The gallbladder is a small sac beneath the liver, and lies under the right rib cage. It stores a fluid called bile, which we need to digest fats. Soon after a meal, the gallbladder releases bile through a narrow passageway called the bile duct. The liver also eliminates certain waste products through bile. Stones can form in the gall bladder.

Bile has highly concentrated cholesterol, salts, and liver pigments. These ingredients can form crystals that become a stone. Gallstones are relatively common, and small ones often pass unnoticed through the duct and into the intestine. However, a stone may grow as large as a golf ball. A large stone may become lodged in the neck of the gallbladder, causing cramps and pain. The gallbladder may become inflamed.

A more serious problem arises when the stone lodges in the bile duct. This blocks the flow of bile into the intestines and leads to poor digestion of fats. It also causes backup of liver pigments, which accumulate throughout the body, giving the skin a deep yellow color known as jaundice. The stone may also lodge where the bile duct meets the duct from the pancreas. The pancreas secretes enzymes that are essential to digestion. Therefore, this kind of blockage can shut down digestion completely. It can also lead to inflammation of the pancreas, which is often a medical emergency.

The pain from gallstones may come and go. It often starts after a rich meal. It is usually intense and sudden, starting in the upper right abdomen and radiating to the right shoulder blade. Other symptoms include nausea and vomiting, fever and chills, and jaundice. If you have sharp, persistent pain in the abdomen, see a healthcare provider. He or she must rule out other causes that need immediate treatment. For example, the appendix is also on the right side. It is lower than the gall bladder.

The usual treatment for gallstones that cause symptoms is removal of the gallbladder. This procedure is called a cholecystectomy. It is relatively safe and usually resolves the problem completely. The treatment of choice has become laparoscopic surgery. Instruments and a fiber optic camera are sent through very small incisions with little trauma to the abdominal wall. It is possible for patients to go home the day after surgery and return to work in a few days. After surgery, bile can still flow directly from the liver to the intestines.

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