If the stones do not cause any discomfort, they are left to lie dormant and wait. There is a very good chance that the carrier will never be bothered by them. If symptoms have already appeared, treatment depends on the current situation.
Acute biliary colic and chronic stone disease.
- Acute biliary colic is treated with antispasmodic and analgesic medications, and infection is treated with antibiotics. For a short time, the affected person must not eat anything, so as not to “shut down” digestion and thus relieve the gallbladder. With the stone removal one waits until the acute episode has subsided.
- Chronic stone disease: There are several options for stone removal: Usually the entire gallbladder is removed immediately (cholecystectomy) – so no new offenders can form. In many cases, this procedure is performed as a laparoscopy, i.e. through a very small incision and by means of a tube with fiber optics. In severe cases or with previous operations, open surgery with a large abdominal incision may be more indicated.
Small stones can be removed by ERCP. In addition, for certain types of stones or patients, there is the possibility to dissolve them with drugs or to break up by means of shock waves from the outside. However, the risk of developing stones and discomfort again is 30-50%. Another disadvantage is that the treatment takes several months to years.
Course and prognosis for gallstones
After gallbladder removal, lifestyle is only slightly affected. The liver continues to produce bile. However, since this can no longer be stored, very fatty or highly spiced foods may be poorly tolerated. After the procedure, food should be low in fat and easily digestible. In most patients, symptoms disappear completely after the first few months and they can eat everything again.
If the gallbladder is still present, the diet should be changed. This reduces the risk of new stones, and any gallstones that are still present can be reduced in size. The following guidelines apply:
- Avoid foods high in cholesterol and other animal fats (eg, eggs, butter).
- High fiber content of the diet
- Long-term weight loss, no radical diets (these can also lead to stones).
- Plenty of fluids (2-3 liters daily)
- Sufficient exercise
