Patients are often surprised by the phrase "there are gallstones" appearing in an abdominal imaging report they had for a completely different reason. This sudden discovery frequently raises worry and questions: Do I need surgery now? Are the stones dangerous? Can they be ignored?
The short answer: it depends entirely on the presence or absence of symptoms — and the assessment of a specialist physician is the primary reference.
What Are Gallstones?
Gallstones are hard deposits that form inside the gallbladder when the balance of bile components (cholesterol, bile salts, and bilirubin) is disrupted. They vary in size from less than a millimeter to several centimeters, and may be a single stone or a cluster.
Causes and Risk Factors for Gallstones
- An imbalance in the proportions of cholesterol and bile salts in the bile
- A family history of gallstones
- Sex: gallstones are more common in women
- Pregnancy and hormonal changes
- Very rapid weight loss
- Obesity and lack of physical activity
Silent Stones vs. Symptomatic Stones
Silent stones (without symptoms):
Discovered by chance during routine abdominal imaging. In most cases they do not call for immediate surgical intervention — periodic follow-up with the physician is sufficient.
Symptomatic stones (with recurring symptoms):
They cause attacks of pain known as biliary colic, and most often require surgical intervention after a comprehensive assessment by the specialist physician.
Symptoms of Symptomatic Stones
- Severe pain in the right side of the abdomen below the ribs, intensifying especially after eating fatty food
- The pain can sometimes extend to the back or the right shoulder
- Nausea, vomiting, and severe bloating after fatty meals
- Yellowing of the skin or the whites of the eyes
When Should You Go to the Emergency Room Immediately?
🚨 Yellowing of the skin or eyes = an immediate emergency. This is a possible indicator of a blockage in the common bile duct or inflammation of the pancreas — both of which are medical emergencies that cannot tolerate waiting.
Signs that warrant going to the emergency room immediately:
- Yellowing of the skin or the whites of the eyes
- Severe, continuous abdominal pain lasting several consecutive hours that does not ease
- Fever with right-sided abdominal pain
- Inability to eat or drink because of the severity of the pain and vomiting
Treatment Options for Gallstones
Silent stones without symptoms:
In most cases, periodic follow-up with the physician through imaging every 6–12 months is sufficient. The physician is the one who decides whether there are indications for pre-emptive surgical intervention based on the size and the patient's general condition.
Symptomatic stones with recurring symptoms:
Laparoscopic gallbladder removal (Laparoscopic Cholecystectomy) is the global gold standard of treatment. It is characterized by:
- Spending only one to two days in the hospital in most cases
- 4 very small incisions instead of a large wound
- Much milder post-operative pain compared to open surgery
- A gradual return to normal life within one to two weeks
Life After Gallbladder Removal
Most patients live a completely normal life after laparoscopic gallbladder removal. During the first weeks it is recommended to reduce heavy fats in the diet, then gradually readjust according to the physician's guidance.
Frequently Asked Questions (FAQ)
Can you live with a silent gallstone for a long time?
Yes — many people live with a silent stone for years without problems. The most important thing is periodic follow-up with the physician to verify that symptoms have not developed and the size of the stone has not changed — and the physician's decision is the reference.
Does diet affect the formation of gallstones?
Yes — diets high in saturated fats and cholesterol are associated with an increased risk of stone formation. Likewise, prolonged fasting changes the balance of the bile. Eating regular, balanced meals helps with prevention.
Can gallstones be dissolved with medication?
Drug-based dissolution options are very limited in effectiveness in modern medical practice and are not widely used. Laparoscopic surgery remains the most effective and durable solution for symptomatic stones. Consulting a physician is essential to determine the most suitable option for each case.
Book an appointment at the General Surgery department at Town Hospital to evaluate your condition and determine whether you need periodic follow-up or surgical intervention.
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General Surgery department at Town Hospital