Discharge Instructions - Gallstones

As discussed in the Emergency Department prior to discharge, you have been diagnosed with gallstones.  The gallbladder is a small, pear-shaped organ that is tucked under your liver.  It stores bile, a fluid that helps the body break down fat.  Gallstones are small stones that form inside the gallbladder.  They can be tiny specks or get as big as the whole gallbladder, which can be up to 6 inches long.

Normally, the gallbladder fills with bile in between meals.  Then, when you eat fatty foods, the gallbladder empties the bile into the intestine.  Sometimes, though, gallstones clog the gallbladder and keep it from draining.  Other times, gallstones just irritate the gallbladder.  If the gallstones are pushed out of the gallbladder, they can keep the liver or pancreas from draining.

In most cases, gallstones do not cause any symptoms.  When they do cause symptoms, gallstones can cause:

-Belly pain (usually right side just under the rib cage or in the middle top portion of the belly)

-Pain in the back or right shoulder

-Nausea and vomiting

If you know that you have gallstones but have no symptoms, you probably will not need treatment.  But if you start having symptoms, you should get treated.  The symptoms can come and go, but they often get worse over time.

In rare cases they can lead to serious problems, including:

    -Jaundice, a condition that turns your skin and eyes yellow

    -Infection of the gallbladder

    -Tears in the gallbladder, which can lead to death

    -Inflammation of the pancreas (an organ also involved in food breakdown)

People with gallstones generally have 3 treatment options.  They can have:

1) No treatment – This option is best for people with no symptoms.  If they start having symptoms, they can think about treatment then.

2) Surgery to remove the gallbladder and the stones.  Gallbladder surgery is routine in the US, but it involves using anesthesia, so it has some risks.  The surgery does not affect digestion very much.  But about half the people who have surgery have mild symptoms afterward, including watery bowel movements, gas, or bloating.  These symptoms usually get better.  People who have their gallbladder removed do not need to worry about gallstones coming back.

3) Treatment to get rid of the stones but keep the gallbladder.  People who choose this approach can take medicines to break up gallstones or be treated with a device that breaks up stones (or both).  These treatments can work, but they take time – months to years.  People with severe symptoms might not want to wait that long to feel better.  Plus, the stones can come back after these treatments.

You should discuss these options with your primary care provider and General Surgery to determine which is right for you.  You should also minimize your intake of foods high in fat, including fried or greasy foods.  It may also be beneficial to lose weight if you are overweight.

Return to the Emergency Department if you develop a fever (≥38.0 °C or 100.4 °F), your pain worsens or is constant for 6 hours, you develop jaundice (a yellow discoloration of the skin or the eyes), persistent or worsening nausea or vomiting, or any other new or concerning symptoms.

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