Gallstones waiting list care in older adults

Overview

Gallstones are hard pebble-like pieces that form inside your gallbladder, a small organ under your liver. They can be as small as a grain of sand or as large as a golf ball. Many people have gallstones without knowing it, but sometimes they cause pain or other problems.

Yes, gallstones are very common. They affect about 10–15% of adults in the UK, and the chance increases with age, especially in women and people over 60.

Gallstones are more common in older adults, women, people who are overweight, those with a family history, and people with certain health conditions like diabetes or liver disease.

Symptoms

Common symptoms

• Sudden, severe pain in the upper right part of your tummy (belly) that can spread to your back or shoulder blade
• Pain that comes and goes, often after a heavy or fatty meal, especially in the evening
• Feeling sick (nausea) or being sick (vomiting)
• Indigestion, bloating, or feeling uncomfortably full

Symptoms in older adults

• Pain may be less sharp and more like a dull ache or feeling of fullness
• Indigestion, loss of appetite, or feeling sick without obvious pain
• Confusion or low energy if an infection develops (more common in older adults)

Causes

Main causes

• An imbalance in the substances that make up bile – usually too much cholesterol or bilirubin – can cause hard deposits to form
• The gallbladder does not empty properly, allowing bile to become concentrated and form stones

Risk factors

• Being overweight or obese
• Losing weight very quickly (for example, after bariatric surgery or a crash diet)
• Having a family history of gallstones
• Being over 60 years old
• Having diabetes, liver cirrhosis, or certain blood disorders (like sickle cell anaemia)
• Taking some medications (like certain cholesterol-lowering drugs or hormone replacement therapy – ask your doctor if this applies to you)

When to see a doctor

See a doctor urgently if:

• If you have sudden, severe abdominal pain that stops you from doing your normal activities
• If you have a high fever or chills with the pain
• If you notice any yellowing of your skin or eyes
• If you have vomited and cannot keep fluids down

Book a routine appointment if:

• If you have repeated episodes of mild to moderate pain in your upper right belly after eating
• If you have persistent indigestion or bloating that does not improve with diet changes
• If you have been diagnosed with gallstones and are on a waiting list, but your symptoms are getting more frequent or worse

Diagnosis

Gallstones are usually found using an ultrasound scan of your tummy. This quick, painless test uses sound waves to create images of your gallbladder and bile ducts.

Tests that may be done

• Ultrasound scan (the main test)
• Blood tests to check your liver function and look for signs of infection or blockage
• CT scan or MRI scan if the ultrasound is not clear or if complications are suspected
• HIDA scan (cholescintigraphy) – a special scan that checks how your gallbladder is working

What to expect at your appointment

The ultrasound is done while you lie on your back on a bed. A small handheld device (probe) is moved over your tummy with some gel. It does not hurt and takes about 15–30 minutes. Your doctor may ask you not to eat or drink for a few hours before the test. You will usually get results within a few days.

Treatment

If your gallstones are not causing symptoms, treatment is usually not needed – you will be monitored. If you have symptoms, the most common treatment is surgery to remove the gallbladder (cholecystectomy). However, you may be placed on a waiting list for surgery. While you wait, managing symptoms with diet and medication can help. Medications (like those that dissolve small cholesterol stones) are sometimes used, but they are not a common treatment and are only suitable for a few people – your doctor will discuss this if it is an option for you.

Self-care at home

• Eat a low-fat diet – avoid fried, fatty, and greasy foods. Choose lean meats, fish, fruits, vegetables, and whole grains.
• Eat smaller, more frequent meals instead of large heavy meals
• Maintain a healthy weight, but avoid rapid weight loss diets
• Drink plenty of water
• Keep a symptom diary to identify foods that trigger pain

Medical treatments

For symptom control while on the waiting list, your doctor may recommend pain relief (such as simple painkillers available without a prescription) or medications to help dissolve small cholesterol stones (these are not suitable for everyone and take months to work). If you develop an infection (cholecystitis), you will need antibiotics. Always follow your doctor's advice – do not take any medication without consulting them.

When is surgery considered?

Surgery is usually recommended if you have had one or more episodes of pain, or if complications develop. The standard operation is laparoscopic (keyhole) cholecystectomy, which has a quick recovery time. Your surgeon will decide if you need an open operation (larger cut) in some cases. Being on a waiting list is normal, and your healthcare team will monitor you.

Living with this condition

Living with gallstones while waiting for surgery means paying attention to what you eat and how you feel. Many people manage well with diet changes and can avoid attacks. If pain occurs, rest and apply a warm compress to your belly. Keep your doctor informed if symptoms change.

Lifestyle tips

• Avoid high-fat foods such as butter, cream, cheese, red meat, and processed snacks
• Eat plenty of fibre – oats, brown rice, beans, lentils, fruits, and vegetables
• Stay active – gentle exercise like walking can help digestion and weight management
• Avoid alcohol if it triggers symptoms
• If you are overweight, aim to lose weight gradually (no more than 1–2 pounds per week)

Diet and exercise

A healthy, balanced diet low in saturated fat can help reduce symptoms. Include healthy fats (like olive oil or avocado) in small amounts. Regular physical activity, such as 30 minutes of moderate walking most days, supports overall health. Talk to your doctor before starting a new exercise routine.

Mental health and emotional wellbeing

Waiting for surgery can cause anxiety or worry, especially if you have had painful attacks. It is normal to feel frustrated or concerned. Talking to your doctor about your waiting time and knowing what to look for can help. If you feel overwhelmed, tell your GP – they can offer support or refer you to a counsellor.

Prevention

You cannot always prevent gallstones, but you can lower your risk by maintaining a healthy weight, avoiding rapid weight loss, eating a high-fibre, low-fat diet, and staying physically active. If you have a family history, these steps are especially important.

Screening programmes

There is no routine screening for gallstones. They are usually found when you have symptoms or during tests for other conditions.

Complications

If left untreated

• Acute cholecystitis – infection and inflammation of the gallbladder, causing severe pain and fever
• Obstructive jaundice – a gallstone blocks the bile duct, causing yellow skin and dark urine
• Pancreatitis – inflammation of the pancreas, a serious condition that can be life-threatening
• Gallstone ileus – a rare blockage in the intestine caused by a large gallstone

Long-term outlook

With proper care, most people with gallstones do well. If your symptoms are mild and you are on a waiting list, coping strategies and medical support can keep you comfortable. If surgery is needed, recovery is usually quick, and living without a gallbladder does not affect quality of life. Your healthcare team will help you manage any complications that arise. The outlook is very good.

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