Gallstones: Symptoms, Causes, Treatment & Warnings
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Introduction
Gallstones are hard deposits that form from substances in bile4,6. Bile is a fluid that helps the body digest fat4. Stones usually form in the gallbladder but can also appear in the bile ducts5,7.
Many people have gallstones without knowing it1,7. These silent stones may cause no symptoms for years1. Problems often start when a stone moves and blocks the flow of bile1,6.
This guide explains gallstones symptoms causes treatment and warning signs in clear terms. It covers gallbladder attack symptoms, risk factors, diagnosis, and gallstone treatment. It also explains when abdominal pain may signal an emergency.
Overview: What Gallstones Are and How They Form
The gallbladder, bile, and bile ducts
The gallbladder is a small, pear-shaped organ under the liver4,8. It stores bile made by the liver4. During a meal, the gallbladder squeezes bile into the small intestine4,8.
Bile travels through small tubes called bile ducts4. The common bile duct links the liver and gallbladder to the small intestine4. A stone can block one of these tubes and stop normal bile flow7,9.
Gallstones form when substances in bile harden into stone-like pieces4,9. They can be as small as sand or as large as a golf ball3,6. One person may have one large stone or hundreds of tiny stones6.
Gallstones in the gallbladder are called cholelithiasis9. Stones in the bile ducts are called choledocholithiasis9. Stones in either place can cause problems if they block bile flow7,9.
Cholesterol stones versus pigment stones
Gallstones are commonly made from cholesterol or bilirubin3,6. Bilirubin is a pigment made when the body breaks down red blood cells3. Cholesterol stones are the most common type3.
Blood cholesterol levels do not directly show whether someone has cholesterol stones3. In fact, these stones are not linked in a simple way to blood cholesterol3.
Pigment stones are made mainly from bilirubin3,9. They can form when bile contains too much bilirubin3,9. Some blood disorders, liver disease, and bile duct infections can raise this risk3,9.
Why some gallstones cause no symptoms
Many stones stay inside the gallbladder without blocking bile flow1,7. Doctors call these silent or asymptomatic gallstones. Stones that do not block a bile duct usually cause no symptoms1.
Symptoms can begin when a stone moves into a duct and gets stuck6,7. Bile may then collect behind the blockage1. This pressure can lead to pain and swelling1.
A lasting blockage can harm nearby organs5,9. It may affect the gallbladder, bile ducts, liver, or pancreas5,9. This is why certain gallstone warning signs need quick care.
Symptoms: Gallstone Symptoms and Gallbladder Attacks
Common symptoms of biliary colic
A gallbladder attack is also called biliary colic1,6. It starts when a stone blocks normal bile flow1. The blockage may be brief, but the pain can be strong1.
Biliary colic often causes steady pain in the upper-right abdomen1,5. Some people feel pain in the upper-middle abdomen instead5,8. Pain may last from several minutes to several hours1,7.
The word “colic” may suggest pain that comes in waves. However, biliary colic can feel steady rather than come and go5.
Common gallbladder attack symptoms include:
Steady pain under the ribs on the right side1,5.
Steady pain in the upper-middle abdomen5,8.
Pain that moves into the back or right shoulder7,8.
Nausea with upper abdominal pain7,8.
Vomiting during an attack7,8.
Pain after a heavy or greasy meal1,5.
Pain that starts in the evening or at night1.
Pain that makes it hard to get comfortable8.
Gallbladder attack symptoms can vary from person to person. Upper abdominal pain can also have other causes. A healthcare professional should assess new or repeated pain.
Pain location, timing, and possible triggers
The gallbladder sits under the liver in the upper-right abdomen4,8. Gallstone pain often starts in this area1,5. It may also start in the upper-middle part of the abdomen5,8.
Pain can spread toward the back7,8. It can also move below the right shoulder blade7,8. Nausea or vomiting may occur at the same time7,8.
Gallbladder attacks often follow heavy or high-fat meals1,5. Eating causes the gallbladder to squeeze and release bile8. A stone near the outlet can block that flow and cause pain5.
Attacks often happen during the evening or at night1. The pain may stop when the stone moves away from the duct1. Pain relief does not mean the stones are gone.
Silent gallstones and recurring attacks
Silent gallstones do not cause typical gallbladder attack symptoms1,7. Doctors may find them during an imaging test done for another reason5. Many silent stones never need treatment2,7.
The outlook changes after the first painful attack. Additional attacks are likely after someone has had one gallbladder attack1. Pain can return when another stone blocks a duct1,2.
A person should seek medical advice for recurring upper abdominal pain2. A clinician can look for gallstones and signs of a blocked duct. Testing also helps guide the right gallstone treatment.
Causes and Risk Factors for Gallstones
Changes in bile and poor gallbladder emptying
Gallstones can form because of changes in bile5,9. Cholesterol stones may form when bile contains too much cholesterol9. Low levels of bile salts may also play a part9.
Poor gallbladder emptying can increase the chance of stone formation5,9. Bile stays in the gallbladder longer when the organ does not empty well5,9. Substances in the bile may then form crystals and stones5.
Pigment stones are linked to excess bilirubin in bile3,9. Cirrhosis, which is severe liver scarring, can raise the risk of pigment stones9. Bile duct infections can also raise the risk9.
Some inherited blood disorders can cause pigment stones9. One example is sickle cell disease9. Fast breakdown of red blood cells can increase bilirubin levels3.
Personal and medical risk factors
A risk factor raises the chance of developing a disease. It does not mean that the disease will occur.
Gallstones are more common in females than in males3,7. They are also more common after age 403. People with excess body weight have a higher risk3.
A family history of gallstones can raise a person’s risk3. Pregnancy is another known risk factor3,8. Rapid weight loss can also make stones more likely3,8.
Some liver, blood, and bile duct disorders raise gallstone risk3,9. A person may have several risk factors at once. However, risk factors do not show whether symptoms will occur.
Someone with several risks may never have an attack. Another person may develop symptoms without knowing their risks. Symptoms and medical tests are more useful than risk factors alone.
Can gallstones be prevented?
Not every case of gallstones can be prevented. People cannot change their age, sex, or family history. They may also have health problems that raise their risk3,8.
Avoiding rapid weight loss may reduce one known risk3,8. Gradual weight control and regular physical activity may also help lower risk8. A balanced diet with fiber and healthy fats may be helpful8.
People planning major weight loss should speak with a healthcare professional. They can ask how to lose weight at a steady pace.
Prevention steps cannot remove stones that have already formed. Food changes may reduce meal-related symptoms for some people. They do not replace medical care for repeated attacks or gallstone warning signs.
When to See a Doctor: Gallstone Warning Signs and Complications
Contact a healthcare professional after symptoms of a gallbladder attack2. This is important when upper abdominal pain returns. Medical care can help find a blocked duct or other cause.
A blockage that lasts more than a few hours can cause serious problems1. These problems may include swelling, organ injury, or infection5,9.
Symptoms that require urgent medical care
Seek urgent medical care for these gallstone warning signs:
Severe or lasting upper abdominal pain1,8.
Pain that prevents you from getting comfortable8.
Fever or chills with abdominal pain1.
Yellow skin or eyes, called jaundice1.
Dark urine or pale stools1.
Repeated vomiting or trouble keeping fluids down1.
Severe pain that spreads into the back5.
Confusion, fainting, or signs of severe illness.
Fever, chills, and jaundice can point to a serious blockage or infection1,9. Dark urine and pale stools can also occur when bile flow is blocked1. Repeated vomiting with severe pain needs urgent assessment1.
Do not treat severe pain, fever, or jaundice as a minor stomach problem1,9. A blocked bile duct can lead to a life-threatening infection9.
Acute cholecystitis
Acute cholecystitis is sudden swelling of the gallbladder5. It can happen when a stone blocks the cystic duct. This duct carries bile out of the gallbladder.
Unlike brief biliary colic, the pain may not go away1,5. Fever or other signs of swelling may occur1,5. This condition needs medical treatment.
Choledocholithiasis and cholangitis
Choledocholithiasis means a gallstone is inside the common bile duct9. The stone can block bile from draining normally9. This blockage may lead to jaundice1,9.
Cholangitis is a serious infection of the bile ducts5,9. It can develop when bile builds up behind a blockage5,9. Signs may include fever, chills, abdominal pain, and jaundice1,9.
Bile duct infections can become life-threatening9. People with these gallstone warning signs need urgent care.
Gallstone pancreatitis
The pancreas has a duct near the common bile duct. A gallstone can block drainage in this area5,9. The blockage can inflame the pancreas and cause gallstone pancreatitis5,9.
Pancreatitis may cause severe upper abdominal pain5. The pain may spread into the back5. Vomiting can also occur during a severe gallstone attack1,7.
Gallstone complications include acute cholecystitis and choledocholithiasis5,9. They also include cholangitis and gallstone pancreatitis5,9. Medical tests help doctors find the blockage and check for organ injury10.
Diagnosis and Treatment of Gallstones
Medical history and examination
A clinician will ask about the pain and its location. They may ask how long it lasts and whether it follows meals. They will also ask about past attacks.
The clinician may check for fever, vomiting, or jaundice. They may press gently on the abdomen to find tender areas. Tests are often needed because many problems can cause upper abdominal pain.
Blood tests and imaging
Abdominal ultrasound is often the first imaging test for suspected gallstones10. It uses sound waves to make pictures inside the abdomen10. The test can show many stones inside the gallbladder3,10.
Cholesterol stones may not appear on a CT scan3. However, they are often visible on an abdominal ultrasound3.
Very small stones can be harder to find. Endoscopic ultrasound may detect stones missed by a standard ultrasound10. This test uses a thin tube with a small ultrasound tool10.
The clinician passes the tube through the mouth and digestive tract10. The device then makes detailed pictures of nearby organs10.
Other imaging tests can study bile flow or search for duct stones10. The doctor chooses tests based on symptoms and earlier results.
Blood tests can show infection, swelling, or organ injury. They may help assess the liver or pancreas. Imaging is often needed to locate stones and blocked ducts10.
When observation is appropriate
Asymptomatic gallstones usually do not need treatment2,5. An exception may apply in certain high-risk situations2,5. Many silent stones never cause symptoms or need treatment7.
Observation avoids treatment when the stones are not causing problems. However, people with silent stones should know the main gallstone warning signs.
New pain, fever, jaundice, or vomiting should lead to medical advice1,2. Gallbladder attacks are likely to return after the first attack1.
Surgery for symptomatic gallstones
Laparoscopic cholecystectomy is the standard treatment for most symptomatic gallstones2,5. Cholecystectomy means surgery to remove the gallbladder. Laparoscopic surgery uses small cuts, a camera, and special tools.
The gallbladder is not needed for normal life2. After surgery, bile still flows from the liver into the small intestine4. Most people can live normally without a gallbladder2.
Surgery removes the organ where most gallstones form. It is often used when attacks return or complications occur2,5. A surgeon can explain the possible benefits and risks.
Endoscopic treatment for duct stones
Doctors may use an endoscopic procedure to remove stones from the common bile duct. Endoscopy uses a flexible tube passed through the mouth. The clinician guides the tube through the digestive tract.
This method can reach a blocked bile duct and remove a stone. However, it does not remove stones that remain in the gallbladder.
Some people may also need gallbladder removal. The plan depends on the stone’s location and any complications. A person’s overall health also guides treatment.
Nonsurgical dissolution treatment
Doctors sometimes use nonsurgical treatment for cholesterol stones2. These treatments are only suitable for selected people2. Pigment stones usually need surgery when treatment is required2.
Dissolution medicines slowly break down certain cholesterol stones2. Treatment may take months or years2. Gallstones can return after the medicine is stopped2.
These limits make medicine less useful for many symptomatic patients. Nonsurgical treatment mainly applies to selected cholesterol stones2. A healthcare professional must decide whether it is a suitable option.
Conclusion
Understanding gallstones symptoms causes treatment and warning signs can support safer choices. Silent stones often need no treatment1,2. Stones that block bile flow can cause pain or serious harm1,5.
A gallbladder attack often causes steady pain in the upper abdomen1,5. The pain may begin after a heavy or high-fat meal1,5. Later attacks are likely after a first painful episode1.
Seek medical advice for pain that keeps returning2. Get urgent help for severe pain, fever, chills, or jaundice1,9. Dark urine, pale stools, or repeated vomiting are also gallstone warning signs1.
Abdominal ultrasound often starts the diagnostic process10. Laparoscopic gallbladder removal is the standard treatment for most symptomatic stones2,5. Prompt care can help doctors find and treat serious gallstone complications.
Evidence used in this article
- 1. Symptoms & Causes of Gallstones - NIDDK
Symptoms & Causes of Gallstones - NIDDK
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2. Health Information
3. Digestive Diseases
4. Gallstones
5. Symptoms & Causes
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English
# Symptoms & Causes of Gallstones
## What are the symptoms of gallstones?
If gallstones block your bile ducts, bile could build up in your gallbladder, causing a gallbladder attack, sometimes called biliary colic. Gallbladder attacks usually cause pain in your upper right abdomen, sometimes lasting several hours. Gallbladder attacks often fol
- 2. Treatment for Gallstones - NIDDK
Treatment for Gallstones - NIDDK
Related Topics
English
# Treatment for Gallstones
## How do health care professionals treat gallstones?
If your gallstones are not causing symptoms, you probably don’t need treatment. However, if you are having a gallbladder attack or other symptoms, contact your doctor. Although your symptoms may go away, they may appear again and you may need treatment. Your doctor may refer to you a gastroenterologist or surgeon for treatment.
The usual treatment for gal
- 3. Gallstones: MedlinePlus Medical Encyclopedia
Gallstones: MedlinePlus Medical Encyclopedia Skip navigation
URL of this page: //medlineplus.gov/ency/article/000273.htm
# Gallstones
Gallstones are hard deposits that form inside the gallbladder. These may be as small as a grain of sand or as large as a golf ball.
## Causes
The cause of gallstones varies. There are two main types of gallstones:
- Stones made of cholesterol -- This is the most common type. Cholesterol gallstones are not related to the cholesterol level in the blood. In mos
- 4. Gallstones | Cholelithiasis | MedlinePlus
Gallstones | Cholelithiasis | MedlinePlus Skip navigation
URL of this page: https://medlineplus.gov/gallstones.html
# Gallstones
Also called: Cholelithiasis
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- 5. Gallstones (Cholelithiasis) - StatPearls - NCBI Bookshelf
Gallstones are crystallized deposits forming in the gallbladder or biliary tree, primarily composed of cholesterol, bilirubin, and bile. These stones often remain asymptomatic, detected incidentally during imaging, but can lead to significant complications such as biliary colic, acute cholecystitis, cholangitis, or pancreatitis. Biliary colic manifests as intermittent right upper abdominal pain, often triggered by greasy or spicy foods, due to gallbladder contraction against obstructing stones.
- 6. Definition & Facts for Gallstones - NIDDK
Definition & Facts for Gallstones - NIDDK
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# Definition & Facts for Gallstones
In this section:
- What are gallstones?
- Do gallstones have another name?
- What is the biliary tract?
- How common are gallstones?
- Who is more likely to develop gallstones?
- What are the complications of gallstones?
## What are gallstones?
Gallstones are hard, pebble-like pieces of material, usual
- 7. Gallstones (Cholelithiasis): Symptoms, Causes & Treatment
Gallstones (cholelithiasis) are hardened pieces of bile that form in your gallbladder or bile ducts. They’re common, especially in females. Gallstones don’t always cause problems, but they can if they get stuck in your biliary tract and block your bile flow. If your gallstones cause you symptoms, you’ll need treatment to remove them — typically, surgery.
...
Gallstones (cholelithiasis) won’t necessarily cause any problems for you. A lot of people have them and never know it. But gallstones can b
- 8. Gallstones - Symptoms & causes
Gallstones - Symptoms & causes - Mayo Clinic
## On this page
Overview
Symptoms
When to see a doctor
Causes
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Prevention
---
## Overview
Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that's released into your small intestine.
### Gallstones
Gallstones are hardene
- 9. Gallstones | Johns Hopkins Medicine
Gallstones | Johns Hopkins Medicine
# Gallstones
## What are gallstones?
Gallstones form when bile stored in the gallbladder hardens into stone-like material. Too much cholesterol, bile salts, or bilirubin (bile pigment) can cause gallstones.
When gallstones are present in the gallbladder itself, it is called cholelithiasis. When gallstones are present in the bile ducts, it is called choledocholithiasis. Gallstones that obstruct bile ducts can lead to a severe or life-threatening infection o
- 10. Gallstones - Diagnosis & treatment - Mayo Clinic
Gallstones - Diagnosis & treatment - Mayo Clinic
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## Diagnosis
Tests and procedures used to diagnose gallstones and complications of gallstones include:
- Abdominal ultrasound. This test is the one most commonly used to look for signs of gallstones. Abdominal ultrasound involves moving a device (transducer) back and forth across your stomach area. The transducer sends signals to a computer, which creates images that sh
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