The progression of gallstones depends on whether you have symptoms. Most people with gallstones have no symptoms and do not need treatment. Those who do have symptoms often have surgery to remove the gallbladder.
Gallstones that do not cause symptoms
Most people who have gallstones never have symptoms. Most people with gallstones that do not cause symptoms remain free of symptoms.
Gallstones that cause symptoms
The most common problem caused by gallstones occurs when a gallstone periodically blocks the cystic duct, which drains the gallbladder. It often causes bouts of pain that come and go as the gallbladder contracts and expands. The bouts of pain are usually severe and steady, lasting from 15 minutes to up to 6 hours. And the pain may get worse after a meal. Symptoms usually improve within a few days.
If this is your first attack of gallbladder symptoms, your best option may be to see whether the pain goes away without surgery. But if the pain is severe or if you have had gallbladder pain before, you may need to have your gallbladder removed.
Depending on where a stone blocks the flow of bile, symptoms can include nausea, vomiting, fever, and severe abdominal pain that lasts longer than 6 hours. If you have these symptoms, you may need surgery to remove your gallbladder or the gallstone causing the blockage.
In rare cases, gallstones can cause pancreatitis, an inflammation of the pancreas. Gallstones back up the flow of digestive enzymes made by the pancreas. Pancreatitis may cause sudden, severe abdominal pain, loss of appetite, nausea and vomiting, and fever.
Do you need surgery or other treatment for your gallstones?
The first attack of gallstone symptoms is often not severe. Serious complications (such as a blocked duct) rarely occur. So you and your doctor may decide to delay treatment to see whether symptoms go away on their own. This is especially true if your doctor is not sure that the symptoms were caused by gallstones. Sometimes surgery for gallstone problems is needed right away. But in most cases, it appears safe to delay treatment until you have a second episode of pain. If you have two attacks, you are likely to have more attacks in the future. In that case, surgery to remove the gallbladder is usually the best option.
People who have gallstone symptoms are at higher risk of having future pain and problems than those who do not have symptoms. It is not possible to predict how often the pain may come back or how severe it might be. Many people who decide not to have treatment do not have future problems. About 1 out of 3 people with a single attack of pain has no other episode of pain.1
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