Do gallstones dissolve on their own. How are gallstones diagnosed. What are the treatment options for gallstones. Is surgery always necessary for gallstone removal. Can gallstones be treated without surgery. What are the risks of leaving gallstones untreated. How can gallstone formation be prevented naturally.

Understanding Gallstones: Causes, Symptoms, and Diagnosis

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. These small, pebble-like formations can range from the size of a grain of sand to that of a golf ball. While some people may never experience symptoms, others can suffer from severe pain and complications.

The primary causes of gallstones include:

• Excess cholesterol in bile
• Too much bilirubin in bile
• Insufficient bile salt
• Incomplete emptying of the gallbladder

Symptoms of gallstones often include:

• Sudden, intense pain in the upper right abdomen
• Pain between the shoulder blades
• Nausea and vomiting
• Fever and chills

Do gallstones always cause symptoms? Not necessarily. Many people have what’s known as “silent gallstones,” which don’t cause any noticeable issues. However, when symptoms do occur, they can be severe and require immediate medical attention.

Diagnostic Procedures for Gallstones

When gallstones are suspected, doctors employ various diagnostic techniques to confirm their presence and assess their severity. These may include:

1. Physical examination: The doctor checks for jaundice and abdominal tenderness.
2. Blood tests: These can reveal signs of infection or obstruction.
3. Ultrasound: This non-invasive imaging technique uses sound waves to create pictures of the gallbladder and surrounding structures.
4. CT scans: These provide detailed images of internal organs and can help identify complications.
5. ERCP (Endoscopic Retrograde Cholangiopancreatography): This procedure allows doctors to visualize the bile ducts and potentially remove gallstones.

Can gallstones be diagnosed without invasive procedures? In many cases, yes. Ultrasound is often the first-line diagnostic tool due to its accuracy and non-invasive nature.

Treatment Options: From Watchful Waiting to Surgery

The treatment approach for gallstones depends on various factors, including the severity of symptoms, the patient’s overall health, and the size and location of the stones. Here are the main treatment options:

Watchful Waiting: When Patience is Key

For many individuals with asymptomatic gallstones or those who have experienced only one mild attack, watchful waiting may be the recommended course of action. This approach involves careful monitoring of symptoms without active intervention.

Why might doctors choose watchful waiting? Research shows that a significant percentage of people who experience a single gallstone attack never have a recurrence. In some cases, the stone may dissolve or become dislodged on its own.

Nonsurgical Therapies: Exploring Alternative Solutions

When surgery is not an immediate option or if the patient is unable or unwilling to undergo surgery, several nonsurgical therapies may be considered:

• Oral dissolution therapy: Medications like ursodeoxycholic acid (Ursodiol) can help dissolve small cholesterol stones over time.
• Shock wave lithotripsy: High-frequency sound waves are used to break up stones, which are then dissolved with bile salt.
• ERCP stone removal: During an ERCP procedure, small stones may be removed using specialized instruments.

Are nonsurgical therapies effective for all types of gallstones? Unfortunately, no. These methods are typically only successful for small, uncalcified cholesterol stones and may not prevent recurrence.

Surgical Intervention: The Gold Standard

For persistent or severe gallstone problems, surgical removal of the gallbladder (cholecystectomy) is often the recommended treatment. This procedure is considered one of the safest and most common surgical operations performed today.

There are two main surgical approaches:

1. Laparoscopic cholecystectomy: A minimally invasive procedure using small incisions and a camera.
2. Open cholecystectomy: A traditional surgery involving a larger incision, typically reserved for complicated cases.

Is life without a gallbladder possible? Absolutely. While the gallbladder serves a purpose in storing and concentrating bile, it’s not essential for digestion or overall health. After gallbladder removal, bile flows directly from the liver to the small intestine.

Natural Remedies and Lifestyle Changes for Gallstone Management

While medical treatments are often necessary for gallstones, several natural remedies and lifestyle changes may help manage symptoms and prevent future stone formation:

• Maintain a healthy weight: Obesity increases the risk of gallstone formation.
• Stay hydrated: Adequate water intake can help prevent bile from becoming too concentrated.
• Exercise regularly: Physical activity may reduce the risk of gallstone formation.
• Eat a balanced diet: Focus on fiber-rich foods and limit saturated fats.
• Consider herbal remedies: Some herbs like milk thistle and peppermint may support gallbladder health.

Can natural remedies replace medical treatment for gallstones? While these approaches may help prevent gallstones or manage mild symptoms, they should not replace professional medical advice or treatment, especially in cases of severe pain or complications.

Complications of Untreated Gallstones: When to Seek Immediate Care

While some gallstones may remain asymptomatic, untreated symptomatic gallstones can lead to serious complications. These may include:

• Cholecystitis: Inflammation of the gallbladder
• Choledocholithiasis: Blockage of the common bile duct
• Pancreatitis: Inflammation of the pancreas
• Gallbladder cancer: A rare but serious potential complication

When should you seek emergency care for gallstone symptoms? If you experience severe abdominal pain, fever, chills, or yellowing of the skin or eyes, seek immediate medical attention. These could be signs of a serious gallstone complication requiring urgent treatment.

Prevention Strategies: Reducing Your Risk of Gallstone Formation

While not all gallstones can be prevented, certain lifestyle choices can significantly reduce your risk of developing them:

1. Maintain a healthy weight: Avoid rapid weight loss or gain, as both can increase gallstone risk.
2. Eat a balanced diet: Include plenty of fruits, vegetables, whole grains, and lean proteins.
3. Stay physically active: Regular exercise can help maintain a healthy weight and promote good digestive health.
4. Stay hydrated: Drink plenty of water throughout the day.
5. Limit high-fat and processed foods: These can increase cholesterol levels and gallstone risk.

Are there specific foods that can help prevent gallstones? Some studies suggest that consuming foods high in vitamin C, calcium, and coffee may have protective effects against gallstone formation. However, more research is needed to confirm these findings.

Living with Gallstones: Management and Long-term Outlook

For those living with gallstones, whether symptomatic or asymptomatic, understanding how to manage the condition is crucial. Here are some key points to consider:

• Regular check-ups: Even if you’re not experiencing symptoms, regular medical check-ups can help monitor your condition.
• Dietary modifications: Working with a nutritionist can help you develop a diet plan that minimizes gallstone-related discomfort.
• Stress management: Chronic stress may exacerbate gallstone symptoms, so finding effective stress-reduction techniques is important.
• Medication management: If you’re taking medications to manage gallstones, ensure you understand their proper use and potential side effects.

What is the long-term outlook for people with gallstones? For many, the prognosis is good, especially with proper management or successful treatment. After gallbladder removal, most people can return to their normal activities without significant lifestyle changes.

Gallstones in Special Populations: Pregnancy, Elderly, and High-Risk Groups

Certain populations may be at higher risk for gallstone formation or may require special considerations in treatment:

Pregnancy and Gallstones

Pregnant women are at increased risk of developing gallstones due to hormonal changes. Management during pregnancy often involves conservative treatments, with surgery typically reserved for severe cases.

Elderly Patients

Older adults may have a higher risk of complications from gallstone surgery. Treatment decisions must carefully weigh the risks and benefits, considering the patient’s overall health status.

High-Risk Groups

Certain populations, such as those with diabetes, obesity, or a family history of gallstones, may require more proactive monitoring and prevention strategies.

How does treatment differ for these special populations? Treatment approaches may need to be tailored to the individual’s specific circumstances, often involving a multidisciplinary team of healthcare providers to ensure the best possible outcomes.

Emerging Research and Future Directions in Gallstone Management

The field of gallstone research is continually evolving, with new insights and potential treatments on the horizon. Some areas of ongoing research include:

• Genetic factors: Understanding the genetic predisposition to gallstone formation could lead to more targeted prevention strategies.
• Microbiome influence: Research is exploring the role of gut bacteria in gallstone development and potential probiotic treatments.
• Novel dissolution therapies: Scientists are investigating new medications that could dissolve gallstones more effectively than current options.
• Minimally invasive techniques: Advancements in surgical technology may lead to even less invasive procedures for gallstone removal.

What potential breakthroughs might we see in gallstone treatment in the coming years? While it’s difficult to predict with certainty, ongoing research suggests that more personalized and less invasive treatment options may become available, potentially reducing the need for surgical intervention in some cases.

In conclusion, gallstones remain a common and potentially serious health issue affecting millions worldwide. While not all gallstones require treatment, understanding the causes, symptoms, and available management options is crucial for those affected by this condition. From watchful waiting to surgical intervention, the approach to gallstone management should be tailored to each individual’s unique circumstances. By adopting healthy lifestyle habits and staying informed about the latest developments in gallstone research, individuals can take proactive steps to manage their risk and maintain optimal digestive health.

Gallstones Diagnosis, Tests, & Treatments

Written by WebMD Editorial Contributors

• How Do I Know if I Have Gallstones?
• What Are the Treatments for Gallstones?
• Conventional Medicine for Gallstones
• Gallstones and Watchful Waiting
• Nonsurgical Therapy for Gallstones
• Surgery to Remove the Gallbladder
• More

If your symptoms suggest a gallstone problem, your doctor might first examine your skin for jaundice, and then feel your abdomen to check for tenderness. A blood test may reveal evidence of an obstruction.

Because other digestive problems, such as an infection of the duct, can produce symptoms similar to those of a gallstone attack, the doctor may also run other tests to determine if gallstones are in fact the culprit.

The most common technique is an ultrasound exam. This quick, painless procedure uses high-frequency sound waves to create pictures of the gallbladder, bile duct, and their contents. CT scans are also sometimes done to look at the anatomy of your internal organs.

A more complicated test may be used if the doctor suspects that a gallstone is lodged in a bile duct. Commonly known by the acronym ERCP, this test allows the doctor to look at the bile duct through a small flexible tube called an endoscope. The doctor sprays the back of the patient’s throat with an anesthetic drug to prevent gagging, sedates the patient, and passes the endoscope into the mouth, through the stomach, and into the area of the small intestine where the bile duct enters. Dye is injected through the tube and into the bile duct, and then the doctor takes X-rays. Stone removal can be done during this procedure as well. The procedure takes about an hour.

In most cases, treatment of gallstones is considered necessary only if you are having symptoms. Of the various conventional treatments that are available, surgical removal of the gallbladder is the most widely used. Some alternative treatments have also been found to be effective in alleviating the symptoms of troublesome gallstones.

When deciding what course of action to take for symptomatic gallstones, doctors usually choose from among three main treatment options: Watchful waiting, nonsurgical therapy, and surgical removal of the gallbladder.

Though a gallstone episode can be extremely painful or frightening, almost a third to half of all people who experience an attack never have a recurrence. In some cases, the stone dissolves or becomes dislodged and thereby resumes its “silence.” Because the problem may solve itself without intervention, many doctors take a wait-and-see approach following the initial episode.

Even when the patient has had repeated gallstone episodes, the doctor may postpone treatment or surgery because of other health concerns. If your surgery has been delayed, you should remain under a doctor’s care and report any recurrences of gallstone symptoms immediately.

If you are unable or unwilling to go through surgery for a gallstone problem that requires treatment, your doctor may recommend one of several noninvasive techniques. Note that though these methods may destroy symptom-causing gallstones, they can do nothing to prevent others from forming, and recurrence is common.

Some gallstones can be dissolved through the use of a bile salt, although the procedure can be used only with stones formed from cholesterol and not from bile pigments. The drug Actigall (ursodiol) is taken as a tablet; depending on its size, the gallstone may take months or even years to go away. Because some stones are calcified, this treatment often doesn’t work.

Another nonsurgical technique, shock wave therapy, uses high-frequency sound waves to fragment the stones. Bile salt is administered afterward to dissolve small pieces. This therapy is rarely used.

Doctors can also attempt to remove gallstones during an ERCP. During the procedure an instrument is inserted through the endoscope to attempt removal of the stone.

While these therapies may work for some, all of the above nonsurgical therapies are usually unsuccessful long term (since recurrence is common) and are rarely advised in clinical practice.

While the gallbladder serves an important function, it is not essential for a normal, healthy life. When gallstones are persistently troublesome, doctors often recommend removing the organ entirely. This operation is considered among the safest of all surgical procedures. Each year approximately 750,000 Americans have their gallbladder removed. It is also the only treatment method that eliminates the possibility that other gallstones will develop in the future.

When the gallbladder has been removed, bile flows directly from the liver into the small intestine, and this sometimes leads to diarrhea. Because bile no longer accumulates in the gallbladder, quantities of the digestive fluid cannot be stored up and used to break down an especially fatty meal. This condition is not considered serious, however, and can be corrected by simply limiting fat in the diet.

In the past, removal of the gallbladder was done through traditional “open” surgery, which requires surgeons to make a large incision in the abdomen. Patients faced a two- or three-day hospital stay plus several weeks of recovery at home.

Today, however, the most commonly used surgical technique is a much simpler approach known as laparoscopic cholecystectomy. The doctor makes several small incisions in the abdomen, then uses special pencil-thin instruments to remove the gallbladder. A tiny microscope and video camera, snaked through the incision to the site, allow the surgeon to view the operation.

Laparoscopic surgery is highly effective and very safe. It has reduced the hospital stay to a day or two. Patients report less pain and are generally able to resume a normal lifestyle in a short period of time. However, people who are obese or who have a severe infection or inflammation in the gallbladder may still be considered candidates for traditional open surgery.

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Gallstones Picture, Causes, Age, & Symptoms

Written by WebMD Editorial Contributors

• What Causes Gallstones?

Gallstones are crystal-like deposits that develop in the gallbladder — a small, pear-shaped organ that stores bile, a digestive fluid produced by the liver.

These deposits may be as small as a grain of sand or as large as a golf ball; they may be hard or soft, smooth or jagged. You may have several gallstones or just one.

Some 30 million American adults suffer from gallstones. Yet most of those who have the condition do not realize it. In this case, what you don’t know probably won’t hurt you; gallstones that are simply floating around inside the gallbladder generally cause no symptoms and no harm.

These “silent” stones usually go unnoticed unless they show up in an ultrasound exam conducted for some other reason. However, the longer a stone exists in the gallbladder, the more likely it is to become problematic. People who have gallstones without symptoms have 20% chance of having an episode of pain during their lifetime.

When symptoms do occur, it’s usually because the gallstone has moved and become lodged within a duct that carries bile, such as the cystic duct, a small conduit that connects the gallbladder to another tube called the common bile duct. The typical symptom is abdominal pain, perhaps accompanied by nausea, indigestion, or fever. The pain, caused by the gallbladder’s contraction against the lodged stone, generally occurs within an hour of eating a large meal or in the middle of the night. Stones can also clog the common bile duct, which carries bile into the small intestine, and the hepatic ducts, which take bile out of the liver.

Obstructions in the bile pathway may cause a duct to become inflamed and possibly infected. Blockage of the common bile duct, which merges with the pancreatic duct at the small intestine, can also lead to inflammation of the pancreas (gallstone pancreatitis).

In a rare but dangerous condition that occurs most often in older women, gallstones migrate into the small intestine and block the passageway into the large intestine; symptoms include severe and frequent vomiting. Although gallstones are present in about 80% of people with gallbladder cancer, it is uncertain whether gallstones play a role, except when really large stones (greater than 3 centimeters in diameter) are present.

About a million new cases of gallstones are diagnosed in the U.S. each year. For reasons that are still unclear, women are two times more likely than men to be afflicted. Native Americans have the highest rates of gallstones in the U.S. because they have a genetic disposition to secrete high levels of cholesterol in bile (a contributing factor to gallstones.) Mexican-Americans also have high rates of gallstones.

Gallstones are also more common in people over age 60, in those who are obese or have lost a lot of weight in a short amount of time, in those who have diabetes or sickle cell disease, and in women who have had multiple pregnancies and who take hormone replacement therapy or birth control pills.

The primary function of the gallbladder is to store bile, a brown or yellowish fluid that helps the body break down fatty food. When you eat a meal, the gallbladder releases its stored bile into the cystic duct. From there the fluid passes through the common bile duct and into the small intestine to mix with food.

Chief among the ingredients of bile are cholesterol and bile acids. Normally, the concentration of bile acids is high enough to break down the cholesterol in the mixture and keep it in liquid form. However, a diet high in fat can tip this delicate balance, causing the liver to produce more cholesterol than the bile acids are able to handle. As a result, some of this excess cholesterol begins to solidify into crystals, which we call gallstones. About 80% of all gallstones are called cholesterol stones and are created this way. The remaining 20% consist of calcium mixed with the bile pigment bilirubin and are called pigment stones. Sickle cell and other blood disorders where red blood cells are destroyed can often lead to pigment gallstones

Gallstones can form even in people who eat properly. And as researchers have found, a diet extremely low in fat can also contribute to gallstone formation: With little fatty food to digest, the gallbladder is called into play less frequently than usual, so the cholesterol has more time to solidify. Other factors that can reduce activity in the gallbladder, possibly leading to gallstone formation, include cirrhosis, the use of birth control pills or hormone replacement therapy, and pregnancy.

Family history, diabetes, sudden weight loss, and cholesterol drugs, and older age can also increase risk for gallstones.

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Treatment and removal of stones in the gallbladder (treatment of gallstone disease, surgery), stones in the gallbladder laparoscopy in Nizhny Novgorod in the clinic

Gallstone disease is a problem that worries most of the population. The main contingent of patients are people with overweight, impaired metabolic processes in the body, diseases of the biliary tract, associated with stagnation of bile in the gallbladder.

The occurrence of stones in the gallbladder is a process associated with the stagnation of bile, the precipitation of cholesterol crystals contained in it. Gradually, small crystals combine and form stones, which sometimes reach impressive sizes. Under the action of the contraction of the bladder, it is possible for the stone to pass through the ducts.

Not always the size of the stone allows it to pass freely, which often leads to obstruction of the duct, accompanied by the so-called hepatic colic – acute paroxysmal pain in the right hypochondrium, and jaundice may also occur.

A large, heavy stone that lies in the gallbladder can form a decubitus due to constant pressure, and subsequently perforate the wall of the gallbladder with the development of peritonitis. All these complications can be prevented if timely treatment of gallstone disease , namely, to remove stones from the gallbladder.

To make a diagnosis, various measures are required (blood tests, ultrasound, x-rays with and without contrast). In particularly difficult cases, it is possible to perform a diagnostic laparoscopy.

Gallbladder stones may not cause any symptoms at all, so it is important to consider this disease in the differential diagnosis.

Gallbladder stones – treatment, modern approach to the problem

Treatment of gallstones can be conservative (without surgery) or surgical. Many people are afraid to go for surgery, as it is associated, in their opinion, with a great risk to health. But they expose themselves to even greater risk by refusing surgery for gallstone disease. Conservative treatment of cholelithiasis is possible in the presence of stones, ideally 5 mm (size up to 15-20 mm is allowed).

We must not forget that getting rid of stones, but not curing the main cause of their occurrence, you can get a relapse of the disease. Therefore, a radical treatment for gallstones is removal of stones from the gallbladder together with it. The operation is called a cholecystectomy.

The classic option for the surgical treatment of gallstone disease is cholecystectomy with laparotomic access (that is, an incision on the anterior abdominal wall).

However, medicine does not stand still and because of its trauma, long recovery period and possible complications, the method fades into the background. The current alternative (and the “gold standard for gallstone surgery”) is laparoscopic cholecystectomy.

The advantage of such an operation for cholelithiasis is that not one large incision is made, but several small ones (5-10 mm in size), which significantly reduces tissue trauma. Trocars and an optical device are inserted into the abdominal cavity through the holes, which transmits the image to the screen.

In this way, the surgeon can examine the gallbladder as well as adjacent organs. Removal of stones from the gallbladder is not performed separately.

During the operation, the entire gallbladder is removed along with its contents using a special electric knife, which ensures a minimum of bleeding. The gallbladder is placed in a special plastic bag in order to remove it from the abdominal cavity without tearing it. This is the prevention of the development of bile peritonitis. Also, the use of such a bag allows at laparoscopy, gallbladder stones should be removed one by one if they are large and cannot pass through a small hole in the abdominal wall at the same time.

Surgery for cholelithiasis is a guarantee of successful recovery and adequate prevention of relapses.

Advantages of laparoscopic surgery for cholelithiasis:

• Early activation of the patient
• Minimize trauma and reduce the risk of complications
• Fast and accurate operation

Treatment of stones in the gallbladder in Nizhny Novgorod

Removal of stones from the gallbladder is possible during a laparoscopic operation – cholecystectomy. This manipulation requires clear and coordinated actions on the part of all participants. Treatment of stones in the gallbladder in Nizhny Novgorod (including surgery) is possible in the TONUS PREMIUM MC.

It is safe to say that the best choice is surgery using laparoscopy. Gallbladder stones must be removed without fail, otherwise serious complications may arise!

The specialists of the center have been performing this operation for many years, which allowed them to perfect their technique, which means that the development of complications is minimized.

You can make an appointment at the TONUS PREMIUM MC by calling 8 (831) 411-13-13

symptoms and when to see a doctor

Cholelithiasis (GSD) is the formation of stones (calculi) in the gallbladder and bile ducts. Gallstones are hardened deposits of digestive fluid that most commonly form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just below your liver. The gallbladder contains a digestive fluid called bile, which is secreted into the small intestine to aid in the digestion of food.

Gallbladder stones range in size from a grain of sand to a golf ball. Some people develop only one gallstone, while others develop many small stones at the same time.

The presence of stones carries the risk of developing dangerous conditions and severe complications.

Symptoms

Gallstones often cause no signs or symptoms. If a gallstone gets stuck in the duct and causes a blockage, the following symptoms develop:

• Sudden and rapidly increasing pain in the center of the abdomen, just below the sternum, on the right
• Pain in the back between the shoulder blades
• Right shoulder pain
• Nausea or vomiting
• Pain associated with gallstone disease can last from several minutes to several hours

When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you.

Read about the diagnosis and treatment of cholelithiasis at the link.

Seek care right away if you develop signs and symptoms of a serious complication associated with gallstones, for example:

• Abdominal pain so severe that you cannot sit still or find a comfortable position
• Yellowing of the skin and whites of the eyes (jaundice)
• High fever with chills

Number for calling an ambulance in Moscow – 103

Causes of cholelithiasis

It is unclear what causes gallstones. Doctors believe that gallstones can occur in the following cases:

Your bile contains too much cholesterol . Normally, your bile contains enough chemicals to dissolve the cholesterol secreted by your liver. But if your liver secretes more cholesterol than bile can dissolve, the excess cholesterol can turn into crystals and eventually stones.

Your bile contains too much bilirubin . Bilirubin is a chemical produced when red blood cells are broken down in the body. Under certain conditions, the liver produces too much bilirubin, including cirrhosis of the liver, biliary tract infections, and certain blood disorders. Excess bilirubin contributes to the formation of gallstones.

Your gallbladder is not emptying properly. If the gallbladder does not empty completely or often enough, the bile can become very concentrated, which promotes the formation of gallstones.

Types of gallstones

Types of gallstones that can form in the gallbladder include:

Cholesterol stones in the gallbladder. The most common type of gallstones, called cholesterol gallstones, are often yellow in color. These gallstones are made up primarily of undissolved cholesterol, but may contain other components.

Pigment stones in the gallbladder. These dark brown or black stones form when your bile contains too much bilirubin.

Risk factors

Factors that may increase the risk of gallstones include:

• Female gender
• Age 40 and over
• Overweight or obese
• Sedentary lifestyle
• Pregnancy
• High fat diet
• High cholesterol diet
• Low fiber diet
• Family history of gallstones
• Diabetes
• Presence of certain blood disorders such as sickle cell anemia or leukemia
• Very fast weight loss
• Taking medications containing estrogen, such as oral contraceptives or hormone therapy drugs.
• Liver disease

Complications

Complications of gallstones may include:

Inflammation of the gallbladder . A gallstone lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain, peritonitis.

Blockage of the common bile duct . Gallstones can block the channels (ducts) that carry bile from the gallbladder or liver to the small intestine. This can lead to severe pain, jaundice, and bile duct infection.

Obstruction of the pancreatic duct . The pancreatic duct is a tube from the pancreas and joins the common bile duct just before entering the duodenum. The pancreatic juices that aid digestion pass through the pancreatic duct.

A gallstone can cause blockage of the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes severe, persistent abdominal pain and usually requires hospitalization. Severe forms of pancreatitis often end in the death of the patient.

Gall bladder cancer . People with gallstones have an increased risk of developing gallbladder cancer.

Prevention of gallstones

You can reduce the risk of gallstones:

Do not skip meals . Try to stick to your regular meal times every day.