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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35035
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have been found (via ultrasound) to have several small

Resolved Question:

I have been found (via ultrasound) to have several small gallstones (ave 8mm). This was an incidental find as the test was done to discover possible causes for left side abdominal discomfort. Nothing was found on the left side. I have had only minor digestive symptoms, like occasional bloating/fullness in the past and recently occasional mild stomach pain (middle under ribs). I also have a small hiatus hernia and reflux, which could explain some of these symptoms.

I have seen a specialist who has said I should have the gall bladder removed. I would like a second opinion, as I have read that asymptomatic gallstones are probably best managed by a wait-and-see approach (I've read some medical studies).

I am inclined to leave it until I develop more serious symptoms, however I am going on a holiday to China in October and wonder whether I am taking a risk in leaving the stones there. I would not like to have to be hospitalised in China where I am unsure of the medical facilities
Submitted: 8 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 8 years ago.


Your symptoms are termed as dyspepsia and are likely due to (as you mentioned) hiatus hernia and reflux. There are some objective finding needed to know whether your gall stones are symptomatic or asymptomatic. The first thing is absence of any acute attack or co-relationship of fatty foods. If this is not there, the second thing is to know about the gall bladder thickness. A symptomatic gallstones will usually have thick walls of the gall bladder (termed as chronic cholecystitis). In the absence of this; again it is likely to be asymptomatic gall stones. The third criteria can be getting an HIDA scan done. If the gall bladder is functioning well, which can be seen on the HIDA scan, then again there is no need of removing the gall bladder and it is unlikely to give you pain during your China visit. Another way of knowing whether gallbladder is working nicely or not is getting an ultrasound done immediately after the food. A good contracted gall bladder (post meal) will denote functioning gall bladder and indicates that it does not need surgery.

Please feel free for your follow up questions.

Dr. Arun

Customer: replied 8 years ago.

Dear Dr Phophalia,

Thank you for your answer. In response, I have had some aversion to fatty foods, but that has passed, I have not had any acute attacks and the scan shows the bladder walls to be of normal thickness. So do you think there is any chance of my condition or symptoms getting worse if I don't remove it? Could these stones remain unchanged for many years? Or are they likely to need treatment in the future?

Many thanks,


Expert:  Dr. Arun Phophalia replied 8 years ago.

Hello Mary,

The asymptomatic gall stones can convert in to symptomatic and the incidence of this conversion is about 5% per year. But there would be almost 25-30% people who would remain asymptomatic.

It is pleasure and privilege assisting you.

Dr. Arun

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