Cholelithiasis, commonly referred to as gallstones are stones that form in the gallbladder over time. The reason is multifactorial and varies by global region.
In the US the most common cause of these stones is a high cholesterol diet.
These stones are present in up to 1 in 4 people. Having stones in and of itself is not an issue but it is an issue once they start to cause symptoms.
These stones can cause infection of the gallbladder, also known as cholecystitis among other potential problems.
In the US approximately 15 million people have gallstones which leads to about 500,000 surgeries performed every year to remove the gallbladder.
Since it is so common, is it safe to travel far from home if you have gallstones?
Before we delve into this question let us take a brief look at what the gallbladder does.
The gallbladder is a sac that lives under the liver and stores bile.
This bile is used for digestion after a meal.
There is a complex connection of ducts that come out of the liver to form the biliary tree. This is how the liver makes bile and transports it into the gallbladder for storage.
When stimulated by eating, especially fatty meals, the gallbladder then squeezes the bile through a system of ducts and eventually into the small intestine to aid in digestion.
How do gallstones form?
In a healthy person, any form of obstruction to the flow of bile can cause pain and discomfort. This is most commonly caused by gallstones obstructing the outflow of bile from the gallbladder.
Bile can form stones that can vary in size and can be as big as a golf ball.
In the western world, these stones are usually made up of cholesterol.
Depending on the size, the stones may block the outflow of bile from the gallbladder or sometimes slip past the gallbladder into the biliary tree and cause more serious problems.
Risk factors for developing stones in the gallbladder include being overweight, female, diets high in fat and cholesterol, pregnancy, and rapid weight loss by using these fad diets.
What symptoms do gallstones cause?
Symptoms can be vague but the most commonly seen symptoms cause by stones in the gallbladder are pain below the rib cage on the right, especially after eating a fatty meal.
Usually the pain comes on in about an hour after a meal and may last for several hours.
Once the gallbladder becomes symptomatic, the symptoms may go away but the risk of having another symptomatic attack stays lifelong.
This is why the recommended treatment once symptomatic is to surgically remove the gallbladder.
It is important to note that many people have stones in their gallbladder and no symptoms. These cases do not require any treatment.
How do you know if you have stones in your gallbladder?
The best test to see if you have stones in your gallbladder and if there is any inflammation around the gallbladder is an ultrasound. Your medical doctor would be the one to order this test for you.
What should you do if you know you have gallstones?
If the gallbladder is causing symptoms, usually the recommended treatment is surgery to remove the gallbladder.
Is there non surgical treatment?
Yes, but they are much less effective.
There are medications that could potentially over time dissolve these stones although how successful this is varies significantly. The two medications available are ursodiol and chenodiol. They decrease cholesterol production in the liver.
This is not the standard treatment for symptomatic gallstones.
So can you travel if you have gallstones?
The first question to ask is how do you know you have stones?
Many times these stones are discovered incidentally during workup for something else.
So if you have stones and no symptoms, there are no restrictions on anything you would do, including travel.
However, if you have symptoms from your stones, you should talk to your medical doctor. There is an increased risk for recurrent attacks that may jeopardize your trip.
If the plan is to travel to remote locations or to austere environments with limited access to medical and surgical care, it may be wise to consult with a surgeon to discuss all options before embarking on a trip.
Please remember that medical information provided by us must be considered an educational service only. This blog should not be relied upon as medical judgement and does not replace your physician’s independent judgement. This is NOT medical advice. Please seek the advice of your physician.