Gallstones
Also known as Cholelithiasis, Biliary colic
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is gallstones?
Gallstones are hardened deposits that form in the gallbladder, most commonly from cholesterol. Many people have them without symptoms and need no treatment. Problems arise when a stone obstructs a duct, causing episodic severe right upper abdominal pain, or leads to inflammation, jaundice or pancreatitis.
Causes
- Excess cholesterol in bile forming stones
- Excess bilirubin producing pigment stones
- Incomplete or infrequent gallbladder emptying
- Rapid weight loss altering bile composition
Symptoms
- Severe steady pain in the right upper abdomen
- Pain radiating to the right shoulder blade
- Onset after fatty meals, often lasting hours
- Nausea and vomiting
- Fever and persistent pain suggesting inflammation
- Jaundice if the bile duct is blocked
Risk factors
- Female sex
- Age over 40
- Obesity and rapid weight loss
- Pregnancy
- Family history
- Diabetes and high triglycerides
- Haemolytic conditions for pigment stones
Diagnosis
- Abdominal ultrasound, the first line test
- Liver function tests to detect duct obstruction
- Amylase or lipase to assess for pancreatitis
- MRCP to visualise the bile ducts
- Endoscopic ultrasound in selected cases
Treatment
- No treatment for asymptomatic stones in most people
- Analgesia for biliary colic
- Laparoscopic cholecystectomy for recurrent symptoms
- Antibiotics and admission for acute cholecystitis
- ERCP to remove stones from the bile duct
- Low fat diet to reduce symptom episodes while awaiting surgery
Self care
- Eat a lower fat diet while awaiting treatment to reduce attacks
- Eat regular meals rather than skipping and then eating heavily
- Lose weight gradually, since rapid loss forms more stones
- Stay well hydrated
- Use paracetamol for mild pain
- Keep a record of what triggers attacks
When to see a doctor
Book an appointment if:
- Repeated episodes of upper right abdominal pain
- Pain reliably following fatty meals
- Nausea and bloating with pain
- Gallstones found incidentally, to discuss whether treatment is needed
- Pain interfering with daily life
- Any yellowing of the skin or eyes
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- Maintain a stable healthy weight and avoid crash dieting
- Eat regular meals with adequate fibre
- Stay physically active
- Manage diabetes and high triglycerides
- Include healthy fats rather than eliminating fat entirely
Outlook
Most gallstones never cause symptoms and need no treatment. Once symptoms begin they usually recur, and laparoscopic gallbladder removal is a definitive cure with a quick recovery for most people. Complications such as cholecystitis, bile duct obstruction and pancreatitis are the main reasons for treating symptomatic stones rather than waiting.
Common questions
Do gallstones always need removing?
No. Stones found incidentally without symptoms are usually left alone, since most never cause trouble. Surgery is generally offered once they cause pain or complications.
Can you live normally without a gallbladder?
Yes. Bile flows directly from the liver into the intestine instead of being stored. Some people notice looser stools or fat intolerance initially, which usually settles over weeks to months.
When is gallstone pain an emergency?
Pain lasting more than a few hours with fever, or the development of jaundice with pale stools and dark urine, suggests infection or duct obstruction and needs urgent assessment.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.