Gallstones: causes, symptoms and modern treatment options

Gallstones are one of the most common digestive problems that affect many people, often without their knowledge. Pain under the right ribcage, bloating or cramping after a fatty meal can all indicate the presence of gallstones. Although many people are afraid to be investigated, modern medicine now offers gentle and effective solutions.

---

What is gallstones and how do they form?

Gallstones (medically known as cholelithiasis) is a solid formation crystallised from substances in bile. Bile is a fluid produced by the liver, stored in the gallbladder and plays a key role in the digestion of fats. If the composition of bile changes, the substances it contains (cholesterol, bilirubin) can precipitate and form stones.

Types of gallstones

Three main types are distinguished:

1. Cholesterol stones: The most common type (about 75%). They are composed mainly of insoluble cholesterol.
2. Black pigment stones: Hard, dark stones that form from too much bilirubin.
3. Brown pigment stones: They are softer, irregularly shaped. They typically develop as a result of bacterial infection.

Risk factors

Factors that increase risk:

• No: More common in women (due to pregnancy, hormone replacement therapy).
• Etrend: Diets high in fat and cholesterol and low in fibre.
• Weight: Obesity and sudden, rapid weight loss also increase the risk.
• Other: Age, genetic predisposition, diabetes, liver disease.

---

The most common symptoms of gallstones

The vast majority of people with gallstones (about 70-75%) are completely asymptomatic, known as „dumb stones”. The problems start when a stone blocks the outlet of the gallbladder or bile ducts.

The most typical symptom is gallstones (biliary colic):

• Sudden onset of intense pain: On the upper right side of the abdomen or under the sternum.
• Radiating pain: Usually in the back, between the shoulder blades or in the right shoulder.
• Duration: The cramp usually lasts from 15 minutes to a few hours, then gradually eases.
• Accompanying symptoms: Nausea, vomiting, sweating, restlessness.

More serious complications:

• Mild gallbladder inflammation: It is associated with persistent pain, fever and chills.
• Biliary obstruction and jaundice: Leads to dark urine, light stools and yellowish skin/eye protein discolouration.
• Pancreatitis: A life-threatening condition that can be caused by a stone caught in the pipeline.

---

How is the diagnosis made?

If symptoms suggest gallstones, it is important to consult a specialist gastroenterologist.

1. Physical examination and medical history: The doctor will ask you about your symptoms and carry out an abdominal examination.
2. Abdominal ultrasound: Most importantly, it is painless and quick, with high accuracy in detecting stones and signs of inflammation.
3. Laboratory tests: Blood tests can help detect signs of inflammation, bile duct obstruction or pancreatic involvement.
4. Further imaging tests: A CT, MR/MRCP or endoscopic ultrasound (EUS) scan may be needed if the diagnosis is uncertain.

---

Modern treatment options for gallstones

Treatment depends on whether the stone is causing symptoms. Silent gallstones usually do not need treatment, regular medical check-ups are sufficient. However, if there are complaints, intervention may be necessary.

1. Medication

• Pain relief: Antispasmodics and non-steroidal anti-inflammatory drugs (NSAIDs) may be given to relieve bile spasm.
• Stone dissolving therapy: In the case of small, clear cholesterol stones, bile acid drugs can be used to try to dissolve the stones, but this is a lengthy process and the stones often reappear.

2. Endoscopic procedures (ERCP)

If a stone has lodged in the bile duct and is causing a blockage, the endoscopic retrograde cholangiopancreatography (ERCP) provides a solution. This special endoscopic procedure allows the doctor to remove the stone from the bile duct.

3. Removal of the gallbladder (Cholecystectomy)

The definitive solution to symptomatic gallstones is surgical removal of the gallbladder. Today, this is done in the vast majority of cases laparoscopic cholecystectomy takes the form of.

Laparoscopic surgery is a minimally invasive procedure with advantages:

• Less surgical strain and less pain.
• Shorter hospital stays (often only 1-2 days).
• Faster recovery.
• Minimal scarring.

After the gallbladder is removed, digestion continues uninterrupted and most people can return to their normal diet.

---

Summary

You don't have to live with gallstones. Today, modern gastroenterology and surgery offer quick, safe and gentle solutions to permanently resolve the problem. Don't delay, take action for your health today!