From the Editor's Desk
Dr. Saravana Bharathy. S. P
Consultant
Internal Medicine
Internal Medicine
Gallbladder Stones: Know the Signs. Act Early.
Gallbladder Stone Surgical Camp, Dr. Mehta’s Multi-Speciality Hospital.
What are gallstones?
Gallstones (cholelithiasis) are solid deposits that form in the gallbladder, a small organ located below the liver that helps digest fats. Many individuals may have gallstones without any symptoms, but some experience pain or serious complications that require medical attention.
What the numbers say!
- In India, the prevalence of gallstones ranges from 4% to 6%, according to population-based studies (ICMR, Indian J Gastroenterol, 2023).
- Women are 2–3 times more likely to develop gallstones than men.
- Urban and northern Indian populations have a higher prevalence due to dietary habits, obesity, and metabolic factors.
- Possible complications include acute cholecystitis, cholangitis, gallstone pancreatitis, and in rare cases, gallbladder cancer.
When should you see a doctor?
- You should consult a physician or surgeon if you experience:
- Recurrent upper abdominal pain lasting more than 30–60 minutes (often after fatty meals)
- Fever with severe abdominal pain
- Jaundice (yellowing of eyes or skin) or dark urine
- Severe vomiting or pain radiating to the back
- Unexplained weight loss or persistent indigestion
What the ultrasound can tell us and what we must not ignore
- 🚨 Concerning findings:
- Gallbladder wall thickening (>3 mm)
- Pericholecystic fluid
- Impacted stone at the neck or cystic duct
- Positive sonographic Murphy’s sign
- Dilated CBD (>6 mm) or visible CBD stones
- ⚠️ Mild findings (need follow-up):
- Biliary sludge
- Small asymptomatic stones
- Polyps >1 cm require further evaluation
Red flags: when to rush to the hospital
- High fever, chills, and abdominal pain (may indicate cholangitis)
- Intense pain radiating to the back with vomiting (possible pancreatitis)
- Persistent jaundice and loss of appetite
- Confusion, low blood pressure, or signs of sepsis
Complications of neglected gallstones
- Acute cholecystitis : infection of the gallbladder, often requiring emergency surgery.
- Choledocholithiasis : stones in bile duct, causing jaundice.
- Ascending cholangitis : life-threatening infection needing urgent ERCP.
- Gallstone pancreatitis : inflammation of pancreas.
- Chronic cholecystitis and gallbladder carcinoma : rare but serious outcomes
Treatment guidelines (based on Indian and global recommendations)
- As per ICMR and the Indian Society of Gastroenterology:
- Laparoscopic cholecystectomy remains the gold standard for symptomatic stones.
- Early surgery (within 72 hours) is advised for acute cholecystitis.
- ERCP + cholecystectomy for CBD stones.
- Asymptomatic gallstones: observation is preferred unless risk factors exist (e.g., diabetes, porcelain gallbladder, hemolytic anemia).
Lifestyle and prevention tips
- Maintain a healthy weight and avoid rapid weight loss, which can trigger stones.
- Exercise regularly.
- Reduce high-fat and high-cholesterol foods.
- Stay hydrated.
- Manage diabetes and triglycerides effectively.
This month, Dr. Mehta’s Multi-Speciality Hospital is conducting a dedicated Gallbladder Stone Surgical Camp, offering evaluation, ultrasound review, surgical consultation, and preventive guidance for gallstone-related conditions.
