Is there anything you can do about abdominal pain from gallstones?

Gallstone disease is one of the most common gastroenterological disorders. There are several well-known risk factors for developing gallstones. These risk factors include being female, age 40 or older, pregnant, obese, or of white, Hispanic, or Native American ethnicity.

Studies have shown that most gallstones are diagnosed at a time when they cause no symptoms. They may continue to cause no discomfort for decades. In this asymptomatic stage gallstones need no treatment. The symptoms that gallstones classicallly cause include severe pain in the upper right part of the abdomen that generally lasts more than 30 minutes. The pain usually comes and goes and may be related to food intake–in particular, to fatty foods.

The treatment for symptomatic gallstone disease is surgery to remove the gallbladder. In recent years, most gallbladder operations have been done laparoscopically, through a set of small holes in the abdomen, rather than by cutting the abdomen open (laparotomy). This has reduced the length of both hospitalization and recovery time for patients.

Although surgery is usually the best treatment option, other therapies are available for symptomatic gallstones. These include an oral medication called ursodeoxycholic acid; dissolving gallstones with a chemical called methyl tertiary butyl ether (MTBE); and shock-wave lithotripsy to break stones into smaller pieces that can be passed out of the body naturally. These therapies are generally only useful for gallstones made up entirely or mostly of cholesterol. These approaches work best when the gallstones are small, limited in number, are causing only mild symptoms, and have not caused an infection. Also, after such treatments stones can reform as often as 50% of the time.

If you have abdominal pain, you should be checked by your doctor, who can conduct the necessary tests to help diagnose your pain and prescribe a treatment plan. You may need further evaluation by a surgeon or gastroenterologist after examination by your primary doctor.

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