Gallstones: Diagnosis, Treatment & Removal

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

Gallstones are pretty common and are usually harmless. They can cause problems though. In this lesson, we will learn about how gallstones are diagnosed and treated.

You Need to go to the Emergency Room!

Mary woke up one morning with a mild pain in the middle of her upper abdomen. She made coffee but didn't finish it because she started getting nauseated. She laid back down hoping she would feel better if she rested some more.

After a short nap, she woke up with worsening pain. Now the pain was radiating to her right shoulder. She was very nauseated and didn't dare eat or drink anything because she could feel that she would throw it up.

She called her mom and told her what was going on. Her mom said she had these same symptoms when she had gallbladder issues. She told her to go to the emergency room.


The gallbladder is part of the digestive system and is located under the liver.
gallbladder


Your gallbladder is a small organ right below your liver. It is shaped like a pear and works as a pouch. Bile is produced in your liver and is stored in the gallbladder. Before you eat, your gallbladder is full of bile and about the size of a pear. When you eat, the bile is secreted into your small intestine to help digest fats. After you eat, your gallbladder is flat and empty like a deflated balloon.

The Doctor Says it's Gallstones, now What?

In the emergency room, the nurses start an IV to give Mary some fluids and medication for her pain and nausea. The doctor tells her that he does think it's her gallbladder and that she may have gallstones. He explains that they will have to do more tests to confirm that.

Gallstones are not stones at all but are solid material that forms in the gallbladder. Gallstones are common and usually harmless. You may have gallstones and never know it. But if they cause complications, you are sure to know it!


Picture of Gallstones
gallstones


The bile in the gallbladder crystallizes forming gallstones. It is believed that high cholesterol or bilirubin content in the bile can cause gallstones to form.

Tests for Diagnosis

Mary is sent to the radiology department for some tests. Tests that allow visualization of the gallbladder may include an ultrasound or CT scan. The doctor can look at the gallbladder with these imaging tests to see if there are gallstones, blockages, or inflammation.

Additional tests can look specifically at the functioning of the bile ducts. These include a HIDA scan, MRI, or ERCP. These tests use a dye to visualize the bile ducts and evaluate for a blockage. If a gallstone is blocking a bile duct, the bile will not be able to be emptied into the small intestine.

Mary had a CT scan that showed gallstones and inflammation of her gallbladder. She also had blood drawn for labs. The doctor explained to her that the labs are to look for complications from the gallstones. Her labs did show signs of infection.

Treatment Options

The doctor also explained to Mary that a person could live without their gallbladder. He recommended that she have surgery to remove her gallbladder. Mary asked if there are any other treatment options. He explained that this is the standard treatment but that there are medications that can be taken to try to dissolve the gallstones. This isn't a reasonable option because it can take months for them to dissolve, it may not work, and the gallstones will likely continue to form. This treatment is usually only offered to someone who is not able to tolerate surgery.

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