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Overview

What Are Gallstones?

Gallstones are hardened deposits that form inside the gallbladder, a small organ that stores bile to help digest fat. Some stones cause no symptoms, while others block the flow of bile and trigger pain or other problems. Gallstones can affect adults of any sex, but they are more common with factors such as increasing age, pregnancy, obesity and rapid weight loss.

Symptoms

Gallstones Symptoms

Many gallstones are silent and do not cause noticeable symptoms. Symptoms usually begin when a stone blocks a bile duct, causing an episode often called biliary colic. Gallstones symptoms may include sudden pain, digestive upset or signs of inflammation.

  • Sudden pain in the upper-right or upper-middle abdomen.
  • Pain that begins or worsens after eating.
  • Pain that spreads to the back or right shoulder.
  • Nausea.
  • Vomiting.
  • Fever.
  • Chills.
  • Yellowing of the skin or eyes (jaundice).
  • Dark urine.
  • Pale stools.

Seek prompt care

Urgent warning signs

Severe or persistent abdominal pain, fever or chills, jaundice, repeated vomiting or confusion requires urgent medical evaluation. These symptoms may indicate a blocked bile duct or an infection.

Causes

What Causes Gallstones?

Gallstones develop when bile contains too much cholesterol or bilirubin, or when the gallbladder does not empty normally. Excess substances can become concentrated and form crystals that gradually harden into stones. Cholesterol stones are the most common type, while pigment stones are less common and contain more bilirubin.

MOST COMMON TYPE

Cholesterol stones

These stones are usually linked to excess cholesterol in bile, concentrated bile or problems with gallbladder emptying.

BILIRUBIN-RELATED

Pigment stones

These stones are associated with excess bilirubin and may occur with certain blood or liver conditions.

Risk Factors

Gallstones Risk Factors

  • A family history of gallstones or genetic factors can increase risk.
  • The likelihood of gallstones increases with age.
  • Being female is associated with a higher risk, partly because of hormonal influences.
  • Pregnancy can raise risk because of hormonal changes and slower gallbladder emptying.
  • Obesity can increase the amount of cholesterol in bile.
  • Rapid weight loss or a very-low-calorie diet can promote stone formation.
  • Diabetes is associated with a higher risk of gallstones.
  • Certain blood disorders and liver conditions can increase risk, especially for pigment stones.
  • Some medications may make gallstones more likely.

Complications

Gallstones Complications

  • Acute cholecystitis is painful inflammation of the gallbladder, often caused by a persistent blockage.
  • A blocked bile duct can cause infection or prevent bile from draining normally.
  • Pancreatitis can occur when a stone blocks the pancreatic duct or the shared opening of the bile and pancreatic ducts.
  • Gallbladder empyema is a serious collection of pus that can develop in an infected gallbladder.
  • Gallbladder cancer is rare but has been linked with long-standing gallbladder inflammation in some cases.

Important

Blocked ducts can be serious

Severe or ongoing pain, fever, jaundice or vomiting may signal a complication such as infection or a blocked duct. Seek urgent medical assessment rather than waiting for these symptoms to resolve.

Diagnosis

How Gallstones Are Diagnosed

Clinicians review the pain pattern and medical history, examine the abdomen and use tests to check for stones. Testing can also show whether a bile duct is blocked or whether the gallbladder, liver or pancreas is inflamed.

  • An abdominal ultrasound uses sound waves to look for gallstones and signs of gallbladder inflammation.
  • Blood tests can identify inflammation, infection or changes affecting the liver and pancreas.
  • A CT scan can show complications and other causes of abdominal pain, although it may not detect every gallstone.
  • Magnetic resonance cholangiopancreatography (MRCP) creates detailed images of the bile and pancreatic ducts without using an endoscope.
  • Endoscopic retrograde cholangiopancreatography (ERCP) may be used when a common bile duct stone needs to be removed.

Treatment & Management

Gallstones Treatment and Management

Symptom-free gallstones may be monitored, while recurrent symptoms or complications usually require treatment. The right option depends on the stone’s location, the severity of symptoms and the person’s overall health. Gallstones treatment may involve medicines, an endoscopic procedure or surgery.

  • Silent stones may be monitored when they are not causing symptoms or complications.
  • Pain and nausea medicines may provide relief during an attack under medical guidance.
  • Laparoscopic cholecystectomy removes the gallbladder and is commonly used for recurrent or complicated symptoms.
  • ERCP can remove stones that have moved into the common bile duct.
  • Selected medicines may dissolve cholesterol stones when surgery is unsuitable, although treatment can take time and stones may return.

Prevention

Can Gallstones Be Prevented?

  • Maintain a healthy weight through sustainable eating and regular physical activity.
  • Lose weight gradually when weight loss is needed.
  • Avoid crash diets, very-low-calorie diets and prolonged fasting.
  • Eat a balanced diet that includes adequate fiber and limits highly processed foods.
  • Discuss preventive medication or monitoring with a clinician when high-risk treatment is planned.

Keep expectations realistic

Prevention is not always possible

Lifestyle changes may lower risk but cannot eliminate gallstones caused by genetics, age, pregnancy or certain medical conditions.

Outlook and Prognosis

Outlook and Prognosis for Gallstones

Silent gallstones may never cause problems, while symptomatic stones often recur. Gallbladder removal is usually definitive for stones located in the gallbladder, and outcomes are generally good when complications are treated promptly. Follow-up depends on symptoms, treatment and any related medical conditions.

When Should You See a Doctor

When Should You See a Doctor for Gallstones?

  • Contact a clinician if you have repeated upper-abdominal pain.
  • Arrange an evaluation for pain that occurs after meals.
  • Seek medical advice if you suspect gallstone symptoms.
  • Make an appointment if symptoms interfere with eating or daily activities.

Get urgent help

Serious warning signs

Seek urgent or emergency care for severe or persistent abdominal pain, fever or chills, jaundice, dark urine with pale stools, repeated vomiting, fainting or confusion. These symptoms may indicate a serious blockage or infection.

Symptoms

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