Gallstones and Gallbladder Disease
DescriptionAn in-depth report on the causes, diagnosis, treatment, and prevention of gallstones.
Alternative NamesCholecystitis; Choledocholithiasis; Common Bile Duct Stones; Lithotripsy
About 90% of gallstones provoke no symptoms at all. If they do occur, the chance of developing pain is about 2% per year for the first ten years after stone formation, after which the chance for developing symptoms declines. On average, symptoms take about eight years to develop. The reason for the decline in incidence after 10 years is not known, although some physicians suggest that younger, smaller stones may be more likely to cause symptoms than larger ones.
The mildest and most common symptom of gallbladder disease is intermittent pain called biliary colic, which occurs either in the mid- or the right portion of the upper abdomen. A typical attack has several features:
Digestive complaints such as belching, feeling unduly full after meals, bloating, heartburn (burning feeling behind the breast bone), or regurgitation (acid back-up in the food pipe) are not likely to be caused by gallbladder disease. Conditions that may cause these symptoms include peptic ulcer, gastroesophageal reflux disease, or indigestion of unknown cause. [For more information, seeWell-Connected Reports #19 Peptic Ulcers or #85 Gastroesophageal Reflux Disease.]
Symptoms of Gallbladder Inflammation (Acute Cholecystitis)
Between 1% and 3% of people with symptomatic gallstones develop inflammation in the gallbladder (acute cholecystitis), which occurs when stones or sludge obstruct the duct. The symptoms are similar to those of biliary colic but are more persistent and severe. They include the following:
Anyone who experiences such symptoms should seek medical attention. Infection develops in about 20% of these cases, which increases the danger. Acute cholecystitis can progress to gangrene or perforation of the gallbladder if left untreated. (People with diabetes are at particular risk for serious complications.)
Symptoms of Chronic Cholecystitis or Dysfunctional Gallbladders
Chronic gallbladder disease (chronic cholecystitis) is marked by gallstones and low-grade inflammation. In such cases the gallbladder may become scarred and stiff. Symptoms of chronic gallbladder disease include the following:
Symptoms of Stones in the Common Bile Duct (Choledocholithiasis)
Stones lodged in the common bile duct (choledocholithiasis) can cause symptoms that are similar to those that lodge in the gallstone, although they may have the following:
As in acute cholecystitis, patients who have these symptoms should seek medical help immediately. They may require emergency treatment.