Pregnancy and Gallstones: Should You Remove Them Before Conceiving?

Pregnancy and Gallstones

Hello Doctor: I would like to ask about gallstones.
In December 2012, a health check revealed gallstones measuring approximately 2.5 cm (the report indicated multiple gallstones).
At that time, the doctor advised to wait until I experience pain before considering surgery.
However, I am now planning to get pregnant and have heard that many people experience gallstone attacks during pregnancy, which can even lead to preterm labor or miscarriage.
Should I consider having the gallstones removed before trying to conceive? Additionally, I have been experiencing nausea and frequent burping lately; could this be related to the gallstones? Thank you, Doctor.

polar, 30~39 year old female. Ask Date: 2014/01/16

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello Polar,
1.
During pregnancy, if there is inflammation due to gallstones, it can indeed be difficult to manage.
However, the incidence is not high, so surgery is not necessarily required at this stage.
Just be cautious and avoid excessive intake of greasy foods.

2.
Burping and acid reflux are symptoms of gastroesophageal reflux disease (GERD).
Please visit a gastroenterology clinic for treatment.
Limit your intake of acidic and sweet foods.
Changhua Hospital cares about your health.

Dr.
Chen Shidian

Reply Date: 2014/01/16

More Info

When considering pregnancy, especially with a history of gallstones, it's essential to weigh the potential risks and benefits of having gallstones during pregnancy. Gallstones are hardened deposits of digestive fluid that can form in the gallbladder, and they can lead to complications, particularly during pregnancy.

Should You Remove Gallstones Before Conceiving?
1. Risk of Gallstone Complications: During pregnancy, hormonal changes can slow down the gallbladder's ability to empty, which may increase the risk of gallstone-related complications. These complications can include cholecystitis (inflammation of the gallbladder), pancreatitis, and biliary colic. If gallstones become symptomatic, they can lead to severe abdominal pain, nausea, and vomiting, which can complicate pregnancy and potentially lead to premature labor or miscarriage.

2. Timing of Surgery: If your gallstones are asymptomatic (not causing any pain or other symptoms), many healthcare providers may recommend monitoring them rather than immediate surgery. However, if you are planning to conceive, it may be prudent to discuss the option of gallbladder removal (cholecystectomy) with your healthcare provider before pregnancy. This is especially true if your gallstones are large (like the 2.5 cm stones you mentioned) or if you have a history of gallbladder attacks.

3. Surgical Considerations: If you decide to have surgery, the best time to do so is typically in the non-pregnant state, as surgery during pregnancy can carry additional risks. The second trimester is often considered the safest time for surgery if it is necessary during pregnancy, but elective surgeries are usually avoided unless absolutely needed.

Symptoms and Gallstones
Regarding your symptoms of nausea and frequent burping, these can indeed be related to gallstones. Gallstones can cause digestive issues, including:
- Nausea and Vomiting: These symptoms can occur if a gallstone blocks the bile duct, leading to bile buildup and irritation.

- Indigestion and Bloating: Gallstones can interfere with the digestion of fats, leading to discomfort after meals.

- Acid Reflux: The presence of gallstones can sometimes exacerbate acid reflux symptoms due to changes in digestion.

Recommendations
1. Consult a Specialist: It is crucial to consult with a gastroenterologist or a surgeon specializing in gallbladder diseases. They can provide personalized advice based on your medical history, the size and number of your gallstones, and your plans for pregnancy.

2. Monitor Symptoms: Keep track of any symptoms you experience. If you notice an increase in pain, nausea, or other gastrointestinal issues, seek medical attention promptly.

3. Healthy Lifestyle: Maintaining a healthy diet and lifestyle can help manage gallstone symptoms. A diet low in fat and high in fiber may reduce the risk of gallstone complications.

4. Preconception Counseling: If you are planning to conceive, consider preconception counseling. This can help you prepare for a healthy pregnancy and address any underlying health issues, including gallstones.

In conclusion, while gallstones can pose risks during pregnancy, the decision to remove them should be made in consultation with your healthcare provider, considering your specific situation and health history. If you are experiencing symptoms related to gallstones, addressing these before conception may lead to a healthier pregnancy experience.

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