gallstones

Overview
Gallstones are hardened deposits of digestive fluid that form in the gallbladder, a small organ beneath the liver that stores bile. These stones can vary in size and number—from a single large stone to hundreds of tiny ones. Gallstones are usually composed of cholesterol or bilirubin and may not cause symptoms until they block the flow of bile, triggering pain or other complications.

Why It’s Important
Gallstones are common and often silent, but when they block bile ducts, they can cause sudden, severe abdominal pain(known as a gallbladder attack) and lead to serious conditions like cholecystitis (inflammation of the gallbladder), pancreatitis, or bile duct infection. Timely diagnosis and treatment can prevent these complications and improve quality of life, especially in those with recurring symptoms.

Quick Facts

  • Most common in adults over 40, especially women

  • Affects about 10–15% of adults in the U.S.

  • Often asymptomatic (“silent gallstones”)

  • Risk factors include obesity, pregnancy, rapid weight loss, and certain diets

  • Chronic condition that may require surgical intervention

What Happens in the Body
The liver produces bile to help digest fats, and the gallbladder stores this bile until it’s needed. Gallstones form when substances in bile—especially cholesterol or bilirubin—become too concentrated and crystallize. These stones can remain in the gallbladder harmlessly or migrate into the bile ducts, leading to obstruction and inflammation. Blockages prevent bile from draining properly, resulting in pain and digestive issues.

Common Signs and Symptoms
Most gallstones are silent, but when symptomatic, they may cause:

  • Sudden, intense pain in the upper right or middle abdomen

  • Pain that radiates to the right shoulder or back

  • Nausea or vomiting

  • Pain after eating fatty meals

  • Jaundice (yellowing of the skin/eyes) if bile flow is blocked

  • Fever and chills in cases of infection

Diagnosis

  • Ultrasound is the most common and effective imaging test

  • CT scan or MRI for more complex cases

  • Blood tests to check for signs of infection or liver problems
    See a doctor if:

  • You experience recurrent abdominal pain, especially after eating

  • You develop jaundice, fever, or persistent nausea

  • Pain lasts more than a few hours or interferes with daily activities

Treatment and Management

  • Watchful waiting for silent gallstones (no symptoms)

  • Surgery (cholecystectomy) to remove the gallbladder is the most common and effective treatment

  • Medications to dissolve stones are rarely used and take months to work

  • Dietary changes (low-fat diet) may help reduce symptoms but don’t eliminate stones

  • Gallbladder is not essential—people can live normally without it

Risks and Complications

  • Cholecystitis (gallbladder inflammation)

  • Pancreatitis (inflammation of the pancreas)

  • Choledocholithiasis (stones in the bile ducts)

  • Bile duct infection (cholangitis)

  • Risk of gallbladder rupture in severe untreated cases

Who Is at Risk

  • Women, especially during pregnancy or while using hormonal birth control

  • Adults over age 40

  • People with obesity or rapid weight loss

  • Individuals with diabetes or metabolic syndrome

  • Diets high in fat and cholesterol, and low in fiber

Related Conditions

  • Cholecystitis

  • Pancreatitis

  • Bile duct obstruction

  • Fatty liver disease

When to See a Doctor

  • If you have sudden, intense abdominal pain that lasts more than a few hours

  • If you experience jaundice, fever, or persistent vomiting

  • If you’ve had multiple attacks or episodes of gallbladder-related pain

  • For evaluation if you’re at high risk and have digestive discomfort

Last Updated: June 28, 2025