Cholelithiasis

What is cholelithiasis?

Cholelithiasis is the formation of stones in your gallbladder, also called gallstones. Your gallbladder is located on the right side of abdomen near your stomach. Your gallbladder stores bile, which helps break down the fat that you eat. Your gallbladder also helps remove certain chemicals from your body.

What causes cholelithiasis?

Cholelithiasis develops when your gallbladder does not empty correctly. Stones can form from different bile materials. The following may increase your risk of cholelithiasis:

• Obesity
  
  
• Pregnancy
  
  
• Having a family member with cholelithiasis
  
  
• Diabetes or previous surgery of the intestines
  
  
• Rapid weight loss
  
  
• Certain medicines, such as estrogen, antibiotics, and cholesterol-lowering medicines

What are the signs and symptoms of cholelithiasis?

The most common symptom of cholelithiasis is severe, constant pain in the right upper abdomen. It is usually just below the rib cage. The pain may also be felt in the right shoulder and between the shoulder blades. You may also have any of the following:

• Nausea and vomiting
  
  
• Feeling bloated
  
  
• Pale-colored bowel movements
  
  
• Dark-colored urine

How is cholelithiasis diagnosed?

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Abdominal ultrasound: This test is done so caregivers can see the tissues and organs of your abdomen. Gel will be put on your abdomen and a small sensor will be moved across your abdomen. The sensor uses sound waves to send pictures of your abdomen to a TV-like screen.
  
  
• Liver and gallbladder scan: This test may also be called a HIDA scan. This is a test to look at your liver and gallbladder. You are given a small amount of radioactive dye in your IV. Pictures are then taken by a special scanner that can "see" the dye in your body. Caregivers look at the pictures to see if your liver and gallbladder are working normally.
  
  
• ERCP: ERCP is also called endoscopic retrograde cholangiopancreatography. This test is done during an endoscopy to find stones, tumors, or other problems. Dye is put into the endoscopy tube. The dye helps your pancreas and bile ducts show up better on x-rays. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to shellfish, dyes, or any medicines. If you have stones, they may be removed during ERCP.
  
  
• Oral cholecystography: Oral cholecystography is a test to look at your gallbladder and its ducts (passages). You are given pills to swallow that have a special dye in them. Then, x-rays are taken over time. The dye makes your gallbladder and its ducts show up on the x-rays. This may make it easier for your caregiver to see any stones or swelling in your gallbladder. Some people may be allergic to the kind of dye used in the pills. Tell caregivers if you are allergic to dye or shellfish (crab, lobster, or shrimp). It is also very important to tell your caregiver if there is any chance you could be pregnant. Your caregiver will tell you what you can and cannot eat before the test. It is important to follow your caregiver's instructions or the test may not work.

How is cholelithiasis treated?

• Medicines:
  
  
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.
    
    
  • Pain medicine: You may be given medicine to take away or decrease pain. Do not wait until the pain is severe before you take your medicine.
  
  
• Cholecystectomy: This is surgery to remove your gallbladder. During a laparoscopic cholecystectomy, small incisions are made in your abdomen. A small scope and special tools are inserted through these incisions. A scope is a flexible tube with a light and camera on the end. You may need an open cholecystectomy. This is when a single, larger incision is made to remove your gallbladder and clean out your abdomen.

What are the risks of cholelithiasis?

Cholelithiasis may block the bile duct and lead to cholecystitis (inflammation of the gallbladder). Small gallstones may also cause a blockage in the small intestines. Infection of the gallbladder and swelling of the pancreas may also occur. Surgery to remove gallbladder may cause infection and injury to the bile duct.

When should I contact my caregiver?

Contact your caregiver if:

• You have nausea and vomiting.
  
  
• Your urine is dark-colored.
  
  
• You have clay-colored bowel movements.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

• You have a fever and chills.
  
  
• Your eyes or skin turn yellow.
  
  
• You have severe pain in your upper abdomen, just below the right rib cage.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Cholelithiasis