Gallstones

Overview

Gallstones are small, hard pebble-like deposits that form inside your gallbladder. The gallbladder is a small, pear-shaped organ under your liver that stores bile, a fluid that helps digest fat.

Yes, gallstones are very common. They affect about 10 to 15 percent of people in the United States and the United Kingdom.

Gallstones are more common in women, people over 40, those who are overweight or obese, and individuals with a family history of gallstones. They also occur more often in people of Native American, Mexican American, and certain European backgrounds.

Symptoms

Common symptoms

• Sudden and severe pain in the upper right part of your belly, often after a fatty meal
• Pain in your right shoulder or between your shoulder blades
• Nausea or vomiting
• Indigestion, bloating, or gas

Symptoms in children

• In children, symptoms may be similar but often less specific, such as belly pain, nausea, and sometimes jaundice (yellowing of the skin or eyes).

Symptoms in older adults

• Older adults may have fewer or milder symptoms, or they may experience confusion or a general sense of feeling unwell, which can make diagnosis more challenging.

Causes

Main causes

• Your bile may contain too much cholesterol, which can form into stones.
• Your bile may contain too much bilirubin, a waste product from broken-down red blood cells.
• Your gallbladder may not empty fully or often enough, allowing bile to become concentrated and form stones.

Risk factors

• Being female, especially if you have had multiple pregnancies
• Being over 40 years old
• Having obesity or being overweight
• Eating a high-fat, low-fiber diet
• Losing weight very quickly (for example, after bariatric surgery or a crash diet)
• Having a family history of gallstones
• Having certain medical conditions, such as diabetes or cirrhosis of the liver
• Taking some medications, such as those that lower cholesterol or contain estrogen

When to see a doctor

See a doctor urgently if:

• If you have severe belly pain that does not go away
• If you have a fever, chills, or jaundice
• If you are vomiting repeatedly and cannot keep down fluids

Book a routine appointment if:

• If you have mild but recurring belly pain after eating
• If you have frequent indigestion or bloating that bothers you

Diagnosis

Gallstones are usually found with a simple, painless ultrasound scan of your belly. This test uses sound waves to create images of your gallbladder and bile ducts.

Tests that may be done

• Abdominal ultrasound – the most common test, fast and comfortable
• Blood tests – to check for signs of infection, blockages, or jaundice
• HIDA scan (cholescintigraphy) – shows how well your gallbladder is working
• Magnetic resonance cholangiopancreatography (MRCP) – an MRI that gives detailed images of the bile ducts
• Endoscopic ultrasound (EUS) – a thin tube with a camera that provides close-up views

What to expect at your appointment

You will likely have an ultrasound first. You may be asked to stop eating for several hours before the scan. The test is painless and usually takes about 30 minutes. Your doctor will discuss the results with you and decide if further tests are needed.

Treatment

Treatment depends on whether you have symptoms. If you do not have symptoms, you usually do not need any treatment. If you have symptoms, the most common treatment is surgery to remove the gallbladder. There are also medications that can sometimes dissolve stones, but they are slow and only work for small, cholesterol-based stones.

Self-care at home

• Eat a balanced, low-fat diet to reduce the chance of attacks
• Maintain a healthy weight through gentle, steady weight loss if needed – avoid crash diets
• Stay active with regular exercise, such as walking or swimming

Medical treatments

If your gallstones are causing symptoms, your healthcare provider may recommend medications that can help dissolve the stones. These medications are taken by mouth over many months, but they do not work for everyone and stones may return if treatment stops. Some people may also undergo a procedure called endoscopic retrograde cholangiopancreatography (ERCP) to remove stones that have moved into the bile ducts.

When is surgery considered?

Surgery to remove the gallbladder (cholecystectomy) is often recommended if you have repeated episodes of pain or complications such as cholecystitis (inflammation of the gallbladder) or pancreatitis (inflammation of the pancreas). It is usually done with keyhole surgery (laparoscopically), which has a quick recovery time.

Living with this condition

If you have gallstones without symptoms, you can live normally without any restrictions. If you have symptoms, taking simple steps like eating smaller, lower-fat meals may help prevent attacks. After gallbladder removal, most people adapt well and can eat a normal diet.

Lifestyle tips

• Eat regular meals and avoid skipping meals to keep bile flowing
• Limit high-fat and fried foods
• Increase fiber from fruits, vegetables, and whole grains
• Stay at a healthy weight – if you need to lose weight, do it slowly (no more than 1 to 2 pounds per week)
• Avoid rapid weight loss or very low-calorie diets

Diet and exercise

A heart-healthy, low-fat diet is best for your gallbladder. Aim for plenty of fruits, vegetables, lean proteins, and whole grains. Regular moderate exercise, like brisk walking for 30 minutes a day, helps maintain a healthy weight and can reduce your risk of further problems.

Mental health and emotional wellbeing

Living with gallstones can be stressful, especially if you experience sudden pain attacks. It is normal to feel anxious about when the next attack might come. Talking to your healthcare provider about treatment options can ease your mind, and many people find that once they are treated, their quality of life improves.

Prevention

There is no sure way to prevent gallstones, but you can lower your risk by maintaining a healthy weight, eating a balanced diet that is low in fat and high in fiber, and avoiding rapid weight loss. Regular exercise also helps.

Complications

If left untreated

• Cholecystitis (inflammation of the gallbladder) – can cause severe pain, fever, and infection
• Gallstone pancreatitis (inflammation of the pancreas) – a serious condition that needs hospital care
• Blocked bile ducts – can lead to jaundice, infection, and liver problems
• Gallbladder cancer – very rare, but gallstones are a risk factor

Long-term outlook

The outlook for people with gallstones is very good. Many people have no symptoms and never need treatment. For those who do have symptoms, gallbladder removal is safe and effective, and most people recover fully and can enjoy a normal, healthy life without a gallbladder.

Find support

International organisations

• World Gastroenterology Organisation ↗

Local organisations

• British Liver Trust ↗ · United Kingdom
• Guts UK ↗ · United Kingdom

Helplines

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