— Terrie, Maryland The most common symptom of gallstones is biliary colic, a crampy abdominal pain that often occurs right after meals, particularly fatty meals. The bloating you mention is very common during these attacks, which usually last anywhere from a few minutes to an hour. Gallstones can also cause cholecystitis, or inflammation of the gallbladder, when one of the gallstones blocks the flow of bile from the gallbladder. Symptoms can include fever, abdominal pain, and jaundice (yellowing of the eyes and skin). Less commonly, gallstones can cause inflammation of the pancreas or cholangitis, the latter a very serious bacterial infection of the biliary tree. Constipation can occur, though rarely, as a complication of gallstones, most commonly because of pancreatitis or gallstone ileus, a pretty rare event in which a large gallstone passes from the gallbladder into the intestine and blocks the flow of digested food from the small intestine into the colon (large intestine). Q2. Now that I’ve started menopause, I’m dealing with an increasing number of gallstones that leave me with nausea and indigestion. Will this stop once I’m postmenopausal, or should I have my gallbladder removed? — Rae, West Virginia Unfortunately, your gallstones — and the suffering they cause — aren’t likely to go away in the future. In fact, they’ll probably worsen. Developing gallstones (or cholecystitis) is a very common problem for people in their fifties, especially postmenopausal women. Once gallstones begin causing symptoms that disrupt quality of life, such as the nausea and indigestion you describe, it becomes pretty clear that it’s time to have your gallbladder removed. If you’re looking for nonsurgical options, most will probably fall short. Some people do find that they’re able to lessen their symptoms by making lifestyle changes, such as losing a modest amount of weight and avoiding fried or fatty foods. If you haven’t tried making these changes yet, by all means do so. But know that they’re rarely successful in the long term; at best, they only delay the need for gallbladder surgery. This is because most people aren’t vigilant enough to make these changes stick, and others don’t get adequate relief. In fact, even when diet and lifestyle changes do work, and a patient puts his or her symptoms on pause, most doctors will still recommend having the gallbladder removed. In my opinion, while all patients are different, there’s little to be gained from waiting to undergo gallbladder surgery. The risks of not having your gallbladder removed can include rupture, gallbladder infection, and sepsis (a general blood infection). While such problems are relatively uncommon and usually not life threatening, they add to the argument that the benefits of having your gallbladder surgically removed outweigh the risks. Compared with the surgeries of decades past, which required a week in the hospital and a long period of healing, newer, less-invasive laparoscopic procedures require small incisions, have a very low risk of complications, and allow most patients to go home the next day. Some patients are even able to return home in as little as eight hours after surgery. If you’re interested in this option, ask your doctor if you’re a candidate for laparoscopic cholecystectomy, which is the technical name for this surgery. Q3. I am 52 years old and I have multiple gallbladder stones. I’ve read about a remedy for gallstones where you drink apple juice for five days and then take a lot of lemon juice with olive oil. Do you think this really works? — Ashok, New Delhi There is no proof that a regimen of apple juice, lemon juice, and olive oil can dissolve gallstones. Some people who have tried this so-called gallstone cure have reported passing stones in their stool, but what they are actually seeing are the remnants of the oil and juice. There are basically two types of gallstones, pigmented — which occur mostly in patients with chronic hemolytic anemias, a group of conditions where red blood cells are destroyed prematurely in the bloodstream — and cholesterol stones, which are the most common. Although some cholesterol stones can be dissolved by taking a prescription medication called ursodeoxycholic acid (Actigall), this only works for small stones that have no calcium deposits. Most stones, unfortunately, contain calcium and may not dissolve even with long-term treatment. Bottom line: Surgery is still the best way to get rid of gallstones. Learn more in the Everyday Health Gallbladder Center.
