Gallstones: Treatment Options and Health Implications

Gallstones

Hello, doctor.
I recently went to the hospital due to upper abdominal pain and was diagnosed with gallstones.
The doctor suggested that if the pain persists, I should consider gallbladder removal.
The doctor also prescribed medication for gallstones, but mentioned that the effectiveness is not very good.
I would like to ask, if I have my gallbladder removed, will it have any impact on my body? I have gastroesophageal reflux disease (GERD), and I am worried it might affect my stomach function.
If I leave the gallstones untreated and they are not causing pain, will the stones eventually pass out of my body on their own?

Liú dīng, 20~29 year old female. Ask Date: 2008/08/07

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
The gallbladder serves to store, concentrate, and excrete bile.
After gallbladder removal, liver cells continue to secrete bile, but it cannot be stored.
If excessive fatty foods are consumed, it may sometimes lead to malabsorption of fats.
A minority of individuals may still experience abdominal pain after gallbladder removal, which could be due to reasons such as residual stones in the bile duct, bile duct strictures, poor sphincter function, or bile duct tumors.
2.
Gallstones that are asymptomatic or only present in the gallbladder do not require treatment.
However, if gallstones migrate from the gallbladder into the bile duct, causing obstruction of the cystic duct and bile duct, it can lead to cholecystitis, cholangitis, or even pancreatitis, necessitating intervention.
3.
Generally, medications for dissolving stones are only effective for small cholesterol stones and are less effective for pigment stones, which are more common in individuals of East Asian descent, and they tend to recur easily.

Best regards,
Dr.
Lin Ming-Hui, Taoyuan General Hospital, Department of Health

Reply Date: 2008/08/07

More Info

Gallstones are a common condition that can lead to various symptoms and complications. Understanding the treatment options and health implications is crucial for making informed decisions about your health.
Gallstones can be classified into two main types: cholesterol stones and pigment stones. Cholesterol stones are the most common type, often forming when there is too much cholesterol in the bile. Pigment stones, on the other hand, are smaller and darker, usually associated with conditions like liver cirrhosis or hemolysis.
In your case, you mentioned experiencing upper abdominal pain, which is a classic symptom of gallstones. Other symptoms may include nausea, vomiting, and even fever if complications arise, such as cholecystitis (inflammation of the gallbladder). The presence of gallstones does not always necessitate immediate surgical intervention, especially if they are asymptomatic. However, if you experience recurrent pain or other complications, surgical removal of the gallbladder (cholecystectomy) is often recommended.

Regarding your concerns about the impact of gallbladder removal on your body, it is important to note that while the gallbladder plays a role in storing bile, it is not essential for digestion. After gallbladder removal, bile flows directly from the liver into the small intestine, which can lead to changes in digestion. Some individuals may experience diarrhea or changes in bowel habits, particularly after consuming fatty meals. However, most people adapt well over time, and many report an improvement in symptoms related to gallstones after surgery.

You also expressed concerns about how gallbladder removal might affect your gastroesophageal reflux disease (GERD). While there is some anecdotal evidence suggesting that gallbladder removal can exacerbate GERD symptoms in certain individuals, research on this topic is limited. It is advisable to discuss your specific situation with your healthcare provider, who can help you weigh the risks and benefits of surgery in the context of your GERD.

As for the possibility of gallstones passing on their own, it is unlikely that they will spontaneously resolve without intervention. Gallstones typically do not dissolve on their own, and while some small stones may pass through the bile ducts, this is not a reliable or safe method of treatment. The risk of complications, such as acute cholecystitis or pancreatitis, increases if gallstones are left untreated, especially if they are symptomatic.

In summary, if you are experiencing recurrent symptoms or complications related to gallstones, surgical removal of the gallbladder may be the most effective treatment option. While there may be some adjustments in digestion post-surgery, many individuals find relief from the pain and complications associated with gallstones. It is essential to have a thorough discussion with your healthcare provider to address your concerns and determine the best course of action for your health. They can provide personalized advice based on your medical history and current condition.

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