Gallstones - discharge
Chronic cholecystitis - discharge; Dysfunctional gallbladder - discharge; Choledocholithiasis - discharge; Cholelithiasis - discharge; Acute cholecystitis; Cholangitis - discharge
You have gallstones. These are hard, pebble-like deposits that form inside your gallbladder.
Most gallstones do not cause symptoms. Sometimes gallstones cause intermittent pain that goes away on its own (biliary colic). This usually does not require hospitalization.
However, because your gallstones caused problems, you were admitted to the hospital. You may have been admitted for cholecystitis, which is inflammation of the gallbladder usually from gallstones getting blocked in the drainage tubes (bile ducts). You may also have been admitted for complications from this, such as infection in the drainage ducts (cholangitis) or gallstone-related pancreatitis. This article tells you how to take care of yourself when you leave the hospital.
Normally a balance of bile salts, lecithin and cholesterol keep gallstones from forming. If there are abnormally high levels of bile salts or, more commonly, cholesterol, stones can form. Symptoms usually occur when the stones block one of the biliary ducts or gallstones may be discovered upon routine x-ray or abdominal CT study.
Stones are great for tossing into a stream or using to line your flowerbeds. But they're not so great when they're trapped inside your gallbladder. If you've got pain in the upper part of your belly, a fever, or yellow skin, they could be signs that you've got gallstones. The stones that form in your gallbladder aren't made of rock. Usually, they're made of cholesterol, a type of fat in your blood. Or, they could be made from a substance called bilirubin, which is processed in your liver. Gallstones can be as small as a grain of sand, or as big as a golf ball. You're more likely to get gallstones if you're over age 40, or if you have a chronic condition like diabetes, anemia, or cirrhosis of the liver. People who've had weight-loss surgery, or who went on a crash diet and lost weight very quickly can also develop gallstones. Gallstones are more common in women than in men, and they may run in families. So, how do you know if you have gallstones? Well, you might not realize it, because often gallstones don't cause any pain. They're often found accidentally during an x-ray or surgery to treat another condition. If the gallstone is very large, though, it may get stuck in one of the tubes, called ducts, which connect to the gallbladder. Then you'll probably feel a sharp or cramping pain in the upper right or middle part of your abdomen. You may also have a fever and feel sick to your stomach. Your doctor can do an ultrasound, or other scan of the gallbladder area to find out if gallstones are causing your pain. You may also have blood tests to check your liver function and to see if your bilirubin levels are too high. You may not need to treat gallstones, unless they're causing symptoms. If that's the case, your doctor will recommend treatment which is usually surgery to remove them. Often, this is done with a laparoscopic procedure that removes the gallstone through very small cuts or incisions. Normally, you can go home the same day as your surgery, or the next day. Most people don't need to have their whole gallbladder removed, unless they have complications, like a blocked duct. There is also medicine that can dissolve cholesterol gallstones, but it isn't that effective because it can take two years or more to work, and often the stones form again after you're done taking it. You can't really prevent gallstones, except by avoiding rapid weight loss or health conditions that can cause gallstones such as obesity, diabetes, or cirrhosis. But if you do get them, gallstones are pretty easy to treat. Most people don't have any symptoms or complications from them, and those who do have symptoms usually recover completely and don't get gallstones again after their surgery. It's important that you call your doctor if you are having abdominal pain, yellow skin or eyes, so you can find out for sure whether you have gallstones, and get them treated.
When You're in the Hospital
You may have had an infection in your gallbladder. You may have received medicines to reduce the swelling and fight the infection. You may have had surgery to remove your gallbladder. This is called cholecystectomy. It is the most common treatment for gallstones that are causing problems or symptoms. There are two types of cholecystectomy procedures:
- Open cholecystectomy. This is performed when your gallbladder is scarred, inflamed, or infected.
- Laparoscopic cholecystectomy. This procedure is more common. It is less invasive and has a shorter recover period than open surgery.
If a gallstone is blocking a drainage duct outside of the gallbladder, then you may have had other procedures to remove those gallstones, but removing the gallbladder is usually done during the same hospital stay or the gallstone problems usually come back.
What to Expect at Home
You may continue to have pain and other symptoms if your gallstones return or were not removed. If you had a cholecystectomy, you will be given instructions to follow up after surgery.
Self-care
You may be on a liquid diet for some time to give your gallbladder a rest. When you are eating regular food again, avoid overeating. If you are overweight try to lose weight.
Take acetaminophen (Tylenol) for pain. Ask your health care provider about stronger pain medicines.
Take any medicines you have been given to fight infection the way you were told to. You may be able to take medicines that dissolve gallstones, but they may take 6 months to 2 years to work, and the gallstones return after stopping the medicine. So, this medicine is not used a lot. That's why if you have symptomatic gallstones, your gallbladder is removed.
When to Call the Doctor
Contact your provider if you have:
- Steady, severe pain in your upper belly
- Pain in your back, right shoulder, or between your shoulder blades that does not go away and is getting worse
- Nausea and vomiting
- Fever or chills
- Yellow color to your skin and the whites of your eyes (jaundice)
- Grey or chalky white bowel movements
References
Cameron J. Gallbladder and biliary tree. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:chap 8.
Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 141.
Glasgow RE, Mulvihill SJ. Treatment of gallstone disease In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 66.
Version Info
Last reviewed on: 10/30/2024
Reviewed by: Jenifer K. Lehrer, MD, Gastroenterologist, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
