Gallbladder
Gallbladder and Gallstones: Causes, Symptoms, Diagnosis, and Treatment
Gallstones are solid deposits that form in the gallbladder due to imbalances in bile composition. They can range in size from as small as a grain of sand to several centimetres. While some people experience no symptoms, gallstones can cause significant discomfort and complications if left untreated. Understanding their causes, symptoms, and treatment options is crucial for managing this condition effectively.
What Are Gallstones and How Do They Form in the Gallbladder?
Gallstones are hardened substances that develop when cholesterol and bile salts crystallise in the gallbladder. The gallbladder, a small organ beneath the liver, stores and releases bile to aid in digestion. When the balance of bile components is disrupted, gallstones can form.
Types of Gallstones and Causes
1. Cholesterol Stones
- The most common type, accounting for approximately 80% of gallstones.
- Composed primarily of cholesterol and bile salts.
- Typically yellow-green in colour.
- Form due to excess cholesterol, insufficient bile salts, or poor gallbladder emptying.
2. Pigment Stones
- Dark brown or black stones composed of bilirubin.
- Often linked to biliary infections, and blood disorders (e.g., sickle cell anaemia).
- More common in individuals with chronic haemolytic conditions.
3. Mixed Stones
- A combination of cholesterol, calcium salts, and bile pigments.
- These stones are more common than pure cholesterol or pigment stones.
Risk Factors for Gallstones
- Gender – Women between the ages of 20 and 60 are more likely to develop gallstones due to hormonal influences.
- Obesity – Increased body weight, raises cholesterol levels in bile, increasing the chance of forming gallstones.
- Hormonal Factors – High oestrogen levels from pregnancy, birth control pills, or hormone replacement therapy increase risk.
- Diabetes – High triglyceride levels associated with diabetes contribute to gallstone formation.
- Rapid Weight Loss – Quick fat metabolism increases cholesterol secretion into bile, promoting gallstone development.
- Diet and Lifestyle – A high-fat, low-fibre diet can increase the risk of gallstones.
Types of Gallbladder Disease We Treat in Brisbane
Symptomatic Cholelithiasis
Gallstones causing biliary colic (sudden right upper abdominal pain lasting 30 mins–6 hours)
Acute/Chronic Cholecystitis
Inflamed gallbladder (fever, persistent pain, nausea)
Choledocholithiasis
Stones migrated to bile ducts, risking pancreatitis or jaundice
Biliary Dyskinesia
Poor gallbladder function without stones (often diagnosed via HIDA scan)
Symptoms That May Require Gallbladder Surgery
Our team here in Brisbane recommend evaluation if you experience:
🔹 Severe right upper quadrant (RUQ) pain radiating to back/right shoulder
🔹 Pain after eating fatty foods (especially at night)
🔹 Nausea/vomiting + bloating lasting hours
🔹 Jaundice (yellow skin/eyes) + dark urine (indicates bile duct blockage)
🔹 Fever with chills (sign of infection)
How Are Gallstones Diagnosed?
Accurate diagnosis is critical in determining the best course of treatment. Diagnostic methods include:
- Ultrasound: The gold standard for detecting gallstones. A non-invasive imaging test that provides a clear view of the gallbladder.
- CT Scan: Used to detect gallstones and assess complications such as inflammation or bile duct obstruction.
- ERCP (Endoscopic Retrograde Cholangiopancreatography): A specialised endoscopic procedure that identifies and removes gallstones from the bile ducts.
- Blood Tests: Can help detect infection, liver dysfunction, or inflammation caused by gallstones.
Complications of gallstones
If left untreated, gallstones can lead to serious complications, including:
- Biliary Colic – Blockage of the bile ducts causing intense, intermittent pain
- Cholecystitis – Inflammation of the gallbladder, leading to infection and severe, prolonged pain.
- Cholangitis – Infection of the bile duct, requiring urgent medical intervention.
- Pancreatitis – Inflammation of the pancreas due to blocked bile flow.
Early detection and treatment are key to avoiding these complications.
Treatment Options for Gallstones and Gallbladder problems
Advanced Gallstone Treatment Options in Brisbane
1. Non-Surgical Management (For Select Patients)
Dietary Modifications
Low-fat diet (<40g fat/day) to reduce gallbladder contractions
Increased fiber (whole grains, vegetables) to improve digestion
Avoid rapid weight loss (>1.5kg/week increases stone risk)
Why surgery is often better:
“While medications can dissolve stones, 70% of patients develop new stones within 5 years,” explains Dr. Goutham, “Laparoscopic removal provides a permanent solution.”
2. Laparoscopic Cholecystectomy (Gold Standard Treatment)
Why Choose Keyhole Surgery?
4 tiny incisions (5–10mm each) vs. 15cm open surgery cut
90% less post-op pain
Return to work in 7–10 days vs. 6 weeks with open surgery
The Procedure Step-by-Step
General anaesthesia administered by specialist anaesthetists
Carbon dioxide gas inflates abdomen for visibility
Surgeon inserts:
Laparoscope (camera)
Grasping/ cutting tools
Gallbladder detached from liver and bile ducts
Specimen removed through umbilical incision
Incision closed with dissolvable stitches
What to Expect: Your Brisbane Gallbladder Surgery Journey
Pre-Operative Phase
Diagnostic Testing
Ultrasound (first-line) – Detects 95% of gallstones
HIDA scan – Measures gallbladder ejection fraction
MRCP – Maps bile ducts if obstruction suspected
Pre-Surgery Checklist
✔ Blood tests (liver function, clotting)
✔ 8-hour fast (clear fluids allowed up to 2 hours prior)
✔ Medication review (stop blood thinners 5–7 days pre-op)
✔ Arrange a driver (mandatory due to anaesthesia)
Day of Surgery
Admission 1–2 hours pre-op for nursing assessment
IV antibiotics given to prevent infection
Procedure time: 45–90 minutes
Recovery room monitoring for 1–2 hours
Post-Operative Recovery
First 24 Hours
Shoulder tip pain (from CO2 gas) – Improves with walking
Light diet (start with toast, broth)
Pain control (paracetamol + ibuprofen usually sufficient)
Week 1–2
Walk daily to prevent blood clots
No heavy lifting (>5kg)
Shower normally (waterproof dressings used)
Long-Term
No dietary restrictions (liver adapts bile secretion)
20% report softer stools (managed with fiber supplements)
Gallbladder Surgery FAQs
What’s the cost of gallbladder surgery in Brisbane?
Private patients: A quote is provided on the day of your consultation. Rebates are available via Medicare and your health fund
Public patients: Free via referral (12–24 month waitlist)
Are there alternatives to surgery?
For high-risk patients, options include:
Percutaneous cholecystostomy (drainage tube)
ERCP + stent placement
What foods trigger gallstone attacks?
Worst offenders:
❌ Fried foods
❌ Full-fat dairy
❌ Processed meats
❌ Egg yolks
Schedule a Consultation with Dr. Goutham
Dr. Goutham specialises in advanced gallbladder surgery and offers comprehensive evaluations for gallstone management. If you’re experiencing symptoms, schedule an appointment today to discuss your treatment options and regain your digestive health.
