Emergency Care Institute Patient Fact Sheet

Published on 6 Jul 2022 Printed on 27 Jan 2023


Gallstones

This fact sheet is for people who have presented to the emergency department with this condition.

This fact sheet provides general information. If you have specific concerns, speak to your healthcare professional for further information and advice.

What are gallstones?

Your gallbladder is a pouch around 10cm long located in the upper right of the abdomen (tummy) – under your liver. Your gallbladder stores bile.

When you eat, the gallbladder squeezes this bile into your intestines to help digest food. Bile is needed by your body to digest fatty foods. Usually, the bile is a liquid, but it can thicken and form lumps, called gallstones. Gallstones can vary in size and number.

Around 80% of gallstones are cholesterol stones while the rest are pigment stones. Lots of people have gallstones and are not aware of them.

Symptoms

Gallstones are very common and produce little or no symptoms in most people. However, gallstones can cause these problems.

Biliary colic: a bout of sudden severe pain in the abdomen when one of the stones moves and gets stuck in the narrow tube (bile duct) coming out of your gallbladder. This causes the gallbladder to squeeze harder to try to push the stone through. The pain can last from minutes to hours. It can be associated with nausea and vomiting but the pain will usually stop if the stone is dislodged.

Cholecystitis: this refers to the thickening or inflammation of the gallbladder when a stone gets completely stuck in the bile duct. Pain from cholecystitis does not usually go away and is often associated with fever. Cholecystitis is a serious condition and requires emergency treatment in hospital.

Treatment for cholecystitis will often consist of pain relief, antibiotics and intravenous fluids while the gut is rested. If not treated, cholecystitis can worsen, and the gallbladder can burst. This is life-threatening. Sometimes people need an operation to remove the gallbladder.

Other problems: gallstones can cause blockages further down the ducts, potentially leading to jaundice (yellowing of the skin), infection of the bile ducts or pancreatitis. Each of these require urgent in-hospital care.

Causes

You are more likely to get gallstones:

  • as you get older
  • if you are pregnant
  • on the contraceptive pill
  • recently lost weight very quickly.

People who are overweight, lead inactive lives, have diabetes or a family history of gallstones are also at risk.

Treatment

Gallstones are usually found on ultrasound, however they can be seen with other tests such as computerised tomography (CT) or MRI. Often gallstones are found accidentally when a test is ordered by your doctor for another reason.

Unless they are causing problems, gallstones require no treatment. However, sometimes other options, including surgery, must be considered.

Surgery is recommended as the best treatment for people with recurrent painful gallstones. It is best done as keyhole surgery, known as laparoscopic surgery. However, you may need to have open surgery if your case is more complicated.

You can have a healthy life without your gallbladder and nine out of 10 people find that their gallstone pain goes away after surgery.

Many people have surgery to remove their gallbladder.

Your doctor will discuss the risks as well as alternatives available to you.

Home care

If you are trialling non-operative therapy or are on the waiting list for surgery, there are steps you can take to reduce the chance of having further painful episodes or suffering from other complications of gallstones. These include:

  • eating a healthy, balanced diet that includes lots of fruit and vegetables
  • gradual weight loss aiming for a healthy weight (avoid crash diets)
  • drinking plenty of fluids to keep hydrated
  • limiting the amount of caffeine and alcohol you drink
  • keeping a diary of food and symptoms to help you identify trigger foods
  • avoiding fatty foods and excess oils when cooking as these make the gallbladder squeeze and can bring on a painful episode.

What to expect

You should see your doctor if you have pain that:

  • is not controlled using simple, pain-relieving medications, like paracetamol or ibuprofen
  • does not go away after a few hours
  • is associated with a fever
  • stops you eating and drinking normally.

Seeking help

In a medical emergency call an ambulance – dial triple zero (000). If you have any concerns, see your local doctor or healthcare professional. If this is not possible return to the emergency department or urgent care centre.

For more information

Ask your local doctor or healthcare professional. You can also call healthdirect 24 hours a day on 1800 022 222 or visit healthdirect.gov.au.

Evidence informedBased on rapid evidence check of grey literature, and where there is no research, based on clinical expert consensus.
CollaborationDeveloped in collaboration with the Agency for Clinical Innovation (ACI) Emergency Care Institute members and the ACI Surgical Taskforce.
Currency Due for review: September 2027.
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