Treatment of gall stones ?
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NICE gallstone disease treatment asymptomatic symptomatic cholecystectomy guideline
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Treatment depends on whether gallstones cause symptoms or complications.
- No symptoms (incidental gallstones): Usually no treatment is needed. Observation is appropriate unless symptoms develop.
- Typical biliary colic: Pain relief during attacks, often an NSAID if safe for the person, plus medical assessment. The definitive treatment for recurrent or troublesome symptoms is laparoscopic cholecystectomy - keyhole removal of the gallbladder.
- Acute cholecystitis (inflamed/infected gallbladder): Urgent hospital assessment, fluids, pain control, sometimes antibiotics, followed by early laparoscopic cholecystectomy, often within a week of diagnosis.
- Stones in the common bile duct: Require duct clearance, commonly by ERCP (an endoscopic procedure), and usually gallbladder removal afterward.
- Complications: Jaundice, cholangitis, or gallstone pancreatitis require urgent specialist/hospital treatment.
Dietary changes, such as avoiding foods that reliably trigger pain, may reduce attacks but do not dissolve or remove stones. Medicines to dissolve stones are rarely used, work only in selected situations, take a long time, and stones may recur.
Seek urgent care today for fever, persistent severe right-upper-abdominal pain, vomiting, yellow eyes/skin, dark urine, pale stools, or confusion. These can indicate infection or bile-duct blockage.
The NICE recommendations advise no treatment for asymptomatic gallbladder stones, laparoscopic cholecystectomy for symptomatic stones, and early surgery for acute cholecystitis.
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