1. Bile Salt Tablets
Many people with gallstones remain asymptomatic and a "wait and see" course of treatment should be used. When your gallstones begin to cause you difficulty, medication may be your first choice of treatment. While bile salts are effective only 50 percent of the time, they are a more attractive option than surgery for those who suffer only mild symptoms. Stones can be made up of cholesterol or pigment, bile salt medications ursodiol and chenociol both work to dissolve cholesterol stones when taken over time. Small cholesterol stones are broken down easier by ursodiol and chenodiol than larger stones and most people have to take the medication for extended periods, even years, to maintain control of the stones. This method of treatment is very expensive and relies heavily on patient compliance for success. Long term use does seem to account for a decrease risk of pain.
2. Ultrasound Therapy
With this procedure, high frequency sound waves are used to break up gallstones, which are then small enough to pass through the bile duct and into the intestines. Fragments of the stones are often left over, and ursodiol (or another bile salt) is taken after the procedure to help dissolve these. If you have multiple stones, or your stone or stones are large, you are most likely not going to be a good candidate for this procedure. Only 15 percent of patients are candidates for this procedure, so it is not widely used. Side effects of the procedure include gallbladder pain, complications from fragments that did not clear the bile duct and pancreatitis. Recurrence is common, often leading to surgery.
3. Surgical Solution
Laparoscopic and open surgeries are both options for gall stone removal. They are in fact the only options with 100 percent success rate and no recurrence of gallstones. The gallbladder is not an essential organ so gallbladder surgery has become a primary treatment. With laparoscopic surgery, only a small incision is needed as a video camera is placed that can produce a magnified view for the surgeon. Several other small incisions will be made for other surgical instruments that will be used to remove the gallbladder. This type of surgery is highly effective and will lead to less pain, scarring and down time due to the surgery. Occasionally, open surgery is indicated or your provider may prefer open surgery. A large abdominal incision is made and your gallbladder is removed. In severe cases where infection is extensive, scar tissue is involved or the gallbladder is less pliable, open surgery is the best option. Open surgery will mean longer hospital stays compared to its laproscopic counterpart as well as several weeks of recovery at home.
With either method of surgery, you may find that after your gallbladder is removed, your bowel habits are different. An increase in bowel movements is expected, along with stool that is runny in consistency (occasional diarrhea). This is expected and should lessen over time.
4. Topical/Contact Gallstone Dissolution
For topical gallstone dissolution, a cholesterol dissolving solution is injected into the gallbladder and left for 5 to 12 hours, giving the solution time to dissolve the stones. People who have had this treatment have suffered a lower recurrence rate compared to others who have used medication as treatment. This treatment is technically complicated and considered experimental. Contact dissolution can cause a severe burning pain, along with its complicated and experimental nature, makes it less than an ideal treatment.
