Gallstones symptoms men: Gallstones – Symptoms and causes

Gallstones – NHS

Gallstones don’t usually cause any symptoms. But if a gallstone blocks one of the bile ducts, it can cause sudden, severe abdominal pain, known as biliary colic.

Other symptoms may develop if the blockage is more severe or develops in another part of the digestive system.

Abdominal pain (biliary colic)

Gallstones can cause sudden, severe abdominal pain that usually lasts 1 to 5 hours, although it can sometimes last just a few minutes.

The pain can be felt:

  • in the centre of your abdomen (tummy)
  • just under the ribs on your right-hand side – it may spread from here to your side or shoulder blade

The pain is constant and isn’t relieved by going to the toilet, passing wind or being sick.  

It’s sometimes triggered by eating fatty foods, but may happen at any time of day and may wake you up during the night.

Biliary colic doesn’t happen often. After an episode of pain, it may be several weeks or months before you have another episode.

Some people also have periods where they sweat excessively and feel sick or vomit.

When gallstones cause episodes of biliary colic, it’s known as uncomplicated gallstone disease.

Other symptoms

Occasionally, gallstones can cause more serious problems if they obstruct the flow of bile for longer periods or move into other organs, such as the pancreas or small bowel.

If this happens, you may develop:

  • a high temperature
  • more persistent pain
  • a rapid heartbeat
  • yellowing of the skin and whites of the eyes (jaundice)
  • itchy skin
  • diarrhoea
  • chills or shivering attacks
  • confusion
  • a loss of appetite

Doctors refer to this more severe condition as complicated gallstone disease.

Read more about the complications of gallstones.

When to get medical advice

Make an appointment to see a GP if you think you may have biliary colic.

Contact your GP immediately for advice if you develop:

  • jaundice
  • abdominal pain lasting longer than 8 hours
  • a high temperature and chills
  • abdominal pain so intense that you can’t find a position to relieve it

If it’s not possible to contact your GP immediately, phone your local out-of-hours service or call NHS 111.

Page last reviewed: 19 November 2021
Next review due: 19 November 2024

Gallstones can be a pain in the back

Gallstones form when bile stored in the gallbladder hardens into stone-like material. Too much cholesterol, bile salts, or bilirubin (bile pigment) can cause gallstones.

What are the symptoms of gallstones?

At first, most gallstones do not cause symptoms. However, when gallstones become larger, or when they begin obstructing bile ducts, symptoms or “attacks” begin to occur. Attacks of gallstones usually occur after a fatty meal and at night. Symptoms may include:

  • Steady, severe pain in the upper abdomen that increases rapidly and may last from 30 minutes to several hours
  • Pain in the back between the shoulder blades
  • Pain in the right shoulder
  • Nausea
  • Vomiting
  • Fever
  • Chills
  • Jaundice (yellowing of the skin or eyes)
  • Abdominal bloating
  • Intolerance of fatty foods
  • Belching or gas
  • Indigestion

People who also experience the following symptoms should consult a doctor immediately:

  • Sweating
  • Chills
  • Low-grade fever
  • Yellowish color of the skin or whites of the eyes
  • Clay-colored stools

Some people with gallstones do not have any symptoms. These stones are called “silent stones,” because they do not interfere with the function of the gallbladder, liver, or pancreas, and do not require treatment in most cases.

The symptoms of gallstones may resemble other conditions or medical problems, such as heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, or hepatitis. Always consult your health care provider for a diagnosis.

What are the risk factors for gallstones?

  • Obesity. Being overweight is a major risk factor.
  • Estrogen. Excess estrogen from pregnancy, hormone replacement therapy or birth control pills appears to increase cholesterol levels in bile and decrease gallbladder movement.
  • Gender. Women are twice as likely to develop gallstones as men.
  • Age. People over 60 are more likely to develop gallstones than younger people.
  • Cholesterol-lowering drugs. Drugs that lower cholesterol in blood can actually increase the amount of cholesterol secreted in bile.
  • Diabetes. People with diabetes generally have high levels of fatty acids, called triglycerides, which increase the risk for gallstones.
  • Rapid weight loss. As the body metabolizes fat during rapid weight loss, it causes the liver to secrete extra cholesterol into bile, which can cause gallstones.
  • Fasting. Fasting decreases gallbladder movement, which causes the bile to become over-concentrated with cholesterol.

Reduce your risk of gallstones

There is no way to prevent gallstones, but you can take steps to reduce the likelihood that you will form gallstones that will cause symptoms.

  • Maintain a healthy weight. Take care not to lose weight quickly through dieting and then gain it back.
  • Eat regular, balanced meals that include whole grains, fiber and calcium. Limit foods high in cholesterol.
  • Exercise regularly, in order to maintain a healthy weight and keep cholesterol levels down.

Worried that you are experiencing gall bladder symptoms? OSF OnCall can provide guidance as to the best course of action.

Gallstones – Causes, Symptoms, Treatment, Diagnosis

The Facts

Gallstones are crystal-like masses that typically form in the gallbladder. The gallbladder is a small organ located on the right side of the abdomen, just below the liver. The gallbladder’s main function is to store bile (made by the liver) and secrete it into the small intestine to help with digestion. Bile is made of water, cholesterol, fats, bile salts (natural detergents that break up fat), and a pigment called bilirubin. Gallstones form if the bile contains too much cholesterol, bile salts, or bilirubin.

There are two types of gallstones. Cholesterol stones contain mostly hardened cholesterol and account for approximately 80% of gallstones. Pigment stones are made of bilirubin and account for the other 20%. Gallstones can range in size from very small to as large as a golf ball. The gallbladder may develop any number and size of stones.

Gallstones are more common in women and people who are older, as well as in certain groups of people, such as Indigenous populations and people who are overweight. In Canada, 20% of women and 10% of men over the age of 60 have gallstones, but many never experience symptoms. However, complications from gallstones can be serious if symptomatic stones are left untreated.


Medical understanding of how gallstones develop is increasing. It’s believed that gallstones may be caused by a combination of factors including heredity, obesity, and the ability of the gallbladder to contract (motility).

Cholesterol gallstones form when there’s too much cholesterol in the bile and not enough bile salts. Problems with the gallbladder’s motility may cause the bile to become too concentrated and lead to stone formation.

The cause of pigment stones is uncertain. They tend to develop in people with pre-existing conditions such as cirrhosis, biliary tract infections, and hereditary blood disorders such as sickle cell anemia. They may also be caused by infections.

Risk factors that may lead to the formation of gallstones include:

  • gender – women between 20 and 60 years of age are three times as likely to develop gallstones as men
  • age – people over the age of 40
  • estrogen – women who are pregnant or using hormone replacement therapy (HRT)
  • obesity – a large clinical study showed that being even moderately overweight increases the risk for gallstone formation
  • ethnicity – some ethnic groups, including Indigenous populations, have a higher prevalence of gallstones
  • diabetes – people with diabetes have an increased the risk of gallstones
  • rapid weight loss – this causes the liver to secrete extra cholesterol into the bile
  • fasting – this inhibits the gallbladder’s ability to contract, causing high concentrations of cholesterol to build up in the bile
  • a diet high in fat and sugar along with an inactive lifestyle – this sets the stage for increased risk for gallstones
  • medications – certain medications, such as octreotide and ceftriaxone, have been linked to the formation of gallstones

  • Symptoms and Complications

    80% of people with gallstones don’t have symptoms. Gallstones in these cases are known as silent stones. They’re sometimes detected during tests for an unrelated condition and usually don’t need to be treated.

    Problems arise when a gallstone attack occurs. Attacks may occur over a period of weeks, months or even years. However, once a full attack occurs, subsequent attacks are more likely. One attack may last from 20 minutes to several hours. Symptoms of an attack include:

    • persistent, severe pain in the upper middle or upper right abdomen that increases rapidly
    • pain in the back between the shoulder blades
    • pain under the right shoulder
    • sweating, nausea and vomiting

    Other signs and symptoms of gallstones may be vague and non-specific.

    The gallbladder is attached to the liver and small intestine by a series of tubes called ducts. Complications can occur if gallstones block the flow of bile by lodging in any of the ducts that carry the bile from the liver and gallbladder to the small intestine. Trapped gallstones may lead to gallbladder inflammation (cholecystitis) and infection of the bile ducts (cholangitis). Gallstones may also become trapped in the pancreatic duct, which can cause painful inflammation (pancreatitis).

    Beware of symptoms such as jaundice (yellowing of the skin and whites of the eyes), fever, clay-coloured stools, tea- or coffee-coloured urine, and persistent pain.

    Making the Diagnosis

    When symptoms seem to indicate a gallstone, your doctor may suggest an ultrasound of the abdomen. A technician will pass a handheld device that emits sound waves over the abdomen. Sound waves bounce off organs and other solid masses, revealing the presence of gallstones.

    In addition, blood test results may show a pattern of abnormal liver enzymes that suggests bile ducts may be obstructed by gallstones. Several other tests can provide additional information needed to make a firm diagnosis.

    Treatment and Prevention

    Some of the risk factors for gallstone formation can be modified, such as obesity. By maintaining a healthy weight through proper diet and exercise, a person can reduce the chances for gallstones. Also, one should avoid diets that result in losing weight very quickly as risk of developing gallstones will increase.

    Most people who have “silent” gallstones in the gallbladder don’t require treatment. People with intermittent pain can try avoiding or reducing their intake of fatty foods.

    If someone has gallstones in the gallbladder that cause repeated attacks of pain, the doctor may recommend removing the gallbladder. This type of surgery is called a cholecystectomy.

    People who have gallstones may develop problems when the gallbladder becomes inflamed. This is called acute cholecystitis. In these cases, sufferers are hospitalized so they can receive fluids intravenously, and antibiotics are usually given as soon as the problem is suspected. If the diagnosis is certain and surgery is not considered risky, the gallbladder is usually removed during the first day or two of the illness.

    Today, almost all cholecystectomies in Canada are performed using laparascopic surgery under general anaesthesia. The surgeon makes small incisions in the abdomen and inserts surgical instruments as well as a video camera that projects a magnified view of a patient’s internal organs onto a monitor. The gallbladder is removed through one of the incisions. Most people are able to go home after the surgery, but some people may require an overnight stay for additional monitoring.

    Open cholecystectomies may be performed if complications are discovered, such as infection or scarring from previous operations. A surgeon may start using laparascopic techniques then switch to open surgery if such a complication is found. In very obese individuals, an open cholecystectomy may be easier to perform.

    A person can live normally without a gallbladder. Once removed, bile flows from the liver through the ducts and directly into the small intestine. No change in diet is necessary, although the more frequent flow of bile to the small intestine may lead to diarrhea.

    For people who are not able to have surgery, a medication called ursodiol can be used to help dissolve some types of gallstones. This medication takes about 6 months to work and is effective in only about 50% of people who use it. Gallstones usually come back once a person stops taking the medication.

    All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source:

Gallstones | Health Information | Bupa UK

Treatment of gallstones

If gallstones aren’t giving you any symptoms, your GP may suggest leaving them alone. If your gallstones start to cause problems, your GP may refer you for further investigations and treatment.


You may be able to manage your symptoms by taking over-the-counter painkillers painkillers like paracetamol or ibuprofen. Your GP may prescribe stronger painkillers if you need them.

If your gallstones have caused an infection, your doctor may prescribe antibiotics. These may be given intravenously (into a vein) in hospital.

Always read the patient leaflet that comes with your medicine and if you have any questions, ask your pharmacist.


There is no special diet for gallstones, but your GP may advise you to avoid any food or drinks that you notice make your pain worse. For more information, see our FAQ: Should I change my diet if I have gallstones? below.


The main treatment for gallstones which give symptoms is an operation to remove your gallbladder. Your gallbladder isn’t essential, and most people don’t notice any difference without it.

The decision to remove your gallbladder may depend on how often you get symptoms, how severe they are and what problems your gallstones are causing. Your decision should also take into account your age and general health. Your doctor or surgeon can explain your options and answer any questions you may have.

An operation to remove the gallbladder is called a cholecystectomy. There are two main ways this can be done.

  • Laparoscopic cholecystectomy (keyhole surgery). Your surgeon will remove your gallbladder through small cuts in your tummy (abdomen). This is the most common way to have your gallbladder removed.
  • Open cholecystectomy. Your surgeon will make one large cut to remove your gallbladder. This technique is used less often but you may have it if keyhole surgery isn’t suitable for you.

Non-surgical treatments

If your doctor thinks you might have gallstones in your bile duct, they may suggest having an endoscopic retrograde cholangiopancreatography (ERCP). This uses a combination of endoscopy and X-rays to find and treat your gallstones. Your doctor passes an endoscope through your mouth down to where the bile duct opens into your intestine. They can then widen the end of the bile duct and take out the gallstones.

If an ERCP isn’t possible, your doctor may recommend a procedure called a percutaneous transhepatic cholangiogram (PTC). In a PTC, the gallstones in the bile duct are removed by passing a tube through the skin below your ribs, and into the liver.

Most people will still need to have an operation afterwards to remove their gallbladder because there may be more gallstones in it.

Gallstones | healthdirect

On this page

Gallstones are hard, pebble-like masses that form in your gallbladder, which is a small pear-shaped organ on the right side of your abdomen, below your liver.

Gallstones can be made of undissolved cholesterol (called cholesterol gallstones) or the digestive fluid bile (pigment gallstones). The stones can be as small as a grain of sand or as large as a golf ball. It is possible to develop one gallstone or many.

The stones can block the tubes that carry the digestive fluids from the gallbladder to the bowel. If you experience pain or other symptoms that you think may be due to gallstones, visit your doctor.

Gallstones are also called cholelithiasis.

What are the symptoms of gallstones?

Many people with gallstones never experience any symptoms, but some people do get symptoms such as:

Seek urgent medical attention if you have a fever or pain that doesn’t go away if you take simple pain relief, that lasts a few hours, or that stops you from eating and drinking normally.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes gallstones?

It is not fully understood why gallstones form. However, you are more likely to get gallstones as you get older, if you are pregnant, if you are taking the contraceptive pill, or if you lose weight quickly. Being overweight and inactive, having diabetes and having a close family relative who has had gallstones also puts you at higher risk.

ARE YOU AT RISK? — Are you at risk of type 2 diabetes, heart disease or kidney disease? Use the Risk Checker to find out.

When should I see my doctor?

If you are experiencing severe and ongoing abdominal pain, make an appointment to see your doctor. If your doctor thinks gallstones may be causing your symptoms, and this is confirmed by doing investigations, then you will be referred to a gastroenterologist or a surgeon.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How are gallstones diagnosed?

Your doctor or specialist might order tests to detect any gallstones. You will probably have blood tests to check your liver function and various tests to check your bile ducts for gallstones.

The most common imaging test to detect gallstones is an abdominal ultrasound.

Other tests may include:

  • a computed tomography (CT) scan
  • magnetic resonance imaging (MRI)
  • a hepatobiliary iminodiacetic acid (HIDA) scan, in which a radioactive tracer is injected into the body, allowing the gallbladder function to be assessed
  • an endoscopy, which involves a doctor inserting a thin, flexible, lighted tube into the mouth and guiding it down through the oesophagus (throat), stomach and small intestine so they can observe the biliary system

You may also be asked to have a specific type of endoscopy that enables your doctor to remove any gallstones detected during the procedure.

How are gallstones treated?

Some people with gallstones will not require any treatment. They recover from whatever caused the gallstones and don’t experience any more problems. Some people discover they have gallstones during an unrelated medical scan but again, they won’t necessarily experience health problems.

Other people, however, may need treatment.

Changes to your diet

For some individuals, the symptoms of gallstones can be managed by simply limiting how much fatty food and dairy products they consume. If you have gallstones, you should eat plenty of fruit and vegetables, drink a lot of fluids and aim to lose weight gradually if you are overweight.


The most common management of gallstones is surgery. Surgeons may remove the entire gallbladder (cholecystectomy), or just the stones from the bile ducts.

Cholecystectomy is the most common method of curing gallstones. It does not affect your ability to digest food. You can live a healthy life without your gallbladder — it just means that after surgery, the bile flows directly from the liver to the small intestine.

The most common type of surgery is keyhole or laparoscopic cholecystectomy. The surgeon will make a few small incisions in the abdomen, insert a miniature video camera and instruments, remove the gallbladder and stitch up the incisions. The trapped gallstones can be removed at the same time.

If your gallbladder is very inflamed you may need open surgery, which requires a larger cut.

Keyhole surgery is better for most people because recovery is usually faster. You may be able to go home the day after your operation. If you have open surgery, on the other hand, you may need to stay in hospital for several days.

Medicines for gallstones

Medicines can be used to dissolve gallstones, but they are not very effective and some have side effects. The gallstones return after treatment, so using medicines to treat gallstones is not commonly recommended.

Can gallstones be prevented?

Although diet doesn’t directly cause gallbladder problems – or cure them – choosing a diet that’s low in fat and cholesterol and high in fibre, and maintaining a healthy weight may help prevent a gallstones from forming. It may also help you avoid discomfort if gallstones develop.

Some studies have shown that eating a lot of fruit and vegetables, and drinking coffee or tea, can also lower your risk of gallstones.

Complications of gallstones

If one of the stones moves or gets stuck in the bile duct, it can cause a severe pain called biliary colic. This can last from a few minutes to several hours and can make you vomit.

Gallstones can also cause thickening or inflammation of the gallbladder, known as cholecystitis. This causes pain and often a fever. Cholecystitis is a serious condition and needs to be treated in hospital. If cholecystitis is not treated, the gallbladder can burst, which is a life threatening condition.

Sometimes gallstones cause blockages elsewhere in the body and can lead to jaundice (a yellowing of the skin), an infection or pancreatitis (inflammation of the pancreas). These are all serious conditions which also need to be treated in hospital.

Gallstone Pain Levels: From 0 to ER

Sept. 9, 2015

Women between the ages of 20 and 60 are three times more likely to develop gallstones than men. The chances increase for women who have had multiple pregnancies, have a family history of gallstones, are of Hispanic or Native American descent, are obese or have experienced rapid weight loss.

Gallstone pain levels: from 0 to ER

Most people who have gallstones experience some pain, but others don’t experience any symptoms at all.

Small gallstones leave the gallbladder and its draining ducts, and then pass out of the body through the intestines. After a high-fat meal, thin muscles in the wall of the gallbladder squeeze to help release bile into the intestines during the digestive process. If the gallbladder squeezes against a gallstone, or if a gallstone blocks the fluid from draining easily, the gallbladder can ache with a strong, steady pain.

These gallstone symptoms are not always felt where you might think:

  • Nausea and vomiting
  • Indigestion, bloating and heartburn
  • Pain in the right upper region of the abdomen
  • Sudden and rapid pain in the center of the abdomen
  • Pain between the shoulder blades
  • Pain in the right shoulder

According to
Dr. Eric Orr, a board-certified surgeon affiliated with
Sharp Grossmont Hospital, many women live their lives without knowing they have gallstones.

When a gallbladder attack occurs, it can land you in the emergency room. Because there is no medication to treat gallstones, surgical removal of the gallbladder may be your only treatment option.

Laparoscopic surgery is the most common surgery used to remove a gallbladder. A surgeon removes the gallbladder and gallstones through several small incisions in the abdomen.

Single-Site™ robotic surgery: a new treatment solution

Unlike traditional laparoscopic surgeries that require three to five small incisions, a new technology is now available that allows for a single, one-inch incision through the belly button, called Single-Site™ robotic surgery.

“During Single-Site surgery, the surgeon sits at a console, viewing a 3-D, high-definition image of the patient’s anatomy, and uses controls to move the robotic arms and camera to perform the surgery,” explains Dr. Orr.

“Because the technology uses one small incision through the bellybutton, one of the major benefits of Single-Site gallbladder surgery is the cosmetic advantage of its virtually scarless results.

Other benefits of Single-Site robotic surgery include the following:

  • Minimal pain
  • Low blood loss
  • Can be performed in about one hour
  • Short hospital stay of less than 24 hours
  • Fast recovery — patients are usually back to their normal lives within seven days

You can live a healthy life without your gallbladder. The bile produced in your liver flows directly into the small intestine, without being stored first in the gallbladder.

Although gallstones cannot be prevented, Dr. Orr advises that there are ways to reduce the risk for both women and men: maintain a healthy weight; eat regular, balanced meals; and exercise daily.

Are gallstones (cholelithiasis) more common in women or men?


Douglas M Heuman, MD, FACP, FACG, AGAF Chief of Hepatology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center; Professor, Department of Internal Medicine, Division of Gastroenterology, Virginia Commonwealth University School of Medicine

Douglas M Heuman, MD, FACP, FACG, AGAF is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Physicians, American Gastroenterological Association

Disclosure: Received grant/research funds from Novartis for other; Received grant/research funds from Bayer for other; Received grant/research funds from Otsuka for none; Received grant/research funds from Bristol Myers Squibb for other; Received none from Scynexis for none; Received grant/research funds from Salix for other; Received grant/research funds from MannKind for other.


Anastasios A Mihas, MD, DMSc, FACP, FACG Professor, Department of Medicine, Division of Gastroenterology, Virginia Commonwealth University School of Medicine; Consulting Staff, Virginia Commonwealth University Hospitals and Clinics; Chief of GI Clinical Research, Director of GI Outpatient Service, Associate Director of Hepatology, Hunter Holmes McGuire Veterans Affairs Medical Center

Anastasios A Mihas, MD, DMSc, FACP, FACG is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, Sigma Xi, The Scientific Research Honor Society, Southern Society for Clinical Investigation, American Federation for Clinical Research, Gastroenterology Research Group

Disclosure: Nothing to disclose.

Jeff Allen, MD Assistant Professor, Department of Surgery, University of Louisville

Disclosure: Nothing to disclose.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.


Firass Abiad, MD Head of Division, General and Laparoscopic Surgery, Specialized Medical Center Hospital, Saudi Arabia

Disclosure: Nothing to disclose.

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine”>BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

David Eric Bernstein, MD Director of Hepatology, North Shore University Hospital; Professor of Clinical Medicine, Albert Einstein College of Medicine

David Eric Bernstein, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.”>Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

David FM Brown, MD Associate Professor, Division of Emergency Medicine, Harvard Medical School; Vice Chair, Department of Emergency Medicine, Massachusetts General Hospital”>David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

William K Chiang, MD Associate Professor, Department of Emergency Medicine, New York University School of Medicine; Chief of Service, Department of Emergency Medicine, Bellevue Hospital Center

William K Chiang, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Medical Toxicology, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Alfred Cuschieri, MD, ChM, FRSE, FRCS, Head, Professor, Department of Surgery and Molecular Oncology, University of Dundee, UK”>Disclosure: Nothing to disclose.

Imad S Dandan, MD Consulting Surgeon, Department of Surgery, Trauma Section, Scripps Memorial Hospital

Imad S Dandan, MD is a member of the following medical societies: American Association for the Surgery of Trauma, American College of Surgeons, American Medical Association, American Trauma Society, California Medical Association, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

David Greenwald, MD Associate Professor of Clinical Medicine, Fellowship Program Director, Department of Medicine, Division of Gastroenterology, Montefiore Medical Center, Albert Einstein College of Medicine

David Greenwald, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and New York Society for Gastrointestinal Endoscopy”>Disclosure: Nothing to disclose.

Eugene Hardin, MD, FAAEM, FACEP Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center

Disclosure: Nothing to disclose.

Faye Maryann Lee, MD Staff Physician, Department of Emergency Medicine, New York University/Bellevue Hospital Center

Faye Maryann Lee, MD is a member of the following medical societies: Phi Beta Kappa

Disclosure: Nothing to disclose.

Sally Santen, MD Program Director, Assistant Professor, Department of Emergency Medicine, Vanderbilt University”>Sally Santen, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Assaad M Soweid, MD, FASGE, FACG Associate Professor of Clinical Medicine, Endosonography and Advanced Therapeutic Endoscopy, Director, Endoscopy-Bronchoscopy Unit, Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Lebanon

Assaad M Soweid, MD, FASGE, FACG is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Gynecological and Obstetrical Society, and American Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment


Gallstone disease (GSD) is considered a fairly common ailment in our time. Mostly women are susceptible to this disease, but men are also affected by this disease. For every 9 women, there is approximately 1 man.

The symptoms of this disease are:

  • Recurrent aching pain in the upper abdomen, especially after eating
  • Fast saturation of the body with small portions of food

The disease can be accompanied by severe complications that can seriously harm the body.So, the situation becomes difficult if the formed stone closes the exit from the gallbladder. The gallbladder increases in size, becomes inflamed, and an infection appears. In medical practice, the disease is called “acute calculous cholecystitis”.

An even more formidable complication is the passage of stones from the cavity of the gallbladder into the bile ducts, as a result of which the stones can close the exit from the common bile duct.
A separate group of diseases is formed by neoplasms of the gallbladder – most often these are mucosal polyps.Given that the polyp is an epithelial formation, it is generally accepted that this is a precancerous disease that has a potential danger.

To prevent these complications, it is necessary to perform the operation to remove the gallbladder in time. Today, the most gentle and modern way to remove the gallbladder is the operation of laparoscopic cholecystectomy.

Indications for this type of intervention are:

  • Chronic calculous cholecystitis
  • Cholesterosis of the gallbladder
  • Gallbladder polyposis
  • Acute calculous cholecystitis

Dixion Clinic has been successfully performing laparoscopic gallbladder removal operations for a long time. The operation is performed in the comfortable conditions of a day hospital in the surgical department within 1 day. An early start of the operation is made (at 08-00 in the morning). Typically, the operation takes about 30 minutes.
Postoperative observation in the first hours after the operation is carried out using the latest generation of tracking equipment (blood pressure, pulse, blood oxygen saturation, ECG, etc.) under the supervision of nursing and medical personnel.

1-1.5 hours after the end of the operation, the patient sits on the bed, slowly begins to get up and walk.After another 2-3 hours, he confidently walks around the ward, goes out into the corridor, begins to drink liquid food.

After 6-7 hours, i.e. in the afternoon, the patient is active and alert. There are almost no abdominal pains, only slight, relieved discomfort. No headache or dizziness, no nausea or vomiting. By 18-00 the patient can be sent home.

The next day, a checkup is scheduled and the removal of small pipe drains, if installed. Recommendations are given on nutrition (from that day on the patient can take regular food) and lifestyle after surgery.

Removal of stitches after 5 days can be carried out either at the Dixion clinic or at the patient’s place of residence. Patient treatment, cholicestoctomy surgery, postoperative management are carried out in a friendly, caring environment of a friendly, attentive team of surgeons, anesthesiologists, nurses, as well as administrators, united by one goal – to make the patient’s stay at the Dixion clinic as comfortable and safe as possible.

Moscow doctors have mastered a thulium laser for removing stones from bile ducts / City News / Moscow website

Endoscopic surgeons at City Clinical Hospital No. 31 were among the first in the country to use a superpulse fiber-optic thulium laser to remove large stones from the bile ducts of the liver and pancreatic duct glands.The operations were successful, now the patients have been discharged home under the supervision of doctors. Their condition is assessed as satisfactory.

Two men and two women over 50 years old were hospitalized at different times with acute pain in the right hypochondrium, complaints of nausea, vomiting and other characteristic symptoms. In three patients, after examinations, large stones were found in the ductal system of the liver. So, the size of a stone in the bile duct of one of the admitted was 18 by 36 millimeters.In another patient, a stone the size of a 10-ruble coin was found in the pancreatic duct.

After the consultation, it was decided to remove stones from the patients using a minimally invasive method. The goal of this approach is to minimize surgical intervention and the degree of trauma to human tissue. The operation is performed through the body’s natural openings or minimal punctures. It is carried out under video surveillance using high-tech equipment, most often endoscopic. One of the first in the country doctors-endoscopists of Hospital No. 31 used a super-pulsed fiber-optic thulium laser to remove large stones from the bile and pancreatic ducts in patients.This is a Russian development. The main advantage of this type of laser is a wide range of settings, which allows you to act on a stone with maximum accuracy. At the same time, there is no pronounced retropulsion effect (involuntary body movement arising from a laser pulse), the stone does not jump along the duct system, but remains in place. This greatly facilitates the work of endoscopic surgeons.

“In all cases, an ultra-thin endoscope was passed into the ducts of the liver and pancreas of the patients, through which the laser fiber was delivered directly to the stones.The special structure of the thulium laser and the use of a superpulse mode allow doctors to modulate the outgoing laser pulses in a wider range, which provides a more accurate and strong effect on calculi (stones). Thanks to the powerful and narrow beam of laser energy, the stones were deeply and strongly influenced. As a result, they were destroyed and fragmented. After that, the formed stone fragments were also endoscopically removed from the duct systems one by one, ”said the press service of the city clinical hospital No. 31.

Urologists at Hospital No. 31 have been using a superpulsed fiber-optic thulium laser since 2019, but it has not previously been used to remove large stones located in the bile and pancreatic ducts. Patients with such diagnoses required abdominal surgery. After it, a person experiences discomfort for a long time associated with the healing of a postoperative wound, and also must observe certain restrictions and wear a bandage for at least a month. The minimally invasive method, in particular with the help of a superpulsed fiber-optic thulium laser, can significantly shorten the recovery period after surgery.Thus, all four patients had no complications and they were discharged from the hospital a few days after the surgery. The operations were done free of charge. Then they will be carried out either on referrals from city polyclinics, or during emergency hospitalization to hospital No. 31.

At present, endoscopists of the City Clinical Hospital No. 31 have prepared articles for scientific medical Russian and foreign journals. In them, specialists described in detail all the features and advantages of using a superpulsed fiber-optic thulium laser in the treatment of patients with large stones in the ductal system of the liver and pancreas.

City Clinical Hospital No. 31 is a multidisciplinary medical complex equipped with the most modern medical equipment. The hospital provides both emergency and routine medical care. In 2020, over 57 thousand patients received it. The hospital is included in the system of providing high-tech medical care in such areas as gynecology, surgery, oncology, cardiovascular surgery, urology, traumatology and orthopedics.

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Agents against the formation of gallstones

Order preparations for thinning bile in the gallbladder

The network of pharmacies 36.6 offers a wide range of preparations for diluting bile in the gallbladder.

A simple search on the site will allow you to select the necessary product according to the active ingredient contained, manufacturer, price or form of release.
Analogues, which will be cheaper or more expensive in price, have become even easier to find on the page.

Medicines presented on the page are certified. All detailed information about this can be found directly on the site.

For the convenience of its customers, pharmacy 36.6 allows you to order delivery to any of 1200 pharmacies in Moscow and St. Petersburg, Moscow and Leningrad regions.

The site constantly carries out promotions and there is a flexible system of discounts. You can pay for the selected product only at the pharmacy department.


Bile is a secret continuously produced by hepatocytes. It is produced in the liver, passing through the ducts, and its excess enters the bile
bubble. Too thick bile creates many problems – it is either poorly secreted or ceases to be secreted. To cure problems like this
drugs are needed to help get rid of bile stagnation in the body.

Preparations for the outflow of bile from the choleretic bladder will help get rid of cholelithiasis [1], also called cholestasis.

Also means of this kind are applicable for:

  • chronic active and acute forms of hepatitis;
  • toxic liver damage;
  • alcoholism;
  • non-alcoholic steatohepatitis;
  • primary biliary cirrhosis of the liver;
  • primary sclerosing cholangitis;
  • cystic fibrosis of the liver;
  • atresia of the biliary tract inside the liver;
  • prevention of liver damage when using hormones.

Drugs against the formation of gallstones have a vasodilating and anti-inflammatory effect, and also lead to the dissolution and crushing of the formed stones


Medicines for thinning bile are contraindicated at:

  • gallbladder dysfunctions;
  • gallstones with a high calcium content;
  • acute cholangitis and cholecystitis;
  • hepatic and renal failure;
  • obturation of the biliary tract;
  • acute infections in the gallbladder and bile ducts;
  • empyema of the gallbladder;
  • hypersensitivity to the components of the drug.

A more detailed list of contraindications is indicated in the instructions for the medicinal product. Be sure to consult with a specialist.

Forms of issue

Medicines for cholelithiasis can be presented in various forms. Pharmacy 36.6 offers the following forms of medicinal products:

  • tablets,
  • capsules.

Countries of origin

Pharmacy chain 36.6 offers drugs from leading manufacturing countries, including:

  1. Czech Republic;
  2. Latvia;
  3. Germany.

Also, buyers are offered a wide selection of Russian-made drugs.



  1. [i] Belousov Yu.B., Moiseev V.S., Lepakhin V.K. Clinical Pharmacology and Pharmacotherapy: A Guide for Physicians. – 2nd ed. rev. and add. M .: Universum publishing, 1997.

City Clinical Hospital No. 31 – Cholelithiasis

Cholelithiasis (also cholelithiasis, cholelithiasis and cholelithiasis) (gallstones) is the formation of stones (calculi) in the gallbladder, bile ducts.Gallstones lead to the development of cholecystitis. With an uncomplicated course of the disease, conservative methods of therapy are used. If it is not possible to extract the calculus from the bile duct with the help of RCPG with EPST, then surgical treatment is indicated.

Calculous cholecystitis – one of the options for the development of gallstone disease, which in turn occurs due to stagnation of bile – the fluid that regulates digestion. Bile stones can be hard and soft, like clay, the size of a grain of sand, or up to a few centimeters in diameter.Their number ranges from a few to tens and even hundreds. However, neither the size nor the amount of these unwanted “jewels” play a big role – even a single small pebble can lead to dangerous consequences.

Indications for a diagnostic procedure are: Bitterness in the mouth, coated tongue.

The main symptom of the disease: pain in the right hypochondrium, radiating under the scapula. If after an hour or two it does not go away, it is better to call an ambulance. An ultrasound scan will help to diagnose.The dangers of getting cholcystitis are more susceptible to fair-haired women. In English-speaking countries, the principle of five “F” is known, because all five risk factors for cholelithiasis and cholecystitis in English begin with this letter: – female (woman), – fat (full), – fair-haired (blonde), – forty ( not younger than 40), – fertile (giving birth).

Each of these signs has its own scientific explanation. Women and men have their own characteristics of the distribution of cholesterol: in the stronger sex, fatty plaques usually clog the vessels, and in women, cholesterol more often passes into bile and forms stones.The female sex hormones estrogens also play a fatal role. They reduce the rate at which cholesterol travels through the gallbladder. Well, and finally, bile stagnation regularly occurs during all periods when a woman’s hormonal level changes dramatically (menstruation, pregnancy, taking oral contraceptives, menopause). But if the critical days last a maximum of a week, then during pregnancy, the outflow of bile is disrupted for all 9 months. The formation of stones can also be promoted, on the one hand, by the abuse of fatty foods, on the other hand, by low-calorie diets.

Unfortunately, there is not a single conservative or minimally invasive way to destroy stones. And drug treatment with bile acid preparations, and the introduction of special chemicals into the gallbladder (through a puncture), and the crushing of stones with ultrasound (lithotripsy) lead only to temporary improvement. All this does not eliminate the main reason for the formation of stones, and therefore after a certain period of time they appear again. Therefore, the main method of treating cholecystitis today is an operation to remove the entire gallbladder (cholecystectomy).

Although formations in the gallbladder may not bother their owner for some time (in medicine this phenomenon is poetically called “silent stones”). But, alas, much more often their movement leads to inflammation of the gallbladder wall (cholecystitis). If microbes are added to the inflammation, acute cholecystitis occurs, which requires surgical treatment. Operation cannot be avoided even if the stone blocks the bile duct. In this case, jaundice, chills, pain occur. Stones can block the outflow of secretions from the pancreas, which causes a deadly disease – acute pancreatitis.Removal of full stones and essentially already useless gallbladder – cholecystectomy – today is performed in the most gentle way, using laparoscopy, after only 3-4 punctures on the body. A few hours after the operation, the patient can already get up, and after 2 days he goes home

Contraindications for cholecystectomy are:

  • Recently transferred or existing at the time of the study, the inflammatory process of the genital organs.