Ask an expert about gallstones 

Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. The gallbladder is a small, pouch-like organ found underneath the liver. Its main purpose is to store and concentrate bile (a liquid produced by the liver to help digest fats). In most cases, gallstones don't cause any symptoms and don't need to be treated. However, if a gallstone becomes trapped in an opening (duct) inside the gallbladder, it can trigger a sudden, intense abdominal pain. Treatment is usually only necessary if gallstones are causing symptoms (such as abdominal pain) or complications (such as jaundice or acute pancreatitis).

Our expert is consultant upper GI surgeon Mr Khaled Dawas. He is a senior member of the upper GI surgery team with much experience in both cancer and benign surgery (such as gallstone surgery). Mr Dawas will be here to answer any question you may have about gallstones, from symptoms to diagnosis and treatment.

A reminder for the web chat can be set in the box below. Questions may be submitted in advance of the web chat to: webmaster@uclh.nhs.uk

Please see the web chat transcript below.


1:17 UCLH: 
Good afternoon and welcome to our web chat. We will begin at 15:00 (3pm), but you can submit your questions now in preparation for the chat. Please note: your questions will not appear in the main chat window until after 15:00 (3pm)

Mr Khaled Dawas will be joining us to take your questions on gallstones and will try to answer as many questions as possible within the hour long web chat.
 
3:00 Mr Khaled Dawas: 
Hi I am Khaled Dawas and I am an Upper GI surgeon. I am happy to atke your questions and shall try to answer as many as possible.
 
3:02 [Comment From Cheli: ] 
Hi. I had my gall bladder out at the end of August then about two weeks after my operation I got this itch all over worse around my lower legs and feet, I had my blood tested and was told it was satisfactory the creams don't seem to work but the antihistamines do take the itch out for a while then it's back , I wonder if you have any ideas as to what may be causing it . Thank you Cheli
 
3:03 Mr Khaled Dawas: 
Hi Cheli. An itch sometimes happens if there is slow flow of bile from the liver to the bowels and comes with jaundice. This should be evident on blood tests. I would advise you consult your GP and a hepatologist if you’re still worried.
 
3:03 [Comment From Alison: ] 
Why do surgical teams continue to recommend low fat diets when no evidence to support their use and not in NICE guidelines?
 
3:03 Mr Khaled Dawas: 
You are right Alison. There is no evidence for this. The rationale, however, is that the gall bladder contracts to eject bile into the bowel in response to fatty foods so less fatty food means less gall bladder contraction and hopefully less pain. It’s a good idea and often does work.
 
3:03 [Comment From Grace: ] 
I’ve had a hepaticojejunostomy because I had/have mirizzis syndrome. Will I ever be able to do strong dynamic exercises again? Every time I try to do them I get quite ill and feel sick especially if twisting my abdominal area. This is important to me as I like to dance. I’m 65, I had the operation 4 months ago. There is nowhere that a lay person can really get any information on this operation. It was not done by that robotic hand.
 
3:04 Mr Khaled Dawas: 
Hello Grace. As long as you have good wound healing and have no hernia in the wound then you should be able to get back to your exercises. 4 months is probably a little early. Muscles take up to a year to get to their final state of healing
 
3:04 [Comment From SebSeb: ] 
Around 10 or 11 years ago I had a scan due to some kidney issues. After the scan I was told, slightly as an aside, that I had gallstones but this was unconnected to the kidney issue. I asked if anything needed to be done and from what I remember they said something about experiencing discomfort when I ate fatty food. But that was it and I didn't really think too much about it and didn't notice too many symptoms. Although recently I have noticed that if I eat too much I am more prone to heartburn than I have been before, so not sure if this is related to the gall stones. So my question is, should I actually do anything about the gallstones or just wait and see if I get much worse pain? Is the heartburn connected to them or just one of those things?
 
3:05 Mr Khaled Dawas: 
Seb, gallstones are very common and the only time you need treatment is if you have symptoms ie pain or other potential problems. Otherwise, ignore them
 
3:06 [Comment From Angie: ] 
When treating gallstones with laser therapy, what is the likleyhood of them coming back?
 
3:07 Mr Khaled Dawas: 
Angie, breaking gallstones up like that is not as effective as with kidney stones. Gallstones tend to recur
 
3:07 [Comment From grace]
iv had a hepaticojejunostomy because i had/have mirizzis syndrome. will i ever be able to do strong dynamic exercises again? as every time i try to do them i get quite ill and feel sick especially if im twisting my abdominal area. this is importan i did have an umblical hernia it was fixed
 
3:08 Mr Khaled Dawas: 
Hi again Grace. I would still advise giving it longer for the muscles to heal
 
3:08 [Comment From John: ] 
Can drinking lemon juice in water minimise the pain and effects of gallstones?
 
3:09 Mr Khaled Dawas: 
Hi John. I dont think it would.
 
3:09 [Comment From Jeannie: ] 
I have multiple gallstones of 3 mm maximum size 6.5mm with no symptom. The only problem I have is acidity. My doctor has advised me to have the gallbladder removed. Is this the right choice?
 
3:10 Mr Khaled Dawas: 
Hi Jeannie. If the symptoms you have are truly due to the gallstones then an operation would help. Acidity is not a common symptom of gallstones. A careful surgical assessment would help
 
3:11 [Comment From Roger: ] 
Since my gallstone surgery my upper abdomen area has never gone down and if I lean over or press on stomach it makes me feel sick. Could this be because of gallstones? Recent liver tests have come back with abnormalities, but I’m unsure what these mean too.
 
3:12 Mr Khaled Dawas: 
Hi Roger. Key hole (laparoscopic) surgery would not give you a bulge. If you had open surgery then the scar may bulge. If your liver tests are abnormal then your doctor will want ot follow these up to find out why
 
3:12 [Comment From Trevor: ] 
Which of the surgical options is the most effective treatment?
 
3:13 Mr Khaled Dawas: 
Trevor, the only relaible treatment is the removal of the gall baldder (a cholecystectomy). other procedures are not effective in the long term
 
3:14 [Comment From Sam: ] 
What foods should I avoid if I have gallstones?
 
3:14 Mr Khaled Dawas: 
Hello Sam.
The culprits that may worsen your pain are fried foods, fatty foods, cheese and other dairy products
 
3:16 [Comment From Shaqib: ] 
Do you perform gallbladder surgery laparoscopically? I have heard that this can be unsafe when it comes to gallbladders. What is your opinion?
 
3:18 Mr Khaled Dawas: 
Hello Shaqib. Most gall bladder surgery is done laparoscopically and this has been the case for about 20 years. As long as the surgeon you deal with has the right experience and training then I would recommend this method. Some people can't have laparoscopic surgery and there is also a proportion who will need to have the laparoscopy converted to open surgery
 
3:18 [Comment From Richard: ] 
Is there a good alternative to surgery?
 
3:19 Mr Khaled Dawas: 
Thanks Richard. There is no effective alternative. But if you are able to control the pain with simple measures such as careful weight loss and dietary changes then surgery may not be necessary
 
3:20 [Comment From Graham: ] 
Is gallstone surgery complicated? How do I find a "good" surgeon? I have always been a bit mistrustful of doctors.
 
3:21 Mr Khaled Dawas: 
Hi Graham. Your GP will be able to guide you she or he wil have a knowledge of who the experts are at your local hospital. I agree, it's an anxious time when you have to contemplate surgery. I have had that experience myself
 
3:21 [Comment From Sheila: ] 
My mother suffered badly from a gallstone. Am I likely to get them as well? I’m a 42 year old female.
 
3:22 Mr Khaled Dawas: 
Hi Sheila. You wont necessarily get them but like many diseases there is a familial link. Dont ponder it too much though.
 
3:22 [Comment From Rachael: ] 
What would be the reasons as to why a laparoscopy would be converted to open surgery? Does this happen often?
 
3:23 Mr Khaled Dawas: 
Hello Rachael. Its either a technical issue eg a very stuck, difficult gall baldder or if there problems such as bleeeding which obscure the camera view. These are rare and I quote a 1-5% conversion rate.
 
3:23 [Comment From Richard: ] 
Thanks Mr Dawas. Why does losing weight have an impact on the pain they can cause?
 
3:24 Mr Khaled Dawas: 
Richard, it probably comes hand in hand with improving the diet and is a reflection of teh dietary changes. Obesity tends to signify a poor diet
 
3:24
iv had a hepaticojejunostomy because i had/have mirizzis syndrome. will i ever be able to do strong dynamic exercises again? as every time i try to do them i get quite ill and feel sick especially if im twisting my abdominal area. this is important after having our gallbladder removed what would be the most beneficial things we could do to keep ourself well.
 
3:25 Mr Khaled Dawas
Hi Grace. After sugery there are no specific requirements or restrictions. But there is no harm keeping a good diet and healthy weight
 
3:26 [Comment From Ana: ] Is it true that milk thistle can help the liver remove toxins from the body?
 
3:27 Mr Khaled Dawas: 
Hi Ana. I don't know about that. The liver, however, is an amazing engine that detoxifies as you correctly say. A healthy diet and lifestyle is enough to keep the liver functioning normally
 
3:27 [Comment From Bill: ] 
Is there any link between gallstones and cancer developing?
 
3:28 Mr Khaled Dawas: 
Hi Bill. The simple answer is "no". That link is really very tenous and probably not present. Gallstones are very common whereas gall bladder cancer is extremely rare
 
3:28 [Comment From Alfred: ] 
I have liver cysts and gallstones. Doctors always assume I must be a big drinker, but I only have an occassional sherry at christmas. What could be going on here? I am in pain at times, but the pain comes and goes.
 
3:29 Mr Khaled Dawas: 
Thanks Alfred. Your pain may be due to the stones but you'd need to discuss this with a specialist. The liver cysts dont normally cause pain
 
3:29 [Comment From Bella: ] 
Does UCLH perform gallbladder surgery using robots like they do with some other conditions?
 
3:30 Mr Khaled Dawas: 
It's an intresting point Bella. We dont here as there is no advantage to using a robot for this kind of surgery.
 
3:31 [Comment From Deirdre: ] 
My doctor has told me I have a "porcelain gallbladder" and now I'm terrified. Does this need surgery?
 
3:32 Mr Khaled Dawas: 
Hello Deirdre. Dont be terrified. That diagnosis is one based on ultrasound. My advice is to speak to a specialist as one needs to correlate your symptoms with the scan findings
Monday November 28, 2016 3:32 Mr Khaled Dawas
3:32 [Comment From Cheli: ] 
I have a fatty liver I do not drink alcohol can this be reversed.
 
3:33 Mr Khaled Dawas: 
Cheli, a fatty liver usually happens in people who are overweight / obese. So weight loss will reverse it.
 
3:34 [Comment From Gilly: ] 
I have quite a lot of abdominal scarring from a difficult total abdominal hysterectomy six years ago. I am due to have my gallbladder out in four weeks so am wondering if that will affect my chances of having the operation with key hole surgery?
 
3:35 Mr Khaled Dawas: 
Hello Gilly. You're rigth that havibg previous surgery starts abdominal scarring which makes conversion a higher risk but often the only way of being certain is at the time of surgery. There are no scans that can tell
 
3:37 
Hi i had my gallbladder removed in July I'm still getting discomfort not show if it's due to doing shakes as a diet as I'm 8 stone over weight it was doing this diet that i had gallstones in the first place.
Monday November 28, 2016 3:37 Hi i had my gallbladder removed in July Im still getting discomfort not show if its due to doing shakes as a diet as Im 8 stone over weight it was doing this diet that i had gallstones in the first place. Thank You Tracy
 
3:38 Mr Khaled Dawas: 
Hi. I dont think the shakes would cause these symptoms. I would ask your doctor to check if there are no stone related causes of your pain
 
3:38
i/4 of my liver atrophied with infection due to the stone in the bile duct. will that ever heal?
 
3:39 Mr Khaled Dawas: 
Hi Grace. The liver is amazing in its ability to regenerate but you need to speak to a hepatologist (liver specialist) about that
 
3:39 [Comment From Ronda: ] 
Can you get pain from the gall bladder even if there are no stones?
 
3:40 Mr Khaled Dawas: 
Thanks Ronda. That would be extremely rare and very unusual. Doctors occasionally disagree about this.
 
3:40 [Comment From Rachael: ] 
If I am meeting a surgeon for a consultation next week due to urgent refferal by my GP, what is the average time it takes to have surgery after that? How quick do they normally do it as I am in a lot of discomfort.
 
3:41 Mr Khaled Dawas: 
Rachael, that will depend on the severity of your symptoms and the waiting times in your hospital
 
3:42 [Comment From Callie: ] 
How easy is gallstone surgery for you? Is it one of the more complicated surgeries or easy?
 
3:43 Mr Khaled Dawas: 
Hello Callie. By nature I am always reluctant to say that any surgery is easy. Let me say that its one of the most common procedures I do and that its mainly done on a day case basis. Call me superstitious!
 
3:43 [Comment From Cheli: ] 
Do gallstones ever grow in the liver itself.
 
3:44 Mr Khaled Dawas: 
Hello again Cheli. Yes they can if there is abnormality in the flow of bile eg narrowings in the ducts
 
3:44 [Comment From trevor: ] 
Is there any research going on to improve the way surgery is carried out or are we as far down the road as we're likely to go?
 
3:46 Mr Khaled Dawas: 
A good question Trevor. There is certainly always room for improvement. On the gall bladder surgery front I would say the main avenues for improvement include better diagnosis, a better understanding of why we get gall stones and how to prevent them. The technical aspects are good at the moment. We always aim to improve our training to minimise the risks of surgical complications
 
3:48 [Comment From Anonymous: ] 
Is it true that wine and whole-grained bread may decrease the risk of gallstones?
 
3:48 Mr Khaled Dawas: 
I dont know of any scientific evidence for that
 
3:50 [Comment From grace.: ] 
would you say that there is more gallbladder surgery than ever before
 
3:51 Mr Khaled Dawas: 
Hi grace. You know, thats probably true. We have better diagnostic tools and our training is better. But I also think we have a bigger problem with poor diets and obesity which no doubts contributes
 
4:01 UCLH: 
That concludes the web chat! Thank you for all of your questions and apologies to those whose questions we were not able to answer today.

 

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