Key Takeaways
- What they are: Gallstones are hardened deposits that develop inside the gallbladder – a small pouch beneath the liver that stores bile. While many cause no symptoms, others can trigger significant abdominal pain or infection.
- How they develop: They form when bile contains excess cholesterol or bilirubin, or when the gallbladder fails to empty effectively.
- Who they affect: Gallstones are more common in people over 40, women, those who are overweight, have experienced rapid weight loss, or have certain medical conditions.
- Diagnosis: A gallstone ultrasound is the first-line test to confirm the presence of stones, inflammation or bile-duct blockage.
- Treatment options: Depending on symptoms and findings, treatment may involve monitoring, medication, or gallstone removal through laparoscopic cholecystectomy (surgical removal of the gallbladder).
Outlook: Most patients recover well after appropriate treatment and experience long-term symptom improvement.
Understanding Gallstones and How They Form
The gallbladder stores bile, which helps digest fat. Gallstones (cholelithiasis) form when bile has too much cholesterol or bilirubin, or when the gallbladder doesn’t empty properly. Over time, these substances harden into stones.
They can occur in anyone but are more common in certain groups. Contributing factors include:
- Female sex or oestrogen exposure (pregnancy, oral contraceptives, hormone therapy)
- People over 40 years old
- Rapid weight loss or obesity
- Diets high in fat and low in fibre
- Diabetes and metabolic syndrome
- Family history of gallbladder disease
In many people, gallstones remain “silent” and go unnoticed. In others, they trigger pain, inflammation or bile duct blockage that requires timely management.
Recognising the Signs and Symptoms
The most common symptom is upper abdominal pain, often described as a sharp, steady ache that can radiate to the shoulder or back. This discomfort, known as biliary colic, frequently occurs after eating rich or fatty foods.
Other possible symptoms include:
- Nausea, vomiting or bloating after meals
- Indigestion or abdominal fullness
- Loss of appetite or mild fever
When infection or bile duct obstruction develops, more serious signs may appear:
- Persistent or severe pain lasting several hours
- Jaundice (yellowing of the skin or eyes)
- High temperature or chills
Anyone experiencing these symptoms should seek prompt medical attention to prevent complications.
How Gallstones Are Diagnosed
As a bariatric and general surgeon, Dr Alex Craven provides a personalised assessment and management for conditions affecting the gallbladder and digestive system.
The most reliable diagnosis method is a gallstone ultrasound. This painless, non-invasive scan uses sound waves to visualise the gallbladder and bile ducts. It can detect:
- The size, number and position of gallstones
- Inflammation or thickening of the gallbladder wall
- Blockages in the bile ducts
If additional information is required, other tests may be used, such as MRCP (MRI of the bile ducts), CT scanning, or blood tests to assess liver and pancreatic function. These investigations help determine whether conservative management or gallstone removal is required.
Treatment Avenues for Gallstones
Not every gallstone requires surgery. The treatment plan depends on the severity of symptoms and overall health.
1. Conservative Management (Watchful Waiting)
When gallstones are found incidentally and cause no symptoms, observation may be the best option. You may be advised on dietary habits, maintaining hydration, and monitoring for pain or digestive changes.
2. Non-Surgical Options
Medication to dissolve gallstones is rarely used and is only considered for patients who cannot undergo surgery. It may take months to work, and stones often recur once treatment ends.
a) Gallstone Removal Surgery
For most people with recurrent pain, inflammation or infection, gallstone removal by laparoscopic cholecystectomy (keyhole surgery) offers the most reliable solution.
- The procedure removes the entire gallbladder to prevent recurrence.
- It is performed under general anaesthesia using small incisions.
- Most patients return home the same day or after one night in the hospital.
Because the gallbladder is not essential for digestion, long-term dietary restrictions are rarely necessary.
b) Endoscopic Treatment (ERCP)
When stones move into the bile duct, an endoscopic procedure called ERCP (endoscopic retrograde cholangiopancreatography) can remove them. This involves passing a flexible camera through the mouth into the intestine, avoiding external incisions. It may be combined with surgery or used as a standalone treatment.
Preparing for and Recovering from Surgery
Before undergoing gallstone removal, a discussion and review your medications, and order pre-operative tests such as blood work and imaging. You’ll receive clear instructions about fasting and recovery expectations.
After surgery, mild abdominal discomfort is normal and managed with simple pain relief. Most people can:
- Walk and move around within hours
- Resume light meals the next day
- Return to regular activity within one to two weeks
A follow-up visit ensures proper healing and allows your surgeon to review your recovery and address any questions. Digestive changes such as bloating or softer stools usually resolve as the body adapts.
Risks, Benefits and Long-Term Outlook
Gallstone removal is one of the most common and safe abdominal surgeries performed in Australia. The benefits include lasting pain relief, prevention of infection, and protection against complications such as bile duct obstruction.
Risks are uncommon but may include bleeding, infection, bile leakage or, very rarely, injury to surrounding structures. Some people experience temporary bloating or changes in bowel habit, which typically settle without intervention.
Once the gallbladder is removed, gallstones cannot return. With proper aftercare and healthy habits, most patients enjoy lasting symptom relief.
Gallstones & Related Services (Overview)
| Clinical Situation (Examples) | Potential Pathway* | Common Techniques / Procedures |
| Incidental or symptom-free gallstones found on imaging | Observation and lifestyle advice | Regular follow-up and gallstone ultrasound as needed |
| Recurring or severe upper abdominal pain after meals | Surgical consultation for gallstone removal | Laparoscopic (keyhole) cholecystectomy |
| Gallstones with gallbladder inflammation (cholecystitis) | Urgent surgical review | Laparoscopic or open cholecystectomy |
| Stones detected in the bile duct (choledocholithiasis) | Endoscopic assessment and clearance | ERCP (endoscopic retrograde cholangiopancreatography) |
| Post-surgery bile-duct symptoms or residual stones | Specialist imaging and targeted intervention | MRCP, repeat ERCP or revision procedure |
| Patients are unable to undergo surgery due to health factors | Non-surgical medical management | Bile acid dissolution therapy (limited role) and structured monitoring |
*Final recommendations are made after individual assessment.
Next Steps
If you’re experiencing ongoing abdominal pain, nausea, or jaundice, early assessment is important. A gallstone ultrasound can confirm the cause and guide whether gallstone removal is needed to prevent complications and aid recovery.
To discuss your results or symptoms, you can book an appointment with Dr Craven by calling (03) 9852 3777 or emailing info@dralexcraven.com.au.
Medical Disclaimer: This information is general and does not constitute individual medical advice. Treatment suitability, risks and recovery vary and are confirmed in consultation with qualified healthcare professionals. Always seek medical attention promptly for concerning symptoms.
FAQs
1. Do all gallstones need to be treated?
Not always. Silent gallstones that cause no discomfort may simply be monitored. Treatment is recommended if symptoms develop or complications arise. Dr Craven will discuss the likelihood of future symptoms and help decide whether observation, lifestyle changes, or surgery is the most appropriate option.
2. How reliable is a gallstone ultrasound?
A gallstone ultrasound is the first and most accurate test for detecting stones and inflammation. It’s painless, radiation-free and provides a clear view of the gallbladder and bile ducts. It can also identify other conditions, such as bile-duct dilation or thickened gallbladder walls, helping to rule out alternative causes of abdominal pain.
3. What happens during gallstone removal?
Gallstone removal is usually done via laparoscopic cholecystectomy — a minimally invasive keyhole operation that removes the gallbladder. Most patients go home the same day and recover quickly. The procedure is performed under general anaesthetic, and your surgeon will provide clear instructions on recovery, wound care, and when to resume normal activities.
4. How long is the recovery after surgery?
Recovery typically takes one to two weeks. Light activities can begin within days, and most people return to work shortly after. Your exact recovery time depends on factors such as general health, surgical findings, and how your body responds in the days following the operation.
5. Will I need to change my diet after a cholecystectomy?
Most people can resume a regular diet, but it’s often best to avoid heavy, fatty meals initially. Over time, your body will adapt to digesting fats without a gallbladder. Eating smaller, more frequent meals and maintaining hydration can help minimise temporary bloating or indigestion during the early recovery period.
