Symptoms

Symptoms may appear as follows:

• Pain in the right side of the upper abdomen with nausea.
• Chronic indigestion accompanied by nausea and heartburn.
• Sharp and sudden pain in the right side of the upper abdomen that moves to the right shoulder or the back, and probably happens half an hour or less after a meal. The pain might also appear without eating and may last for a few hours. The patient may be free of pain for long periods ( weeks and perhaps months or years) , so the pain on a daily basis is really rare.
• The stone might move from its place to the bile duct, in this case, the pain may become more severe, and other symptoms might occur as a result of obstruction and inflammation like jaundice (Yellowish color of the skin), high temperature, and change in urine and feces color, all of which require immediate treatment.

The pain resulting from gallstones happens in about 10% of people. The disease affects women more than men, especially women over the age of forty.

Complications of gallstones are infrequent, though some of them are serious, the treatment however is easy and accessible which is a Cholecystectomy to remove the gallbladder including the stones.

How Do Gallstones Form?

The normal function of the gallbladder is to store bile that is produced by the liver, which helps in the digestion and absorption of fats in the duodenum.

Gallstones compose a solid formation of cholesterol and bile salts. However, research shows that approximately 80 to 90 percent of all gallstones are cholesterol gallstones which form when the liver begins secreting bile that is abnormally saturated with cholesterol. The excess cholesterol crystallizes and then forms stones which are stored in the gallbladder or the cystic duct. Gallstones can also form due to low levels of bile acids and bile lecithin.

And there are two types of gallstones:

1. Cholesterol Stones: The most common type.
2. Pigment Stones: Those who develop pigment stones most often include people who have hereditary blood disorders that include sickle cell anemia.

• Cholesterol Increase: when (cholesterol) production increases in the liver, cholesterol gallstones form when the liver begins secreting bile that is abnormally saturated with cholesterol. The excess cholesterol crystallizes and then forms stones which are stored in the gallbladder or the cystic duct. It is worth mentioning that the (cholesterol) we are talking about here is not related to high blood cholesterol, and then it is not treated with the same cholesterol-reducing drugs.
• Low levels of bile acids and bile lecithin: this will lead to increased levels of bilirubin in the blood and this happens in pregnancy periods and long periods of fasting.
• Gender: women are twice more likely to become infected with gallstones, female hormones and birth control pills are among the factors. 
• Weight gain: overweight women are six times more likely to have gallstones than others, carbohydrates and fatty food may be an important.
• Progress in Age.
• Genetic factors.
  

Diagnosis is done after careful history and physical examination and doing ultrasound study . An abdominal ultrasound scan uses sound waves to produce images of internal organs that show - clearly - the presence of stones or not. Other blood tests like complete blood count and liver function test may be needed .

As for when there’s a doubt that of one of the bile ducts is blocked, an (ERCP) Endoscopy is performed through the duodenum by pumping a radiation dye to reveal the channels to locate the blockage.

80% of gallstones cases do not show any symptoms, so there is no need for treatment, even if they were discovered during any other tests. The doctor usually advises to wait and observe the symptoms, if symptoms start showing, the treatment then is surgery.

Removing the gallbladder is the ideal surgical procedure for most situations, and the fact is removing the gall bladder due to gallstones is one of the most performed operations in hospitals at the present time, and it has become a lot easier after performing it through the laparscopic surgeries. Operations using the laparoscopy require at latest three small openings about the size of the finger tip in the abdominal wall. The openings are for the surgical instruments, and the endoscopy opening for the small camera to give a complete picture of the abdominal cavity. Thanks to the small openings for laparscopic operations, complications are fewer and do not require the patient to stay in the hospital for long periods.

After the operations, there may be a period of time where the patient needs to refrain from eating fatty meals; to avoid indigestion and excessive gas, but with time things will improve.

Complications:

As already highlighted, the complications happen when the bile ducts are blocked then gets inflamed, or when an acute inflammation occurs in the gallbladder itself. Sometimes complications occur when the blockage happen near the connecting point of the bile ducts and the pancreas, therefore, the pancreas becomes inflamed. All these complications require a quick fix and immediate action.