Gallstones: Symptoms, Risks, and Surgical Options - Gastroenterology and Hepatology

Gallstones

I discovered this two years after giving birth.
At that time, I was experiencing unexplained back pain, which led to further examinations.
A CT scan revealed that I had two types of stones, and my gallbladder wall was somewhat thick (I don't know how thick).
The surgeon recommended removal.
During the abdominal ultrasound, the gallbladder was contracted, and the surgeon was unsure about its condition (the CT scan was done afterward).
Eventually, I did not undergo surgery.
Now, I feel like there is something pressing in my right upper abdomen when sitting.
If I raise my right arm or straighten my back, the discomfort is less noticeable.
Could this be related to my gallbladder? Is it really okay to remove it? Won't the stones just move to another location, like the bile ducts or liver? Also, is there a higher risk of developing colon cancer? Am I at risk of serious complications? This is really troubling me.
If I encounter my menstrual period, can I still have the surgery? Recently, I have been experiencing pain and numbness in my tongue and oral cavity; could this be related?

Xiao Ke, 30~39 year old female. Ask Date: 2006/12/13

Dr. Chen Jianhong reply Gastroenterology and Hepatology

Hello! The symptoms mentioned in the letter are quite vague, so it is advisable to promptly visit a hepatobiliary specialist for a detailed examination.
If it is indeed necessary to remove the gallbladder due to gallstones, it will not affect digestive function.
Menstruation should not impact the surgery, but the physician will conduct a thorough assessment prior to the procedure.
As for the oral issues, it is recommended to consult a dentist.

Reply Date: 2006/12/13

More Info

Understanding gallstones and their management can be quite complex, especially when considering the symptoms, risks, and surgical options available. Based on your description, it seems you have been living with gallstones for some time, and your symptoms have raised concerns about the necessity of surgical intervention.

Symptoms of Gallstones
Gallstones can present a variety of symptoms, the most common being right upper abdominal pain, especially after eating fatty meals. This pain can sometimes radiate to the back or shoulder. Other symptoms may include nausea, vomiting, and in some cases, fever if there is an associated infection like cholecystitis. The sensation of pressure or fullness in the upper abdomen, as you described, can also be indicative of gallbladder issues.
In your case, the feeling of something "pushing" in your right upper abdomen could indeed be related to your gallstones, especially if they are causing irritation or inflammation of the gallbladder wall. The thickening of the gallbladder wall noted in your imaging studies can be a sign of chronic inflammation, which may warrant surgical evaluation.

Risks of Not Treating Gallstones
Leaving gallstones untreated can lead to several complications. While many individuals with gallstones remain asymptomatic, those who experience symptoms are at risk for more severe conditions, such as acute cholecystitis (inflammation of the gallbladder), pancreatitis (inflammation of the pancreas), or even biliary colic. If gallstones obstruct the bile duct, it can lead to jaundice and serious infections.
Regarding your concerns about cancer, while there is some association between gallstones and an increased risk of gallbladder cancer, this is relatively rare. The risk of developing colon cancer is not directly related to gallstones, but maintaining a healthy diet and lifestyle is crucial for overall cancer prevention.

Surgical Options
The standard treatment for symptomatic gallstones is laparoscopic cholecystectomy, which is a minimally invasive procedure to remove the gallbladder. Many patients worry about the necessity of having their gallbladder removed, fearing complications or changes in digestion. However, the gallbladder is not essential for digestion; it stores bile, which helps in fat digestion. After its removal, bile flows directly from the liver into the intestine, and most people adapt well without significant long-term issues.
If you are experiencing recurrent symptoms, it is generally advisable to consider surgery. The timing of the surgery can be flexible, but it is often best to avoid scheduling it during your menstrual period due to potential complications with bleeding.

Additional Symptoms
The symptoms you mentioned regarding your tongue and oral cavity could be unrelated to your gallstones. However, if you are experiencing persistent pain or numbness, it would be wise to consult a healthcare professional to rule out other conditions, such as oral infections or neurological issues.

Conclusion
In summary, given your history of gallstones, the symptoms you are experiencing, and the potential risks associated with untreated gallstones, it would be prudent to discuss surgical options with your healthcare provider. They can provide a thorough evaluation and help you weigh the benefits and risks of surgery versus continued observation. It is essential to address these concerns promptly to avoid complications and improve your quality of life.

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