Gallstones (cholelithiasis): treatment and course

Gallstones (cholelithiasis): treatment and course

If the stones don’t cause any problems, let them lie dormant and wait. There is a perfect chance that the wearer will never be bothered by them. If symptoms have already occurred, the treatment depends on the current situation.

Acute biliary colic and chronic stone disease

  • Acute biliary colic is treated with antispasmodic and pain-relieving medication and infection with antibiotics . The affected person is not allowed to eat anything for a short time to not “shut down” the digestion and thus relieve the gallbladder. Wait until the acute attack has subsided before removing the stone.
  • Chronic stone disease: There are several options for stone removal. Usually, the entire gallbladder is removed (cholecystectomy) – this way, no new culprits can form. In many cases, this procedure is performed as a laparoscopy, i.e. via a tiny incision and using a tube with fibre optics. In severe cases or the case of previous operations, an open operation with a large abdominal incision may be indicated.

Small stones can be removed using ERCP. In addition, it is possible to dissolve certain types of rocks or patients with medication or smash them from the outside using shock waves. However, the risk of developing stones and symptoms again is 30-50%. Another disadvantage is that the treatment takes several months to years.


Course and prognosis of gallstones

After the removal of the gallbladder, the lifestyle is only slightly affected. The liver continues to produce bile. However, fatty or spicy foods may be poorly tolerated since they can no longer be stored. After the procedure, the food should be low in fat and easily digestible. Symptoms disappear entirely after the first few months for most affected people, and they can eat anything again.

If the gallbladder is still present, the diet should be changed. This reduces the risk of new stones, and any gallstones still present can be reduced in size. The following guidelines apply:

  • Avoid foods high in cholesterol and other animal fats (e.g. eggs, butter).
  • High dietary fibre content
  • Long-term weight loss, no radical diets (these can also lead to stones)
  • Plenty of fluids (2-3 liters daily)
  • Sufficient movement


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