Gallstones waiting list care in children

Overview

Gallstones are small, hard deposits that form in the gallbladder, a small organ under the liver that helps digest fats. In children, gallstones are less common than in adults but can still occur. When a child is diagnosed and placed on a waiting list for treatment, the focus is on managing symptoms and preventing complications until surgery can be done.

Gallstones are relatively rare in children compared to adults, affecting about 1 in 100 to 1 in 200 children. However, rates are increasing due to rising childhood obesity.

Children of any age can develop gallstones, but they are more common in older children and teenagers. Children with certain risk factors, such as obesity, hemolytic anemias (like sickle cell disease), cystic fibrosis, or those who have had rapid weight loss, are more likely to be affected.

Symptoms

Common symptoms

• Pain in the upper right part of the belly, especially after eating a fatty meal
• Nausea or vomiting
• Feeling bloated or full

Symptoms in children

• Vague belly discomfort that comes and goes
• Pain that may spread to the back or right shoulder
• Sometimes no symptoms at all (silent gallstones)

Symptoms in older adults

• More classic 'biliary colic' – severe, crampy pain that lasts hours
• Fever or chills if infection develops
• Jaundice (yellow skin or eyes) if bile duct is blocked

Causes

Main causes

• An imbalance in the substances that make up bile, such as too much cholesterol or bilirubin
• The gallbladder not emptying completely or often enough
• Inflammation or infection of the bile ducts

Risk factors

• Obesity or being overweight
• Rapid weight loss (e.g., after bariatric surgery or very low-calorie diets)
• Blood disorders like sickle cell disease or thalassemia
• Family history of gallstones
• Certain medications (e.g., some antibiotics, hormone treatments)
• Conditions like cystic fibrosis or Crohn's disease

When to see a doctor

See a doctor urgently if:

• If the child has severe belly pain that does not go away
• If there is fever, chills, or jaundice
• If the child cannot keep food or drink down

Book a routine appointment if:

• If the child has mild, occasional belly pain after meals
• If there is a family history of gallstones and you have concerns
• If the child has a known risk factor (like sickle cell disease) and develops new symptoms

Diagnosis

Gallstones are most often discovered during an ultrasound scan of the belly. The doctor may also order blood tests to check for signs of infection or blocked bile flow.

Tests that may be done

• Abdominal ultrasound – uses sound waves to create pictures of the gallbladder and detect stones
• Blood tests – to check liver function and look for infection or jaundice
• Sometimes a CT scan or MRI if more detail is needed

What to expect at your appointment

If gallstones are found, your child's doctor will discuss symptoms and risk factors. They may recommend 'watchful waiting' (monitoring without treatment) if there are no symptoms, or plan for removal of the gallbladder (cholecystectomy) if symptoms are present. On a waiting list, you will be given advice on managing symptoms at home and when to seek urgent care.

Treatment

Treatment for gallstones depends on whether the child has symptoms. If symptoms are present, the most common treatment is surgical removal of the gallbladder. While waiting for surgery, the goal is to control pain and avoid foods that trigger attacks.

Self-care at home

• Eat a low-fat diet to reduce gallbladder work – avoid fried foods, fatty meats, and rich desserts
• Keep a healthy weight – avoid crash diets that can worsen gallstones
• Encourage regular physical activity
• Give over-the-counter pain relief as advised by your doctor (never give aspirin to children without medical advice)

Medical treatments

There are no medications that reliably dissolve gallstones in children. Antibiotics may be given if an infection develops. In rare cases, a procedure called ERCP may be used to remove stones blocking the bile duct, but this does not treat the gallbladder itself. Always discuss treatment options with your child's healthcare team.

When is surgery considered?

Surgery (cholecystectomy) is recommended when gallstones cause repeated pain, inflammation, or complications like jaundice or pancreatitis. It is usually done laparoscopically (keyhole surgery), with a short recovery time. If your child is on a waiting list, the surgeon will prioritize based on symptom severity and risk.

Living with this condition

While waiting for treatment, many children can lead a normal life. They may need to avoid fatty foods and have a plan for managing pain if it occurs. Keep a diary of symptoms to share with the doctor.

Lifestyle tips

• Maintain a healthy body weight for your child's age
• Encourage gradual weight loss if needed – avoid rapid weight loss
• Include lots of fruits, vegetables, and whole grains in meals
• Stay active as a family – walking, biking, or playing sports

Diet and exercise

A low-fat diet helps reduce gallstone attacks. Focus on lean proteins (chicken, fish), low-fat dairy, and plant-based foods. Regular exercise helps with weight management and overall health. It's important not to skip meals, as that can cause the gallbladder to contract more forcefully and trigger pain.

Mental health and emotional wellbeing

Waiting for surgery can be stressful for both the child and family. Children may feel anxious about pain or the procedure itself. It is normal to have these feelings. Talk to your child and reassure them. If anxiety becomes overwhelming, speak to your healthcare provider who can offer support.

Prevention

While not all gallstones can be prevented, maintaining a healthy weight and eating a balanced diet low in saturated fat may reduce the risk. Avoid rapid weight loss diets in children. If your child has a condition that increases the risk (like sickle cell disease), work closely with their specialist to manage overall health.

Vaccines

There is no vaccine for gallstones.

Screening programmes

Routine screening for gallstones is not recommended for most children. However, if your child has a high-risk condition (e.g., hemolytic anemia), the doctor may recommend periodic ultrasounds to check for stones.

Complications

If left untreated

• Inflammation of the gallbladder (cholecystitis) – causing severe pain and infection
• Blockage of the bile duct – leading to jaundice and infection (cholangitis)
• Pancreatitis – inflammation of the pancreas, which can be serious
• Rarely, a stone can block the intestine (gallstone ileus)

Long-term outlook

Most children with gallstones do very well. If surgery is needed, it is a safe and effective cure. Recovery from keyhole surgery is usually quick, with children returning to school and activities within a week or two. With proper care while waiting and after treatment, the long-term outlook is excellent. The body can digest food normally without a gallbladder.

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