Gallstones can be painful, especially when they trigger an obstruction or infection of the gallbladder, bile duct, or pancreas (pancreatitis). Gallstones can cause intense and severe pain that requires hospitalisation. They can also cause nausea, vomiting, jaundice, and infection if left untreated. However, not everyone who has gallstones experiences pain and may not have any symptoms.
Gallstones can affect people of any age and background, although certain factors can increase the risk of developing gallstones. These risk factors include:
- Gender: women are generally more prone to gallstones than men.
- Age: individuals over the age of 40 are at a higher risk of developing gallstones, especially if they have other medical conditions such as diabetes.
- Obesity: being overweight or obese is a significant risk factor for gallstones; this is due to their links to increased cholesterol secretion by the liver. Singapore has seen an increase in obesity rates in recent years, which may contribute to a higher risk of gallstones.
- Rapid weight loss: rapid weight loss methods may increase the risk of gallstones due to a bile composition imbalance.
- Diet: a diet high in saturated fats and cholesterol can increase the risk of gallstones.
- Genetics: having a family history of gallstones indicates a genetic predisposition to gallstones.
- Hormones: women who have had multiple pregnancies, taking hormone replacement therapy, or using birth control pills with high oestrogen levels may be at a higher risk of gallstones.
- Medical conditions: having certain medical conditions, such as diabetes, cirrhosis of the liver, Crohn's disease, and blood disorders, increases the risk of gallstones.
A diet low in saturated fats and cholesterol can improve and prevent gallstones.
Gallstones are generally diagnosed through a combination of the following:
- Medical history: your surgical specialist will obtain your detailed medical history. They may ask about your symptoms, such as abdominal pain, nausea, vomiting, and other related issues.
- Physical examination: a physical examination may also be done to check for signs of gallbladder or abdominal tenderness.
- Blood tests: blood tests may be ordered to check for signs of other conditions, such as inflammation or infection, that gallstones could be causing.
- Imaging studies: imaging studies such as an ultrasound of the liver and gallbladder, computed tomography (CT) scans of the abdomen, and magnetic resonance imaging (MRI) of the bile ducts.
In general, treatment options for gallstones in Singapore include:
- Monitoring: as not everyone with gallstones experiences symptoms or complications, your surgical specialist may recommend monitoring the condition over time and treating it only if symptoms develop.
- Lifestyle modifications: for those with mild or infrequent symptoms related to gallstones, lifestyle changes may be recommended, such as improving diet and reducing high-fat foods, as well as exercising more.
- Cholecystectomy: gallbladder removal surgery or cholecystectomy is commonly performed and is the mainstay treatment for symptomatic gallstones. It involves the surgical removal of the gallbladder using minimally invasive laparoscopic techniques.
- Medications: medications may be prescribed to dissolve gallstones or manage symptoms such as Ursodeoxycholic acid (UDCA).
- Endoscopy: an endoscopy, also known as endoscopic retrograde cholangiopancreatography (ERCP), removes gallstones that have dropped into the bile duct.
A cholecystectomy may be necessary for severe cases of gallstones.