Gallstones: Symptoms, Treatment & Prevention

What Causes Gallstones?

Your gallbladder stores bile, a digestive fluid produced by your liver to help break down fats. Gallstones form when the balance of substances in your bile shifts, causing crystals to harden into stones. Gallstones may develop when:

• Bile contains too much cholesterol, which can form crystals
• Bile contains excess bilirubin, a substance produced during red blood cell breakdown
• The gallbladder does not empty completely or often enough

Over time, these substances can combine and grow into stones. Your risk of developing gallstones may be higher if you:

• Have a family history of gallstones
• Are over 40
• Are female
• Have experienced rapid weight loss, which can cause the liver to release extra cholesterol into bile
• Pregnancy
• Follow a diet high in fat or low in fiber
• Are obese
• Have diabetes or metabolic syndrome

“Understanding your risk factors helps us have more informed conversations about prevention," said Dr. Kumar. "If you have a family history or other risk factors, we may recommend earlier screening or lifestyle modifications that can lower those risks.”

Gallstones Symptoms

Many people with gallstones experience no symptoms. Approximately 70-80% of gallstones are asymptomatic. However, symptoms can appear suddenly when a stone blocks a bile duct. This is called a gallbladder attack or biliary colic, and it often leads to intense pain.

The most common gallstones symptoms include:

• Sudden, steady pain in the upper right portion of the abdomen
• Pain that spreads to the right shoulder or between the shoulder blades
• Pain that lasts from several minutes to several hours
• Pain that wakes you in the middle of the night
• Pain that occurs after eating fatty meals

Along with pain, other symptoms may include:

• Bloating or abdominal discomfort
• Indigestion, especially after eating fatty foods
• Nausea or vomiting
• Dyspepsia – burning in the upper abdomen combined with pain, bloating, nausea, belching, and feeling uncomfortably full

In certain cases, symptoms may signal a more serious problem. Warning signs include fever, chills or yellowing of the skin or eyes (jaundice), and persistent, severe pain, which can indicate a blockage that requires immediate medical attention.

Are Gallstones Dangerous?

Most gallstones never cause problems. However, when a stone blocks the flow of bile or causes swelling, complications can develop, and this is when medical care is necessary. Possible complications include:

• Gallbladder inflammation (cholecystitis) — A trapped stone can prevent the gallbladder from emptying properly, causing severe pain, fever and nausea. Treatment often includes gallbladder removal.
• Bile duct blockage — Gallstones can move from the gallbladder into the bile ducts, including the common bile duct. This may cause jaundice, pain and infection.
• Infection — When bile flow is blocked, bacteria can build up in the gallbladder or bile ducts. This can lead to fever, chills and abdominal pain. Infections require medical treatment and may become serious if not treated.
• Pancreatitis — A gallstone can block the pancreatic duct, causing inflammation of the pancreas, known as pancreatitis. This leads to severe pain, nausea and vomiting. Pancreatitis usually requires a cholecystectomy and hospitalization, followed by inpatient management.

Early evaluation and treatment can help prevent these complications.

Diagnosis: Finding the Stones

Your physician uses several imaging tests and procedures to confirm the presence of gallstones and determine if you need treatment. These tests tell us whether gallstones are causing symptoms or complications. The most common diagnostic test is an ultrasound.

If necessary, additional tests may include:

• HIDA scan — measures how well the gallbladder releases bile
• ERCP (Endoscopic Retrograde Cholangiopancreatography) — identifies and treats problems in the liver, gallbladder, bile ducts and pancreas
• MRCP (Magnetic Resonance Cholangiopancreatography)
• Endoscopic Ultrasound
• Blood tests — detect infection, inflammation or bile duct blockage
• Liver function tests

Gallstones Treatment Options

If you have been diagnosed with gallstones, your treatment plan depends on your symptoms and how they affect your daily life. Many people with silent gallstones live comfortably without any intervention. For others experiencing symptoms, treatment can bring real relief and prevent future complications.

Surgical Treatment

When symptoms become frequent or severe, many physicians recommend removing the gallbladder — a procedure called laparoscopic cholecystectomy. This is a safe and commonly performed procedure that is highly successful in relieving symptoms. After the procedure, bile flows directly from the liver to the small intestine. This may sound daunting, but it is one of the most common surgical procedures performed today, and most patients experience significant relief afterward.

“Gallbladder removal is safe and highly effective,” said Dr. Kumar. “Most patients recover quickly and return to their normal lives without ongoing symptoms.”

Nonsurgical Options

For some patients, surgery may not be the right choice. In these situations, physicians may recommend nonsurgical alternatives.

For a small percentage of patients - oral bile acid medications may be used to help dissolve small cholesterol stones. Physicians typically recommend this treatment when surgery is not possible or when patients need a different approach based on their overall health.

Reducing the Risk - Gallstone Prevention

Although gallstones cannot always be prevented, certain lifestyle habits can lower your risk and support a healthy digestive system. You can help protect your gallbladder by making small, consistent changes:

• Maintain a healthy weight — If you need to lose weight, aim for gradual, steady progress.
• Avoid rapid weight loss — Extreme diets, skipping meals or rapid weight-loss programs can increase gallstone risk. Instead, focus on steady weight loss of about one to two pounds per week through healthy eating and physical activity.
• Eat a balanced diet with healthy fats and fiber — Try adding foods like fruits, vegetables, whole grains, beans and lentils. Choose healthy fats from sources such as olive oil, nuts, seeds and fish. Replace fried foods with grilled chicken, roasted vegetables or whole grains like brown rice or quinoa.
• Stay hydrated — Drinking enough water helps support digestion and keeps bile moving normally.
• Limit highly processed foods — Foods high in refined carbohydrates and unhealthy fats can increase gallstone risk.
• Manage diabetes and other metabolic conditions.

Fiber helps bile move efficiently through the digestive system, while healthy fats support normal gallbladder function. Over time, these consistent habits can help reduce your risk of gallstones and improve overall digestive health.

When to See a Physician for Gallstones

Recurring abdominal pain, especially after eating, may be a sign that gallstones are affecting your digestive system. Early evaluation can help your physician identify the cause of your symptoms and recommend the most appropriate treatment.

If pain continues, is accompanied by fever, worsens or begins to interfere with daily activities, speak with your physician. Getting care early can help prevent complications.