Gallstones: When To Call A Doctor

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When To Call a Doctor

Abdominal pain can be a sign of a serious or even life-threatening condition, especially if you have a heart condition or are older than 60. If you are having sudden or severe pain and are not sure what is causing it, you may need immediate medical treatment. You should be especially concerned if you are having trouble breathing or you faint or lose consciousness. For more information, see the topic Abdominal Pain, Age 12 and Older. For more information on abdominal pain in children, see the topic Abdominal Pain, Age 11 and Younger.

Call your doctor immediately if you have:

• Pain that may be caused by gallstones (continuous moderate to severe pain in the upper right abdomen ) along with a fever of or higher and chills that are clearly not caused by stomach flu or any other reason.
• Pain in the upper midsection or upper right abdomen, along with a yellow tint to your skin and the white part of your eyes, dark yellow-brown urine, or light-colored stools.
• Diabetes or an impaired immune system and you have symptoms that may be caused by gallstones.

If you have symptoms of gallstones but no fever, chills, or yellowing of your skin or the white part of your eyes, you may still require evaluation and treatment. Schedule an appointment with your doctor.

Watchful Waiting

Watchful waiting is a period of time during which you and your health professional watch your symptoms or condition to see whether you need treatment. Watchful waiting is often the first approach to a first attack of gallstone pain.

Gallstones that cause symptoms

If your gallstones are causing symptoms, treatment is recommended if your symptoms are severe or if they occur again. Treatment can relieve pain and reduce the risk of complications.

• It is generally considered safe to wait until your symptoms come back at least once before you have surgery for gallstones.²
• About 1 in 3 people with gallstones who have a single attack of pain or other symptoms do not have symptoms again.¹

Gallstones without symptoms

If your gallstones were found by a test that you had for another condition and the stones have never caused symptoms, the risk that you will develop a complication is low. Treatment is not needed in most cases.

In rare situations, doctors may advise surgery for gallstones that do not cause symptoms. Watchful waiting may not be appropriate for you if you have:²

• A very large gallstone.
• An increased risk of gallstone cancer (for example, if you are a Pima Indian).
• Sickle cell disease. Symptoms of gallstones can be like symptoms of sickle cell crisis, and people who have sickle cell disease are likely to form gallstones.
• A calcified gallbladder (also known as porcelain gallbladder).
• Plans to get an organ transplant (such as a heart or kidney).

For more information, see the Surgery section of this topic.

Who To See

Symptoms caused by gallstones can be evaluated by any of the following health professionals:

• Nurse practitioner
• Physician assistant
• General practitioner
• Family medicine doctor
• Internist
• Gastroenterologist
• General surgeon

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Last updated:	August 02, 2007
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC