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Gallbladder / Bile Duct Stones

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What are Gallbladder / Bile Duct Stones?

The gallbladder is a little pouch situated just under the liver. Its close proximity to the liver allows it to easily store the bile produced by the liver and releases it via the bile ducts when it is required for digestion.

Gallbladder stones, commonly known as gallstones or choleslithitis in Singapore, can range in size from the size of a grain of rice, to the size of a ping pong ball. They may be symptomatic or asymptomatic, depending on where the gallstones are located.
If it is still in the gallbladder, it will not cause any symptoms. However, if the gallstones have travelled down the bile ducts, they are known as bile duct stones, and you will experience some intense symptoms. There are two types of gallstones, these are:
  • Cholesterol stones: most common type and are yellow-green, consist of solidified pieces of cholesterol.
  • Pigment stones: small and dark and made of bilirubin.

What causes Gallbladder / Bile Duct Stones?

The cause of gallbladder/bile duct stone depends on what type of gallstones were formed. The causes are as follows:
  • Excess cholesterol: these form cholesterol stones when your liver makes more cholesterol than can be dissolved in your bile.
  • Excess bilirubin: bilirubin is normally produced when red blood cells are broken down.
  • Concentrated bile: if your gallbladder does not empty properly, bile will start to build up and become concentrated, this causes stones to form. 

What are the common symptoms of Gallbladder / Bile Duct Stones in Singapore?

Most of the time, gallbladder stones do not cause any symptoms, this is especially true if they are still in the gallbladder and are quite small. However, if the gallstones are too big or if they travel down the bile duct and get stuck there, various symptoms might occur. These are:

  • Sharp pain in the upper right side of your abdomen
  • Pain in your right shoulder
  • Abdominal discomfort
  • Vomiting
  • Indigestion
  • Heartburn
  • Fever and chills
  • Jaundice
  • Dark urine
  • Light coloured stools

What causes Gallbladder / Bile Duct Stones?

The cause of gallbladder/bile duct stone depends on what type of gallstones were formed. The causes are as follows:
  • Excess cholesterol: these form cholesterol stones when your liver makes more cholesterol than can be dissolved in your bile.
  • Excess bilirubin: bilirubin is normally produced when red blood cells are broken down.
  • Concentrated bile: if your gallbladder does not empty properly, bile will start to build up and become concentrated, this causes stones to form.

What are the symptoms of Gallbladder / Bile Duct Stones?

Most of the time, gallbladder stones do not cause any symptoms, this is especially true if they are still in the gallbladder and are quite small. However, if the gallstones are too big or if they travel down the bile duct and get stuck there, various symptoms might occur. These are:

  • Sharp pain in the upper right side of your abdomen
  • Pain in your right shoulder
  • Abdominal discomfort
  • Vomiting
  • Indigestion
  • Heartburn
  • Fever and chills
  • Jaundice
  • Dark urine
  • Light coloured stools

If you experience the above symptoms, make an appointment to see a gastroenterologist.

Are Gallbladder / Bile Duct Stones painful?

Yes, if the gallstones are stuck in your bile duct. Most of the time, gallbladder stones do not cause any symptoms since the stones are small and remain in the gallbladder.

Who is at risk of Gallbladder / Bile Duct Stones in Singapore?

The following factors increase your risk of gallbladder/bile duct stones:

  • Gender: women are more prone to gallbladder stones than men.
  • Age: increasing age results in increasing risk of gallbladder stones.
  • Weight: overweight individuals are at a high risk of gallbladder stones due to other associated conditions such as insulin resistance, high blood pressure, high cholesterol.
  • Unhealthy lifestyle: diets high in refined sugars and fat and low in fibre, coupled with a lack of exercise, increases your risk of gallbladder stones.
  • Pregnancy: increased oestrogen during pregnancy increases cholesterol and reduces emptying of the gallbladder.
  • Family history: having a relative with gallbladder stones increases your risk.
  • Other medical conditions: liver cirrhosis, bariatric surgery, type 2 diabetes, high cholesterol, etc. increases your risk of gallbladder stones.

How are Gallbladder / Bile Duct Stones diagnosed?

As gallbladder stones do not usually cause symptoms, they are typically only discovered during screenings for other medical conditions. However, if you are experiencing symptoms, your gastroenterologist may conduct the following tests to make a diagnosis:

  • Blood test: to check for infection or elevated levels of enzymes.
  • Ultrasound: able to locate gallstones, particularly in the gallbladder.
  • Magnetic resonance cholangio-pancreatography (MRCP): used to confirm the presence of gallbladder stones.
  • Endoscopic retrograde cholangio-pancreatography (ERCP): combination of x-rays and an upper gastrointestinal tract endoscopy to identify or treat problems with the pancreatic or bile ducts.

What are the treatment options for Gallbladder / Bile Duct Stones in Singapore?

If your gallbladder stones are asymptomatic, treatment is not necessary. However, if you do have symptoms, the following treatments are available:

  • Laparoscopic cholecystectomy: your gallbladder is removed via keyhole surgery. It is a minor surgery, and you will be able to go home the same day if no complications arise. 
  • Open cholecystectomy: a cut is made in your abdomen to remove your gallbladder; you may need to stay in the hospital for a few days.
  • Endoscopic retrograde cholangio-pancreatography (ERCP): combination of x-rays and an upper gastrointestinal tract endoscopy to identify or treat problems with the pancreatic or bile ducts. Bile duct stones can be removed during this process.
  • Medication: certain medications can be used to dissolve gallbladder/bile duct stones; however, this process can take a few years and they may come back once you stop the medication.

Frequently asked questions

Do gallbladder/bile duct stones go away by themselves?
No, they do not, however, if you are not showing any symptoms, you do not require any treatment. If symptoms appear, the above-mentioned treatments may benefit you.
What can I do to prevent gallbladder/bile duct stones?
Having a healthy lifestyle is key to preventing gallstones. A 2019 study found that consumption of monosaturated fats, high fibre, olive oil, oily fish with omega 3, fruits, coffee, and vitamin C supplementation appear to have a protective effect against gallstones.

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