Common misconceptions and myths about gallstones

Mysconceptions and Myths
Common misconceptions and myths about gallstones
By Dr. Lee Ser Yee
There are many myths and misconceptions surrounding gallstones and how they should be treated. Here, we clear up some common ones so that you are well-informed of what to expect.

Myth 1: Gallstones can be ‘flushed’ away

Many alternative therapies on the internet ‘guarantee’ to get rid of your gallstones using ‘natural remedies’ such as olive oil, lemon juice or some concoction. None of these are supported by any scientific evidence and are best avoided.

Gallstones come in all shapes and sizes. If gallstones are present, the best place for them to remain is within the gallbladder, as problems arise when the stones are pushed out the gallbladder and gets stuck along the way and/or block important structures such as the bile duct or the pancreatic duct or even the intestines if the gallstone is large enough (gallstone ileus).

But even if it was possible to flush away gallstones, the root of the problem remains, an unhealthy gallbladder and the susceptibility to form more stones remains.

Gallstones can also lead to long-term (chronic) irritation of the gallbladder, causing it to be at higher risk of gallbladder cancer and recurrent infections.

Myth 2: Gallstones can be broken up using shockwaves

Extracorporeal Shock Wave Lithotripsy (ESWL) has been used to treat kidney stones successfully. Many confuse this as treatment for gallstones as well. Even though, it can break up the stones in smaller fragments, the issue remains that the stone fragments may still block the gallbladder, bile duct or pancreatic duct.

Myth 3: Surgery for gallstones is risky and painful

Whilst no procedure is risk-free, surgery for gallstones is very safe and effective. Complication rates are very low and occur in less than 1%. Via keyhole surgery to remove your gallbladder (laparoscopic cholecystectomy), most can be done as day surgery with minimal pain and downtime.

Myth 4: You can’t eat normally or lead a normal life without a gallbladder.

Majority of patients have no problems following the removal of their gallbladder and are glad as it had significantly affected their diet and life. However, a very small proportion of patients may have digestive problems in the short-term but most cases settle without the need for treatment.

The gallbladder’s function is to store a portion of bile produced by the liver and release it in a controlled manner during meals. Bile then help digest the fat aiding absorption. After the gallbladder is removed during surgery, bile trickles continuously into the intestines. For a small group of patients , this can lead to loose stools during oily/fatty meals; and in others the bile can travel back into the stomach causing heartburn-type symptoms (bile reflux). In most cases, these symptoms settle down within a few months after surgery.

Myth 5: All gallstones should be treated.

Gallstones are often found ‘incidentally’ on scans when your doctor is investigating other problems. In the vast majority of cases, these gallstones can be left alone without worry if they do not cause symptoms or has not in the past. It is, however, important to remember that you have gallstones in case they begin to cause problems in the future.

Myth 6: It is ok and better to just remove the gallstones alone

If gallstones cause symptoms, they should be treated by removing the gallbladder and the stones within together. Removal of the gallstones without the gallbladder does not address the root of the problem that remains, a diseased gallbladder and its susceptibility to form more stones in the future.

Moreover, the removal of the gallstones without the gallbladder is more complicated and riskier than removing the gallbladder and the stones within together. Thus, it is not recommended.

Dr Lee Ser Yee
Dr Lee Ser Yee
Senior Consultant Hepatopancreatobiliary Surgeon

MBBS, MMed (Surgery), MSc, FAMS, FRCSEd

Prior to private practice, liver surgeon Dr Lee Ser Yee was a founding member and Senior Consultant at the Department of Hepatopancreatobiliary (HPB) and Transplant Surgery at Singapore General Hospital (SGH). He served as the Director of the Laparoscopic programme and the Director of the Surgical Skills Training Program and the SingHealth Surgical Skills Centre.

He started his medical training at the National University of Singapore in 1996 and completed his training in General Surgery, HPB surgery and Liver Transplantation at SGH and National Cancer Centre, Singapore.

He also completed dual USA-fellowships in Advanced Laparoscopic HPB surgery and Liver Transplantation under Professor Daniel Cherqui at the New York Presbyterian Hospital-Weill Cornell Medical Center and a Complex Surgical Oncology clinical fellowship at Memorial Sloan Kettering Cancer Center in New York.

Doctor Lee Ser Yee