Gallstone pain is similar to childbirth

Gallstones: symptoms, complications, prognosis & prevention

Signs & Symptoms

The symptoms caused by gallstones can sometimes be unspecific and can be similar to those of many other diseases. The typical biliary colic has a characteristic painful character; the pain is localized in the middle or right upper abdomen. They sometimes radiate into the back and down to the shoulder blade. The pain intensity swells rapidly, then reaches a plateau, and then decreases rapidly, either spontaneously or after drug therapy. Biliary colic typically lasts from 15 minutes to several hours. They occur mainly at night and often not in chronological order after eating. Most patients can remember the onset of pain very precisely.

The cause of biliary colic is assumed to be an increase in pressure in the gallbladder due to a temporary blockage of the outlet of the gallbladder caused by stones (cystic duct). A similar mechanism can also explain the severe pain caused by stone-related obstruction of the biliary tract in the area of ​​the exit of the biliary tract to the duodenum (papilla Vateri), where the bile duct (mostly in combination with the pancreatic duct) opens into the duodenum.

Effects & Complications

If a gallstone closes the outlet of the gallbladder (ductus cysticus) for more than a few hours, it can develop into an acute inflammation of the gallbladder (cholecystitis). As the disease progresses, it can lead to suppuration of the gallbladder (gallbladder empyema) and even a rupture of the gallbladder wall (gallbladder perforation). In extreme cases, this results in peritonitis (bilious peritonitis).

If a gallstone closes the main bile duct, the bile can no longer drain into the small intestine and builds up. As a result, jaundice (jaundice) develops, the urine turns dark, the stool turns pale, and the person's skin and eyeball turn yellow. The backwater can inflame the bile duct (cholangitis). Then, in addition to the severe pain in the upper abdomen, there are also fever and chills (Charcot triad). In addition, inflammation of the pancreas (biliary pancreatitis) can be caused by an obstruction in the area of ​​the bile duct opening (papilla Vateri).

Even without ever causing biliary colic, gallstones can rarely cause acute inflammation of the gallbladder (cholecystitis).

Wall calcification ("porcelain gallbladder"), which is extremely rare today, increases the risk of gallbladder carcinoma.

Forecast & course

The minority of gallstones causes problems for their carriers. If they do, they are relatively easy to remove. As a rule, the bile duct takes over the storage function of the gallbladder after a gallbladder has been removed. As a result, most patients are symptom-free just a few weeks after a gallbladder operation.

Gallstones that have been dissolved with medication can easily form again. And even if the gallbladder has been removed, new gallstones can sometimes develop in the bile ducts.

Prevention & protection

If you want to reduce the risk of gallstone disease, you should eat a balanced diet, avoid fatty foods and instead consume a lot of fiber. He should also avoid being overweight. A small late meal (e.g. a glass of milk or yoghurt) can stimulate the gallbladder to vigorously emptying it again before the long night, so that there is less time for stone formation.

After gastric bypass surgery, preventive (“prophylactic”) medication is advisable to prevent the formation of stones, which often occurs.