Q: I am a 29-years-old female. Recently I got my liver, pancreas and kidneys scanned. All reports were normal except that the gallbladder showed evidence of a small calculus, measuring 7.5 mm. What causes stone formation in gallbladder and what is the treatment for it? Do I need to undergo surgery or can this problem be solved through medicines? The report of serum amylase was 422 U/L and serum LDH is 343 U/L. Is this normal? What precautions do I need to take so that the stones in my gall bladder dont increase in number and size?

A:The tiny gallstone noticed in the scan needs to be treated if it causes symptoms like pain in the right side of the upper abdomen, especially after fatty diet. Small stones would not need surgery and may remain asymptomatic and not enlarge. However, if you develop any such symptoms, you need to consult a specialist for the right advice. Gallstones are formed as precipitation when there is metabolic abnormality of the cholesterol / fat in the liver. Obesity, familial disposition and lot of other factors can be responsible for gallstone formation which cannot be described in the email. I suggest you have regular gallbladder scans as follow up, say every two years or so, or whenever you get symptoms.