Ask The Doctor Do I Need Gallbladder Surgery

Overview

Your gallbladder is a small organ under your liver that helps your body digest fat. Sometimes it gets inflamed or stones form, causing pain. Surgery to remove the gallbladder is called a cholecystectomy. Most people who have this surgery feel much better.

Yes. Gallbladder problems are common, and gallbladder removal is one of the most frequently performed operations in the UK and around the world.

Anyone can have gallbladder problems, but they are more common in women, people over 40, people who are overweight, and people who have lost weight quickly.

Symptoms

Common symptoms

• Sudden, severe pain in the upper right or centre of your tummy
• Pain that lasts from 30 minutes to several hours
• Pain that spreads to your back or right shoulder
• Nausea or vomiting
• Indigestion, bloating and gas, especially after fatty meals
• Fever or chills, which may suggest an infection

Symptoms in children

• Gallstones in children are rare, but if they happen, symptoms are similar to adults.
• Children may complain of tummy pain after meals, nausea, or vomiting.
• Some children have no symptoms at all.

Symptoms in older adults

• Older adults may not feel the typical sharp pain.
• Instead, they may have a dull ache, fever, confusion, or a general feeling of being unwell.
• Tenderness in the belly and a fast heartbeat can also be signs.

Causes

Main causes

• Most gallbladder problems are caused by gallstones — small hardened deposits of bile that form in the gallbladder.
• Gallstones can block the opening of the gallbladder or the bile duct, causing pain and inflammation.
• Other causes include gallbladder sludge, infection, or, less commonly, growths.

Risk factors

• Being female
• Being over 40
• Having a family history of gallstones
• Being overweight or obese
• Losing weight very quickly
• Having diabetes
• Taking certain medicines, such as oral contraceptives or cholesterol-lowering drugs

When to see a doctor

See a doctor urgently if:

• Severe pain in your upper tummy that lasts more than 30 minutes
• Fever, chills, or vomiting
• Yellowing of your skin or eyes

Book a routine appointment if:

• Frequent discomfort or indigestion after fatty foods
• Recurring mild pain that comes and goes

Diagnosis

Your doctor will ask about your symptoms, examine you, and may arrange tests. The most common test is an ultrasound scan, which uses sound waves to look at your gallbladder and nearby organs.

Tests that may be done

• Ultrasound scan of the abdomen
• Blood tests to check for infection or liver function
• A CT scan or MRI scan in some cases
• A HIDA scan to measure gallbladder function (less common)

What to expect at your appointment

Most tests are simple and painless. An ultrasound is done with a gel on your tummy and a small hand-held probe. You may be asked to fast (not eat or drink) for a few hours before the scan. Your doctor will explain the results and what they mean for you.

Treatment

Treatment depends on whether you have symptoms, how bad they are, and whether there are complications. If you have no symptoms, you may not need any treatment. If you have pain attacks, your doctor may suggest surgery to remove the gallbladder. Surgery is very common and safe.

Self-care at home

• Eat smaller, low-fat meals during an attack
• Avoid fatty or fried foods that may trigger pain
• Stay hydrated and rest
• Use a warm compress on your tummy for comfort (check with your doctor first)

Medical treatments

Some people are offered medicines to dissolve gallstones, but this is rarely used and only for certain types of stones. The main treatment for troublesome gallbladder problems is surgery to remove the gallbladder. This can be done by keyhole surgery, which uses small cuts, or open surgery, which uses a larger cut. Your doctor will discuss which approach is right for you. If there is an infection, you may need antibiotics, but these do not cure the underlying problem.

When is surgery considered?

Surgery is usually recommended if you have repeated attacks of pain, have had a complication such as inflammation of the gallbladder or pancreas, or if gallstones are blocking the bile ducts. If you have occasional mild symptoms, you and your doctor may choose to watch and wait.

Living with this condition

Most people adjust well after surgery. After removal, bile goes straight from the liver to the intestine, and most people can eat a normal diet. Some people notice looser stools, especially after fatty meals, but this usually settles over time.

Lifestyle tips

• Keep a healthy weight
• Eat plenty of fibre, fruit and vegetables
• Limit foods high in saturated fat
• Stay active with regular exercise

Diet and exercise

After surgery, start with small, light meals and gradually return to your usual diet. Avoid rich, fatty foods for the first few weeks. Regular gentle exercise like walking can help you recover and keep your digestion regular.

Mental health and emotional wellbeing

Living with pain or planning surgery can be stressful. It is normal to feel anxious or low. Talk to loved ones, ask your care team for support, and give yourself time to recover emotionally as well as physically.

Prevention

You cannot always prevent gallstones, but some lifestyle choices may lower your risk. Eating a balanced diet, staying at a healthy weight, avoiding crash diets, and being active can help.

Vaccines

There is no vaccine to prevent gallstones or gallbladder disease.

Screening programmes

There is no routine screening test for gallstones in people without symptoms. Testing is only done if you have symptoms.

Complications

If left untreated

• If gallstones keep blocking the gallbladder, they can cause inflammation of the gallbladder (cholecystitis)
• Gallstones can move into the bile duct and block the flow of bile, causing jaundice and infection
• In rare cases, a gallstone can trigger inflammation of the pancreas (pancreatitis)

Long-term outlook

Most people who have gallbladder surgery recover well and go back to normal activities within two to four weeks. Without surgery, many people manage their symptoms by diet and lifestyle, but some will eventually need treatment. Everyone is different, so talk to your doctor about what is best for you.

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