In this episode of My Health Focus, Catriona speaks with Nick Chatzizacharias, an HPB (Hepato-Pancreato-Biliary) and liver transplant surgeon, about a condition many of us have heard of, but few of us truly understand: gallstones and gallbladder disease.
Gallstones are incredibly common, particularly in midlife, yet symptoms are often misunderstood or ignored. In this clear and practical conversation, Mr Chatzizacharias explains what the gallbladder actually does, why gallstones form, the impact of modern weight-loss medications such as Wegovy, Ozempic, and Mounjaro, and when surgery becomes necessary.
If you’ve ever experienced unexplained upper abdominal pain, especially after eating, this will certainly be of interest.
What Is the Gallbladder and Why Do We Have One?
The gallbladder is a small sac tucked underneath the liver, on the right-hand side of your abdomen. Its main role is storage.
The liver produces bile.
Bile helps digest fats.
When we are not eating, bile is stored in the gallbladder.
When we eat particularly fatty foods a hormone signals the gallbladder to contract and release bile into the intestine.
It’s a clever storage and release system. But when the chemistry of bile becomes imbalanced, problems can begin.
Top 5 highlights from the conversation
1. Gallstones Form When Bile Chemistry Changes
Gallstones develop when bile components particularly cholesterol become imbalanced. Small “nuclei” or sludge can form, eventually hardening into stones.
Common risk factors include:
Age over 40
Female sex (hormonal influence)
Higher BMI
Rapid weight loss
Pain from gallstones is called biliary colic typically a sharp pain in the upper right abdomen after eating fatty meals.
2. GLP-1 Weight Loss Medications Can Increase Risk
Modern GLP-1 medications such as Wegovy, Ozempic, and Mounjaro have transformed weight management.
However, they may increase gallstone risk in two ways:
Rapid fat mobilisation increases cholesterol in bile.
They may reduce gallbladder contraction, leading to bile stagnation.
Importantly, rapid weight loss itself, regardless of method can increase gallstone risk.
3. Many People Have Gallstones Without Symptoms
A significant number of adults may have gallstones detected incidentally on ultrasound and never experience symptoms.
However, when symptoms do occur, they can escalate from:
Intermittent pain
to……Gallbladder infection
Blocked bile ducts
Jaundice
Pancreatitis
These complications can be serious, which is why medical assessment is important.
4. Diagnosis Is Usually Straightforward
If gallstones are suspected, a GP will typically arrange:
Blood tests
An abdominal ultrasound
Ultrasound is highly effective at detecting gallstones and assessing inflammation.
5. Treatment Usually Means Removing the Gallbladder
Unlike kidney stones, gallstones cannot be “blasted” or removed individually.
If surgery is required, the standard treatment is laparoscopic (keyhole) cholecystectomy, removal of the gallbladder.
Key points:
Often, same day or 24 hour discharge
Small incisions
Return to normal activities within weeks
No long-term dietary restrictions
And reassuringly, you can live perfectly well without a gallbladder.
About the Expert
Mr N. Chatzizacharias is a Consultant Hepatopancreatobiliary (HPB) and Liver Transplant Surgeon in Queen Elizabeth Hospital, Birmingham. He graduated from the University of Athens, Greece, Medical School and holds a PhD from the same institution. Alongside his NHS commitments, he holds an Honorary contract with the University of Birmingham School of Medical and Dental Science as an Associate Clinical Professor. He is a member of various national and international societies, including the European-African and International HPB Associations.
Mr Chatzizacharias holds a PhD in pancreatic cancer. He has authored a number of peer reviewed publications and has numerous presentations in national and international meetings. He is the principal investigator in the DISSECT trial (investigating the role of periadventitial dissection in achieving improved surgical margins during surgery for resectable pancreatic cancer), as well as various other prospective and retrospective studies. He is an educational supervisor of final year medical students and a supervisor in the MSci intercalated programme of the University of Birmingham Medical School.
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Medical disclaimer
This content is for general information only and is not a substitute for professional medical advice. Always consult your GP or a qualified healthcare professional if you have any concerns about your health.