GallBladder Stones (Gallstones)

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GallBladder Stones (Gallstones)

Gallbladder is a small pear-shaped sac located under the lobes of liver.  It stores bile juice (a secretion from liver) that helps in the digestion of fats.  When the food reaches the intestine, gallbladder releases the bile into the intestine through a duct called common bile duct.

Gallstones are usually formed due the development of hard crystals of the digestive fluid. 

Simplistic Illustration of Gallbladder
Simplistic Illustration of Gallbladder

Complete or partial blockage of the bile duct can cause severe pain in the upper right side of the abdomen, however some patient do not experience any pain.

Typically, the pain is sudden and may last for many hours.   Gallstones range greatly in terms of size and can be as big as a golf ball or as small as a grain of sand.  It is possible to have multiple stones and these can be of varying sizes. 


The signs and symptoms vary greatly and some people do not even know they have stones. About 80% of people who have gallstones do not experience any symptom or pain and thus no treatment is needed.

Symptoms generally occur when a stone blocks the duct in the gallbladder and may 

Illustration of Liver and Gall Bladder
Illustration of Liver and Gall Bladder


  • Upper right abdominal pain that gets worse quickly and comes on suddenly (that is called gallbladder attack)
  • Right shoulder pain and upper right back pain
  • May feel nausea and vomiting
  • Pain can last from one to several hours. Pain usually starts after heavy meals
  • It can cause infection in the bile duct or liver resulting in fever and yellowing of skin (jaundice)
  • If untreated, gallstone can result in severe complications

There are two main types of gallstones, including pigment gallstones and cholesterol gallstones. 

The pigment type results from too much bilirubin in the bile and they are black or dark brown in color. 

The cholesterol type are made from many components, but cholesterol that is not dissolved is the most common component.  This is the most common gallstone type (more than 80%) and they are usually yellow in color.

Doctors do not fully understand why people get gallstones, but there are a few things that are thought to lead to them, including:

  • Too much cholesterol in the bile
  • The gallbladder does not empty properly
  • Too much bilirubin in the bile

There are many known risk factors for gallstones that everyone should be aware of.  These stones are quite common, but you have a higher risk of developing them if you have the following risk factors:

  • Being female
  • Being obese or overweight
  • Eating too much fat or high cholesterol containing food
  • Not eating enough fiber
  • Having diabetes
  • Taking certain medications to lower cholesterol
  • Being 60 years of age or older
  • Being pregnant
  • Having family members with gallstones
  • Losing weight rapidly
  • Taking medications with estrogen in them 

It is not hard for the doctor to diagnose gallstones.  In addition to a physical examination, learning about the patient’s medical history and talking about symptoms, the following tests may be done:

Common imaging tests

Ultrasound of the abdomen and CT scans allow the doctor to see the gallbladder and the other organs closely.  Gallstones may be visible on the different scans and images.

 Blood testing

Blood is drawn to see if any gallstone complications are happening.  These tests can show things like jaundice, infection and pancreatitis.

 Advanced imaging

If the ultrasound and CT scan is not showing enough, the doctor may want to get more advanced scans to see if the patient has a blockage due to a gallstone.  Common tests include magnetic resonance imaging (MRI), hepatobiliary iminodiacetic acid scan (HIDA) and endoscopic retrograde cholangiopancreatography (ERCP).  If the doctor finds gallstones during the ERCP test, they can remove them right then.

If gallstone is not causing problems, the patient does not require treatment. 

In fact, many people have gallstones and have no idea they have them.  The doctor may suggest just keeping an eye on them and doing some testing from time to time.  If the stones are in a sensitive area or are blocking the bile duct, they should be treated to prevent complications.  Treatment options for gallstones include the following:

Dissolving medications

Some people are able to take medications that can dissolve their gallstones, allowing them to avoid surgery. However, not everyone has luck with medication and there is no guarantee it will work.  These medications can also take months or longer to work.  In many cases, these medications are considered for people who cannot have surgery.

 Open Cholecystectomy

This is a surgery where the doctor removes the gallbladder. Once the patient has gallstones, there is a high risk that the patient will get them again so removing the gallbladder helps to prevent this.  A person can live without the gallbladder and not having one usually does not cause problems in the long-term.  Some people have short-term diarrhea right after the surgery, but this is usually temporary. 

Laparoscopic cholecystectomy surgery is carried out by making a few small holes in the abdomen through which laparoscope (flexible tube with camera) is inserted. The surgeon can remove the gall bladder without making big incisions.

Those with gallstones are at risk for a few different complications, all of which vary in severity.  These may include:

  • Common bile duct blockage:  This duct lets bile get from the liver or gallbladder to the small intestine.  It can get blocked, blocking bile flow.
  • Gallbladder cancer:  This is a very rare cancer, but those who have a history of gallstones are at an increased risk.
  • Gallbladder inflammation:  Gallbladder inflammation can occur if a gallstone gets stuck in the gallbladder neck.
  • Pancreatic duct blockage:  This is a duct that lets certain juices used for digestion get to their destination. A gallstone can get lodged in this duct and cause pancreatitis, a condition that usually means patient may have to spend time in the hospital.

Make sure to follow the treatment plan exactly and if the pain gets severe, consult with doctor right away.  The doctor may also recommend some diet adjustments, such as eating a low-fat diet.  Also eat regularly and avoid skipping meals whenever possible. 

Make sure to maintain a healthy weight and eat a well-balanced diet.  If needed to lose weight, do not lose more than two pounds per week because losing weight too fast can heighten gallstone risk.

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