Attack Of The Gallstones

Overview

Gallstones are small, pebble-like stones that form in the gallbladder, a small pouch that sits under your liver. The gallbladder stores bile, a fluid that helps you digest fatty foods. Most gallstones are made of cholesterol, but some can be made of other substances found in bile.

Yes, gallstones are very common. It's estimated that about 1 in 10 adults in the UK have gallstones, though many don't know it because they don't cause symptoms.

Gallstones are more common in women, especially those who have been pregnant or take hormone replacement therapy. They also become more likely with age, after age 40, in people who are overweight, and in those who have lost a lot of weight very quickly. Family history can also play a role.

Symptoms

Common symptoms

• Sudden, sharp pain in the upper right side of your belly that can last from a few minutes to a few hours
• Pain between your shoulder blades or in your right shoulder
• Nausea or vomiting
• Pain that often happens after a fatty meal, especially in the evening
• Indigestion, bloating, or a feeling of fullness

Symptoms in children

• Gallstones are less common in children, but when they occur, symptoms may include vague abdominal pain, nausea, and discomfort after eating.
• Children may not complain of the classic sharp pain, so it's important to see a doctor if your child has ongoing belly pain.

Symptoms in older adults

• Older adults may have similar symptoms, but sometimes the pain is less intense or more general.
• They may also experience fever, confusion, or a rapid heartbeat if the gallbladder becomes infected — these need urgent medical help.

Causes

Main causes

• Your bile contains too much cholesterol or bilirubin, which can form crystals and then stones.
• Your gallbladder doesn't empty fully or often enough, so bile stays too long and becomes concentrated.
• A combination of these changes can lead to the formation of gallstones over time.

Risk factors

• Being female, especially during pregnancy or if you use hormone replacement therapy
• Being over age 40
• Having a family history of gallstones
• Being overweight or having obesity
• Losing weight very quickly, for example on crash diets or after weight-loss surgery
• Having diabetes, liver disease, or Crohn's disease
• Taking certain medicines, such as some cholesterol-lowering drugs or medicines that contain hormones (ask your doctor about your own medicines)

When to see a doctor

See a doctor urgently if:

• You have any of the emergency symptoms listed above, such as severe pain, fever, jaundice, or repeated vomiting.
• You are unable to keep liquids down for more than a few hours.

Book a routine appointment if:

• You have recurring belly pain, especially after meals, that interferes with your daily life.
• You have been feeling nauseated or bloated often after eating fatty foods.
• You notice any dark urine or pale stools for more than a day.

Diagnosis

A doctor will first ask about your symptoms and do a physical exam, pressing on your belly to check for tenderness. They will likely order an ultrasound, which is a painless test that uses sound waves to create a picture of your gallbladder and look for stones.

Tests that may be done

• Ultrasound of the abdomen — the main test used to find gallstones.
• Blood tests — to check for signs of infection, jaundice, or inflammation of the pancreas.
• CT scan or MRI — sometimes used if the ultrasound is unclear or to look for complications.
• HIDA scan — a test that tracks bile movement from the gallbladder to the intestine, used less often.

What to expect at your appointment

Your doctor will explain what the tests show and what that means for you. If gallstones are found but you don't have symptoms, they may suggest no treatment and just monitoring. If your symptoms are significant, they will talk about your options, which may include surgery to remove the gallbladder.

Treatment

Treatment depends on whether your gallstones are causing symptoms. If you have no symptoms, you likely won't need treatment. If you have pain or other problems, the most common and effective treatment is surgery to remove the gallbladder. In some cases, medication can be used, but it's not as effective and takes a long time.

Self-care at home

• Rest during an episode of pain and avoid heavy meals.
• Eat small, low-fat meals more often, rather than large, fatty ones.
• Drink plenty of water but avoid sugary or fizzy drinks.
• Avoid fried, greasy, and processed foods that can trigger pain.
• Do not try to treat the pain with home remedies without speaking to a doctor.

Medical treatments

There is no pill that reliably cures gallstones. In a small number of people, a medicine can be given by mouth to try to dissolve cholesterol gallstones, but this takes months or years, works only for small stones, and stones often come back after stopping treatment. Other procedures, such as shock wave therapy, are rarely used now. The standard treatment for gallstones that cause problems is surgery to remove the gallbladder.

When is surgery considered?

Surgery to remove the gallbladder (cholecystectomy) is recommended when gallstones cause frequent pain, inflammation, or complications. This is usually done with keyhole surgery, meaning smaller cuts and a quicker recovery. Most people go home within a day or two and can return to normal activities within a few weeks.

Living with this condition

After gallbladder removal, most people have no problems with digestion. Without a gallbladder, bile flows directly from your liver into your intestine. Some people notice loose stools or bloating, especially after very fatty meals, but this usually settles over time. You can eat normally, though a balanced, low-fat diet may help.

Lifestyle tips

• Maintain a healthy weight for your body.
• If you need to lose weight, do it gradually — rapid weight loss can make gallstones more likely.
• Stay physically active with regular exercise, like walking, swimming, or cycling.
• Avoid smoking and limit alcohol, as these can affect your liver and digestive system.

Diet and exercise

Eat a diet rich in fruits, vegetables, and whole grains. Choose lean proteins like chicken, fish, beans, and lentils, and healthy fats from nuts, avocados, and olive oil. Try to limit saturated fats and processed foods. Exercise for at least 30 minutes most days — this supports healthy bile flow and overall well-being.

Mental health and emotional wellbeing

Dealing with recurrent gallstone pain can be stressful and tiring. Chronic pain can affect your mood, sleep, and quality of life. If you feel anxious or depressed, it's important to talk to your doctor. They can offer support, and if you're having surgery, you may want to ask about what to expect during recovery.

Prevention

You may be able to lower your risk of gallstones by keeping a healthy weight, eating a balanced diet low in saturated fat, and avoiding crash diets. Regular exercise also helps. If you have a family history of gallstones, you can't change that, but you can still take these steps to protect your digestive health.

Vaccines

There is no vaccine to prevent gallstones.

Screening programmes

No routine screening test is recommended for people without symptoms. If you have risk factors, your doctor may consider testing if you develop symptoms.

Complications

If left untreated

• Inflammation of the gallbladder (cholecystitis) — can cause severe pain, fever, and infection.
• A gallstone blocking the bile duct — can cause jaundice, infection, and severe illness.
• Acute pancreatitis — inflammation of the pancreas, which can be dangerous.
• Gallstones in the intestine — rare but can cause a blockage.

Long-term outlook

Most people with gallstones never have any problems. For those who do get symptoms, treatment is very effective and safe. Removing the gallbladder is a common operation with excellent results, and most people return to their normal lives without long-term issues. With the right care and follow-up, the outlook is very good.

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