Dr. Thawatchai Suksanong, our General Surgeon at Bangkok Hospital Hua Hin, shares that his patients always have questions about what gallstones look like. The two main types of gallstones are cholesterol stone and pigment stone. In Asia, more pigment stone which is a dark color, round or square lumps are found. This type of gallstone is caused by an imbalance of the bile composition. The gallstones will cause problems when they obstruct the flow of bile causing inflammation in the gall bladder. They may also block the bile duct causing similar infection leading to jaundice or the condition of yellow eyes and skin and if the stones remain for a prolonged period of time, it increases the risk of cancer of the gall bladder and biliary system. ” The earliest symptoms of gallstones are distension and pain under the rib cage area or the middle part of the upper abdomen. Other symptoms include flatulence, easily full when eating a big meal or fatty diet. There are more severe symptoms with the inflammation of the gallbladder along with fever, nausea and vomiting. For the diagnosis, ultrasound of the abdomen can detect and help with the diagnosis. For the patients who are symptom-free, surgery may not be necessary. On the other hand, if the symptoms or complications appear, the timely surgery to remove the gall bladder is recommended. Currently, laparoscopic cholecystectomy has become a standard procedure for treatment for gallstones. During the procedure, 3 – 4 small holes are made for the insertion of the instruments into the abdomen, the patient will have less pain and will recover more quickly and can leave the hospital in 1 – 2 days. The hospitalization may be longer in cases with inflammation of the gall bladder. The conventional surgery may be needed in some cases with complications “ It is better for the patients to receive the cholecystectomy, surgical removal of the gallbladder, before it gets complicated or worse “ Dr. Thawatchai said. However, patients always have concerns for the long-term effect of not having the gallbladder. The bile is created from the liver and then stored in the gallbladder. When you eat fattening food such as rice with pork leg, a very popular dish in Thailand, the stored bile is excreted to help digest fat. Therefore, if the gallbladder is removed, patients can still eat fatty diets as normal but it may take more time for the digestion so more proportion of vegetables and fish is recommended.  We should avoid fattening food when we are 40 – 50 years old anyway. After the surgery, the patients may find that oily food may still cause flatulence or fatty stool. Most patients can adjust themselves with the eating habits. For those with concerns can receive the annual health check up to prevent disease and with an early detection, it can be treated. ************************************************************************** For more information, please contact : General Surgery Clinic, Bangkok Hospital Hua Hin, 1st floor Tel. 032-616-833