Gallstones do not always mean gallbladder must go

By Marissa Harshman, Columbian health reporter

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This month, Laina Harris learned she will need surgery to remove her gallbladder.

The reason: multiple gallstones that cause abdominal pain, sometimes severe enough to bring the 41-year-old to her knees.

Gallstones are hardened deposits of digestive fluid that can form in the gallbladder.

Throughout the day, the liver produces bile used to digest food. The gallbladder stores the bile until it's needed for digestion. If the bile gets too concentrated while in the gallbladder, it can crystallize and grow, forming gallstones, said Dr. Matthew Casimo, a gastroenterologist at The Vancouver Clinic. Casimo does not treat Harris.

Gallstones aren't uncommon, Casimo said. Researchers estimate 5 to 15 percent of Americans have gallstones. But research has found only about 20 percent of people with gallstones ever have symptoms, he said.

People usually experience symptoms when a gallstone lodges in and blocks the duct that delivers the bile from the gallbladder to the intestine. Those symptoms include sudden and rapidly intensifying pain in the upper right portion of the abdomen or in the center of the abdomen (just below the breastbone); back pain between the shoulder blades; and pain in the right shoulder. The pain can last several minutes or hours, according to the Mayo Clinic.

Gallstones won't likely go away on their own. But unless they're are causing symptoms, they don't need to be removed, Casimo said. When the gallstones

obstruct the gallbladder ducts, however, the entire gallbladder is removed. The reason, Casimo said, is people who get gallstones once will typically get them again. Removing the gallbladder eliminates that possibility.

Laparoscopic surgery has made gallbladder removal significantly less invasive. Most people who have the surgery (but are not in an emergency situation) leave the hospital the same day, Casimo said.

Without the gallbladder, some people may find they are a little less tolerant of fatty foods. Some may also experience diarrhea, but it's treatable with medication, Casimo said. Other than those two issues, most people don't have negative outcomes from surgery, he said.

While gallstones are common, some people are more at risk for gallstones. Women, people with diabetes and people older than 60 are at higher risk, as are people who are overweight, obese or pregnant, according to the Mayo Clinic.

In addition, people who eat high-fat, high-cholesterol or low-fiber diets are at increased risk. People who lose weight quickly or who have a family history of gallstones are also at risk, according to the Mayo Clinic.