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 they move into another part of the digestive system.
- inflammation of the gallbladder (acute cholecystitis)
- infection of the bile ducts (acute cholangitis)
- acute pancreatitis
- cancer of the gallbladder
- gallstone ileus
Inflammation of the gallbladder (acute cholecystitis)
In some cases of gallstone disease a bile duct can become permanently blocked. This can lead to a build-up of bile inside the gallbladder. This can cause the gallbladder to become infected and inflamed.
The medical name for inflammation of the gallbladder is acute cholecystitis.
- pain in your upper abdomen that travels towards your shoulder blade. Unlike biliary colic, the pain usually lasts longer than 5 hours
- a high temperature (fever) of 38 degrees Celsius or above
- a rapid heartbeat
Around 1 in 7 people will also experience jaundice.
Acute cholecystitis is usually first treated with antibiotics. This is to settle the infection.
Keyhole surgery may be used to remove the gallbladder. This operation can be more difficult when performed as an emergency. It could become an open procedure in an emergency.
Sometimes a severe infection can lead to a gallbladder abscess. The medical name for this is empyema of the gallbladder. Antibiotics alone don't always treat these. They may need to be drained.
An inflamed gallbladder can tear. This can lead to peritonitis. Peritonitis is inflammation of the inside lining of the abdomen.
If this happens, you may need to have antibiotics given into a vein. This is called intravenous antibiotics. You may need surgery to remove a section of the lining if part of it becomes severely damaged.
If a gallstone passes out of the gallbladder into the bile duct and blocks the flow of bile, jaundice occurs.
Symptoms of jaundice include:
- yellowing of the skin and eyes
- dark brown urine
- pale poo
Sometimes the stone passes from the bile duct on its own. If it does not, the stone needs to be removed.
Infection of the bile ducts (acute cholangitis)
If the bile ducts become blocked, bacteria can infect them. The medical term for a bile duct infection is acute cholangitis.
- pain in your upper abdomen that travels towards your shoulder blade
- a high temperature - above 38 degrees Celsius
- itchy skin
- generally feeling unwell
Antibiotics will help to treat the infection. But it's also important to help the bile from the liver to drain. This can be then with an endoscopic retrograde cholangio-pancreatography (ERCP).
Acute pancreatitis can develop when a gallstone blocks the opening of the pancreas. This will cause it to become inflamed.
The most common symptom is a sudden severe dull pain around the top of your stomach.
The pain of acute pancreatitis often gets worse until it reaches a constant ache. The ache may travel from your abdomen and along your back. You may feel worse after you have eaten. Leaning forward or curling into a ball may help to relieve the pain.
Other symptoms of acute pancreatitis can include:
- feeling sick
- being sick
- loss of appetite
- a high temperature of 38 degrees Celsius or above
- tenderness of the abdomen
There's currently no cure for acute pancreatitis. Treatment focuses on supporting the functions of the body until it passes.
This usually involves admission to hospital so you can get:
- fluids into a vein (intravenous fluids)
- 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 a rare. But it's a serious complication of gallstones.
A history of gallstones increases your risk of developing gallbladder cancer. About 4 out of every 5 people who have cancer of the gallbladder also have a history of gallstones.
People with a history of gallstones have a less than 1 in 10,000 chance of developing gallbladder cancer.
Your GP may recommend that your gallbladder be removed if you have:
- a family history of gallbladder cancer
- high levels of calcium inside your gallbladder
Symptoms of gallbladder cancer
They may remove it as a precaution, even if your gallstones aren't causing any symptoms.
The symptoms of gallbladder cancer are like those of complicated gallstone disease. They include:
- abdominal pain
- high temperature (fever) of 38 degrees Celsius or above
Treatment of gallbladder cancer
Gallbladder cancer can be treated with a combination of:
Another rare but serious complication of gallstones is gallstone ileus. This is where the bowel becomes blocked by a gallstone.
Gallstone ileus can happen when an abnormal channel opens up near the gallbladder. Gallstones are then able to travel through the channel and can block the bowel. This channel is known as a fistula.
Symptoms of gallstone ileus include:
- abdominal pain
- being sick
- swelling of the abdomen
A bowel obstruction needs immediate medical treatment. If it's not treated, there's a risk that the bowel could split open (rupture). This could cause internal bleeding and widespread infection.
If you think you have a blocked bowel, contact your GP as soon as possible.
You'll usually need surgery to remove the gallstone and unblock the bowel. The type of surgery you have depends on where in the bowel the blockage has occurred.