DEAR DR. ROACH: What advice do you have for the treatment of gallstones? — N.W.

ANSWER: Gallstones are common (6% of men and 9% of women will get one over a lifetime) and are mostly composed of bile salts and cholesterol. The goal of treatment is to reduce symptoms and the risk of complications. Depending on the size and composition of a person’s gallstones, there are different therapies available.

The most common treatment for symptomatic gallstones is surgery. Surgery is highly effective, although there are complications of surgery such as bleeding, infection and leaks. About 10% of people will develop diarrhea after surgery, which tends to get better over weeks to months, but sometimes it requires treatment with a bile-acid-binding drug like cholestyramine. Surgery is performed laparoscopically, which means faster healing times.

For people who are not good candidates for surgery (such as those with significant medical illnesses) or people who do not want surgery, there are other options. Medications given by mouth, such as ursodiol (Actigall), can dissolve gallstones, but this can take a long time, usually several years. People with smaller stones that are mostly made of cholesterol are good candidates for this treatment. However, it is not 100% effective.

Another option is a tube placed into the gallbladder through the abdominal wall to drain bile, which is also sometimes done to remove stones, but I have seldom seen it done. Similarly, shock-wave treatment, which is commonly used for kidney stones, is rarely used but a reasonable option in people with only one or two stones.

DEAR DR. ROACH: I am a soon-to-be 84-year-old woman with a question about excessive hair shedding. I have always had very thick good hair, and in fact, I get a lot of compliments on my beautiful hair. I get my hair cut every four to five weeks, and my hairdresser always thins my hair at each visit.

On my last visit, she asked me if I had been ill. She said while my hair is not coming out in clumps, she said it was shedding more than she has ever seen before with my hair. I, too, have noticed during the past month that there is more hair on my brush, shower drain and clothes. With my hair being so thick, I have always had some shedding and hair appear on my clothes, but nothing to this extent.

I’m not on any new medicines. What could be causing my hair to shed so much? This is the last thing I thought I would be a problem for me. Is it something serious? Can it be treated and reversed? I hate to think that I am about to lose the only good asset I have. — J.M.W.

ANSWER: The most common cause of hair loss I see in older women is female pattern hair loss, but your story sounds more like acute telogen effluvium, which means the loss of hair during the resting phase. This condition is sometimes but not always associated with a stressful event. There are other medical causes, but in a third of cases, no underlying cause can be identified.

The good news about telogen effluvium is that hair usually comes back, often around 6-12 months. However, I know how important hair can be to both men and women, so I always recommend a visit with a dermatologist, especially one who has expertise in hair disorders as they have additional tools to evaluate patients for other causes.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved