts and cause blockage of bile from the liver itself into the bowel. When this happens one can become jaundiced and experience a condition called ‘cholangitis’. A stone in the duct can also occlude/block the pancreas duct from releasing pancreas juice as both the bile and pancreas ducts combine before they enter the bowel and this condition is called ‘acute pancreatitis’. Pancreatitis can be very serious and normally presents with severe abdominal pain and vomiting.
Mr Neville Menezes
Incidentally detected gallstones in patients who are not symptomatic may be left alone. But if they are causing symptoms or presenting with complications one has to consider treatment. Gallstones can cause severe complications some of these have been mentioned here
Cholecystitis: Inflammation and infection of gallbladder.
Jaundice: Migration of stone from the gallbladder into the bile duct obstructing the flow of bile from the liver.
Pancreatitis: gallbladder stone having migrated into the bile duct causing obstruction of the pancreas duct and pancreatitis.
A gallbladder causing symptoms is like a warning sign before complications.