Dr. M.J. Bazos, MD Patient Handout

About Your Diagnosis
You have cholelithiasis, also known as gallstones. This means that you have stones that have developed in your gallbladder. Your gallbladder is the small sack attached to the underside of your liver. These organs sit in the right upper portion of your abdomen, or belly. Your gallbladder stores the bile that your liver makes. Your gallbladder then squirts the bile into your bowels whenever you eat a meal, especially if the meal contains much fat. Bile helps in the digestion of fats in the food you eat. Under the right conditions and over time, gallstones can form in your gallbladder. Gallstones are common: 10% to 20% of men and 20% to 40% of women get gallstones during their lifetime. Women are more likely to get gallstones because of the effects of estrogen (a female hormone) on bile. Being overweight increases your risk of getting gallstones, as does getting older. Prolonged fasting causes bile to stagnate in the gallbladder, making stones more likely to form. The actual cause of stone formation is a loss of balance between the various chemicals in bile, which include cholesterol, bile salts, and others. Ultrasound detects 95% of gallstones and is usually he first test performed. A special x-ray test also will detect stones. Gallstones can be cured by surgically removing the gallbladder. Treatment is recommended only if you have symptoms.

Living With Your Diagnosis
Most gallstones cause no symptoms and may never cause any problems for you. However, gallstones can cause severe pain, as well as other problems. If a gallstone gets stuck in the bile duct that empties bile from the gallbladder into the bowel, the gallbladder will squeeze harder and harder, and the duct may contract around the stone. This will cause severe, crampy pain in the right upper part of your abdomen, or perhaps between your shoulder blades. The pain gets worse for a few hours before it gets better. You will likely feel sick to your stomach and may vomit. The symptoms go away if the stone either falls back into the gallbladder, or moves all the way through the bile duct and into the bowel. If the stone stays in the bile duct long enough, you may have other problems such as inflammation or infection in the gallbladder or pancreas.

Treatment
Gallstones that do not cause symptoms rarely need treatment. If you have had symptoms from your gallstones, treatment will probably be necessary, especially if the stones have caused other problems. The usual treatment is surgery to remove the gallbladder and stones. In some cases your doctor may ask you to take medicine to try to dissolve the stones, but this does not always work. Surgery usually cures gallstone disease, and once you recover from surgery you will not miss your gallbladder. Your body will function well without it.

The DOs
Maintain a normal weight. If you are overweight, ask your doctor to help you with a weight loss program. You should try to lose weight at a slow, steady rate. If you have pain that you think gallstones may be causing, take some pain medicine, rest, and do not eat anything. Call your doctor if the pain lasts
for more than 3 hours, or if you get a fever.

The DON’Ts
Don’t eat meals high in fat. Fat foods cause the gallbladder to contract strongly, which may cause a stone to get squeezed into the bile duct. It is even more important to avoid meals high in fat once you have been on a low-fat diet for awhile. Avoid extra large meals and foods that cause indigestion. Do not fast for prolonged periods or go on a crash diet.

When to Call Your Doctor
Call your doctor if you think you are having symptoms from gallstones. If you have had gallstones diagnosed and have had symptoms before, you should call your doctor if the symptoms last more than 3 hours, or if you get a fever.