Understanding Gallbladder Symptoms, The Causes and your Treatment Options

One of the most common complaints seen in the emergency room of clinics in the Philippines is that of distressing upper abdominal pain radiating to the back with associated heartburn, “kabag”, frequent burping, passage of flatus and stomach upset.  This is frequently experienced after eating, especially a meal that is heavy in fats.  If you or anyone you know has any of these symptoms, then you may be suffering from gallstones and we advise you to read on.

What is the gallbladder and how does someone develop gallstones?

• The gallbladder is an organ which main function is the storage of bile, a yellowish fluid created by the liver and is used for food digestion.

• Bile fills up the gallbladder and is released to the bile ducts and into the digestive system after each meal to help in the process of digestion.  Bile is made up of different chemicals with cholesterol being one of its main components.  It appears that if the concentration of cholesterol or the other components of the bile is decreased or increased, these chemicals tend to crystallize (become solid) within the gallbladder to form gallstones.

The exact reason why stones form is not clearly known but it is more likely to develop in the following individuals:
• Overweight persons
• Women with previous pregnancies
• Those with strong family history of having gallstones

What are the usual complaints of patients with gallstones?

• Upper abdominal pain, usually on the right side and radiating to the back. This is usually experienced after having a large meal or one heavy in fats. This may be accompanied by nausea and vomiting, gas pains, indigestion or feeling of “kabag”. 
• Frequent burping & frequent passage of flatus. 

The pain may range from a relatively mild complaint to a severe type of pain that requires emergency room consultation.  In the majority of cases, the pain disappears after some time with or without the intake of pain medications and the patients return to their usual activities only to have the symptoms recur at a later time. 

How can one find out if he/she has gallstones?

After being evaluated by a physician, your doctor may request a series of blood tests but the best and easiest way to determine the presence of gallstones is to undergo an ultrasound examination. This is a painless and accurate way to determine if you have stones, their location and approximate number.

Can gallstones be treated with medications?

Pain medication can be given to patients suffering from the symptoms of gallstones but this treatment will not make the stones disappear. Some medications have been tried to dissolve the stones but such treatment is hardly ever successful since it works extremely slow. In addition, this is used only for certain types of stones and must be taken for a significantly long time with the risk of stones redeveloping if these medications are discontinued.

What is the best treatment option for gallstones?

The surgical removal of the gallbladder is the only adequate treatment for patients with gallstones.  This procedure, called cholecystectomy, is one of the most frequently performed surgical operation in the country.  There are two ways to remove the gallbladder – open cholecystectomy and laparoscopic cholecystectomy. Both procedures can be performed with relatively low risk and complications.

What is the difference between open cholecystectomy versus laparoscopic cholecystectomy?

• Open cholecystectomy, or the traditional approach to the removal of the gallbladder, requires making a single incision, approximately 4-7 inches below the right ribcage or in the midline of the upper abdomen. Patients usually undergo this procedure under epidural or general anesthesia and are discharged in 2-4 days time. 

• In the Laparoscopic approach, 4 smaller incisions, all less than an inch long, are made on the abdomen with a camera called  laparoscope connected to a TV monitor to help the surgeon view the surgery on the screen. This is inserted through an incision in the navel and into the abdominal cavity.  The three other incisions are used to insert small but long instruments which will be used in removing the gallbladder.  Since the incisions are smaller with less manipulation of the abdominal wall and the internal organs, the laparoscopic approach results in significantly less post-operative pain and discomfort with   faster recovery and return to full activities and work. This procedure is always done under general anesthesia and most patients go home day after the surgery though some prefers to stay an extra day. 

Who performs these procedures and how does one decide which operation to choose?

Either procedure can be performed by a properly trained general surgeon.  The options, risk and complications can be explained to you by this surgeon including which surgery is best for you.

What should a patient expect after the gallbladder is removed?

Gallbladder surgery is a major operation. Some degree of pain and discomfort is expected after the surgery.  Nausea and vomiting are not uncommon as the patient recovers from the effects of the operation and the anesthesia.

With the gallbladder removed, the patient should expect no significant change in the digestive process.  However, on certain occasions, the patient will experience some indigestive or soft stool especially after a heavy meal as the body adapts to the recent removal of the gallbladder.  It is thus recommended that patients eat light meals that are low in fats.

Patients will be fed soon after the surgery depending on one’s rate of recovery.  Activity is usually limited especially after the invasive technique. However, walking is to be encouraged.

Gallbladder surgery is one of the most successful types of surgery.  Patients may expect to live a full and healthy life even without a gallbladder.

Note:   This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment.   If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.

For more information, please call:

DEPARTMENT OF SURGERY

Tel No. (632) 988-1000 / (632) 988-7000 ext 6288 

CENTER FOR PATIENT PARTNERSHIP
Tel No. (632) 988-1000 / (632) 988-7000 ext. 6444