Gallstones

Gallstones form in the gallbladder, a small sac under the liver where bile collects. Most people do not even know they have them. They are often discovered by chance, during an abdominal ultrasound done for something else.

Problems appear when a stone blocks the outflow of bile. This causes biliary colic: severe, increasing pain under the right ribs or in the pit of the stomach, which often spreads to the back or under the right shoulder blade. It lasts from half an hour to a few hours and is accompanied by nausea and vomiting; many people also describe restlessness, because they cannot find a position in which it is easier.

Colic tends to appear at night or after a fatty meal. Once it passes, you feel exhausted but well, which is one of the reasons many people only book an appointment after the third or fourth episode.

Who has them more often

They become more common with age. Stones are more common in women, especially after several pregnancies, and in people with increased body weight, diabetes and a family history.

A strict weight-loss regime also poses a risk. With rapid loss of body weight, the composition of bile changes in a way that makes stones form more easily.

Many people with stones remain without symptoms all their lives.

When it is an emergency

If pain under the right ribs lasts more than a few hours and does not ease, is joined by fever and chills, or the abdomen is very tender to the touch and tense, seek emergency medical help. With severe, sudden abdominal pain and feeling unwell, call 112.

Yellowing of the skin and the whites of the eyes, dark urine and pale stool mean that the outflow of bile is blocked. This calls for an examination and medical care as soon as possible.

Similarly, pain spreading like a band from the pit of the stomach straight through to the back also occurs with inflammation of the pancreas, which is also an emergency. In that case, the pain is usually accompanied by persistent vomiting.

How it is diagnosed

The basic examination is an abdominal ultrasound, which is available at Medicinski center Ljubljana. It is complemented by laboratory tests, including liver function tests and inflammatory markers.

At the surgical examination, what matters most are the patient's symptoms: how the pain began, where it was, how long it lasted, what triggered it and how many times it has recurred. Finding stones by chance on ultrasound, without symptoms that bother the patient, is not necessarily a reason for surgical treatment.

Bring the results of tests you have had and a list of the medicines you take regularly, including blood-thinning medicines.

What the treatment options are

Stones that cause no problems are often just monitored.

When colic keeps recurring or the gallbladder has become inflamed, the established treatment is removal of the gallbladder, as a rule laparoscopically, i.e. through small incisions. The stones are not removed separately, because new ones would form in the gallbladder.

A diet with less fat can reduce how often colic occurs, but it does not dissolve the stones or cure the disease. The same applies to herbal tea blends and various home remedies.

Surgical care at Medicinski center Ljubljana is self-pay; you do not need a referral. Appointments are booked with the clinic that runs the service.