Gallstone related conditions

What is it?
Biliary colic is a type of abdominal pain caused by a gallstone temporarily blocking the bile duct (usually at the gallbladder neck). It often occurs after eating, especially fatty foods.

Symptoms:

• Sudden pain in the upper right or middle abdomen
• Pain that can spread to the back or right shoulder
• Nausea or vomiting
• Pain usually lasts 30 minutes to a few hours and then eases
   

Treatment:

• Pain relief (e.g. paracetamol or anti-inflammatory medications)
• Avoid fatty foods
• Definitive treatment is usually gallbladder removal surgery (laparoscopic cholecystectomy)

What is it?
This is an inflammation of the gallbladder, most often caused by a gallstone blocking the cystic duct.

Symptoms:

• Severe, constant pain in the upper right abdomen
• Fever and chills
• Nausea or vomiting
• Tenderness over the gallbladder area
   

Treatment:

• Hospital admission for monitoring
• Antibiotics to treat infection
• Pain relief
• Surgery to remove the gallbladder (often during the same hospital stay)

What is it?
These are gallstones that have moved into the bile duct, which can block bile flow and lead to serious complications like jaundice or infection.

Symptoms:

• Abdominal pain (upper right side)
• Yellowing of the skin or eyes (jaundice)
• Dark urine and pale stools
• Nausea, vomiting, or fever (if infection develops)
   

Treatment:

• Mr Laing often performs a specialised operation called laparoscopic cholecystectomy and bile duct exploration to remove the stones during the same procedure - sparing patients from having two separate procedures.
• If CBD exploration is not feasible then ERCP (Endoscopic Retrograde Cholangiopancreatography): a procedure using a camera and tools via the mouth to remove the stones
• Follow-up gallbladder removal surgery to prevent further stones

What is it?
A rare condition where a gallstone becomes stuck in the neck of the gallbladder or cystic duct and presses on the bile duct, causing blockage and possibly inflammation or fistula formation.

Symptoms:

• Similar to bile duct stones or cholecystitis
• Right upper abdominal pain
• Jaundice (yellowing of skin/eyes)
• Sometimes fever or infection
   

Treatment:

• Surgery is usually needed to remove the gallbladder and relieve the bile duct obstruction
• Sometimes complex bile duct repair is needed depending on severity

What is it?
Some people experience ongoing or new pain after having their gallbladder removed (cholecystectomy). This is known as post-cholecystectomy pain or post-cholecystectomy syndrome.

Symptoms:

• Persistent upper abdominal pain
• Bloating or indigestion, especially after meals
• Diarrhoea or changes in bowel habits
• Sometimes nausea or discomfort similar to gallbladder pain
   

Causes may include:

• Bile duct irritation or spasm
• Retained stones in the bile duct
• Digestive changes due to lack of gallbladder storage
• Other conditions like stomach ulcers, acid reflux, or irritable bowel syndrome
   

Treatment:

• Depends on the underlying cause
• May include dietary changes, medications for acid or bile regulation, or further investigations (e.g. scans or endoscopy)
• Most cases improve with time and appropriate management