Gallstones 

Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. In most cases, gallstones do not cause any symptoms.

However, in a small number of cases, gallstones can become trapped in a duct (an opening or channel), irritate and inflame the gallbladder, or move out of the gall bladder and into other parts of the body. This can lead to a range of symptoms, such as:

• a sudden intense pain in your abdomen
• nausea and vomiting
• jaundice (yellowing of the skin and the whites of the eyes)

‘Gallstone disease’ is the general term that describes the symptoms and associated complications caused by gallstones.

The gallbladder

The gallbladder is a small, pear-shaped, pouch-like organ that is situated underneath the liver. The main purpose of the gall bladder is to store and concentrate bile.

Bile is a liquid that is produced by the liver, which is used to help with the digestion of fats. It is passed from the liver through a series of channels, known as bile ducts, into the gallbladder.

The bile is stored in the gallbladder and, over time, it becomes more concentrated (stronger), increasing its effectiveness at digesting fats. The gallbladder is able to release bile into the digestive system when it is required.

While the gallbladder is a useful organ, it is not an essential one. You can safely have your gallbladder removed without it interfering with your ability to digest food.

Types of gallstone disease

There are three main types of gallstone disease:

• Asymptomatic gallstones: gallstones are present in the gallbladder but do not cause any symptoms.
• Uncomplicated gallstone disease: usually caused when gallstones block the opening to the bile duct. This usually leads to repeated episodes of abdominal pain that last for one to five hours. The episodes of pain usually occur infrequently. It may be several weeks or months before you experience a further episode.
• Complicated gallstone disease: gallstones have triggered a range of more serious complications, such as inflammation of the gall bladder (cholecystitis). Symptoms of complicated gallstone disease are usually wide ranging and severe, and can include a high temperature (fever) of 38C (100.4F) or above, jaundice and constant abdominal pain.

How common are gallstones?

Gallstones are very common. It is estimated that, in England, 10-15% of the adult population have gallstones. In most cases, they are asymptomatic (do not cause symptoms).

Every year, it is estimated that 1-4% of people with asymptomatic gallstones develop uncomplicated or complicated gallstone disease. Most people usually experience the symptoms of uncomplicated gallstone disease before developing complications. However, not everyone with uncomplicated gallstone disease will also have complications.

Known risk factors for gallstones include:

• Age: the older a person is, the more likely they are to develop gallstones.
• Sex: women are two to three times more likely to develop gallstones than men.
• Obesity.

Outlook

The outlook for gallstone disease is good. Both uncomplicated and complicated gallstone disease can be treated by surgically removing the gallbladder. This is a relatively straightforward procedure with a good success rate. However, not everyone with uncomplicated gallstone disease will require surgery if their symptoms are not particularly frequent or severe.

Even though gallstone disease can usually be easily and successfully treated, some of the complications of the condition can be life threatening. In England and Wales in 2008, there were 650 deaths as a result of gallstone disease. Most deaths occurred in people aged over 70.

Because of the risks associated with complicated gallstone disease, the condition may require immediate treatment. See Symptoms of gallstones for more information.