A small number of people with gallstones may develop serious problems. This can happen if the gallstones cause a severe blockage. It can also happen if the gallstones move into another part of the digestive system.
Complications include:
- inflammation of the gallbladder (acute cholecystitis)
- yellowing of the skin and eyes (jaundice)
- infection of the bile ducts (acute cholangitis)
- acute pancreatitis
- gallbladder cancer - this is very rare
- gallstone ileus - this is very rare
Inflammation of the gallbladder (acute cholecystitis)
In some cases of gallstone disease (when gallstones cause symptoms or complications), a bile duct can become permanently blocked. This can lead to a build-up of bile in the gallbladder. It can cause the gallbladder to become infected and inflamed.
This is sometimes called acute cholecystitis.
Jaundice
If a gallstone passes out of the gallbladder into the bile duct and blocks the flow of bile, you will have jaundice.
Symptoms of jaundice include:
- yellowing of the skin and eyes
- dark brown urine
- pale poo
- itchy skin
Sometimes the stone passes from the bile duct on its own. If it does not, it needs to be removed.
Infection of the bile ducts (acute cholangitis)
If the bile ducts become blocked, they can get infected. This is sometimes called acute cholangitis.
Symptoms include:
- pain in your upper abdomen that moves towards your shoulder blade
- a high temperature of 38 degrees Celsius or above
- jaundice
- chills
- confusion
- itchy skin
- generally feeling unwell
- pale poo
- dark urine
Antibiotics will help to treat the infection. But it's also important to help the bile drain from the liver. Your doctor can do this with an endoscopic retrograde cholangio-pancreatography (ERCP).
Acute pancreatitis
Acute pancreatitis can develop when a gallstone blocks the opening of the pancreas. This causes it to become inflamed.
The most common symptom is a sudden severe dull pain around the top of your stomach.
The pain does not go away and often gets worse. It can move from your abdomen (tummy) into your back. You may feel worse after you have eaten. Leaning forward or curling yourself up may help to relieve the pain.
Other symptoms of acute pancreatitis can include:
- feeling sick (nausea)
- getting sick (vomiting)
- diarrhoea
- loss of appetite
- a high temperature
- tenderness of the abdomen
- jaundice
There's no cure for acute pancreatitis. Treatment focuses on helping you manage symptoms until it passes.
You will usually have to go to hospital for:
- intravenous fluids (fluids into a vein)
- pain relief
- nutritional support
- oxygen through tubes into your nose
With treatment, your condition should improve within a week. You should be well enough to leave hospital after 5 to 10 days.
Cancer of the gallbladder
Gallbladder cancer is very rare. The chance of getting gallbladder cancer is less than 1 in 10,000.
But about 4 out of 5 people who have gallbladder cancer have a history of gallstones.
Your GP may recommend you have your gallbladder removed if you have:
- a family history of gallbladder cancer
- high levels of calcium in your gallbladder - this is sometimes called porcelain gallbladder
- polyps that are bigger than 1.5cm or have grown over a year
Treatment of gallbladder cancer
Gallbladder cancer can be treated with a combination of:
- surgery
- chemotherapy
- radiotherapy
Gallstone ileus
Gallstone ileus is another rare but serious complication of gallstones. This is where the bowel becomes blocked by a gallstone.
Gallstone ileus can happen when an abnormal connection opens up between the gallbladder and bowel. Gallstones are then able to travel through this channel and can block the bowel. This channel is known as a fistula.
Symptoms of gallstone ileus include:
- abdominal (tummy) pain
- being sick (vomiting)
- swelling of the abdomen
- constipation
- not producing any gas out of your bottom (farting)
If your bowel is obstructed you need immediate medical treatment. If it's not treated, there's a risk that the bowel could rupture (tear). This could cause internal infection.
Urgent advice: Contact your GP for an urgent appointment if:
- you think you have symptoms of a gallstone ileus
You will usually need surgery to remove the gallstone and unblock the bowel. The type of surgery you have depends on where the blockage is in your bowel.
