Gallstones
What Are Gallstones?
Gallstones are hardened deposits that form in the gallbladder, a small organ under the liver that stores bile — a digestive fluid that helps break down fats. Gallstones vary in size and number, and while some cause no symptoms, others can block bile flow and lead to pain, inflammation, or infection.
Gallstone disease (cholelithiasis) is common, and many people live with gallstones without knowing it. When gallstones cause symptoms or complications, medical or surgical treatment is often necessary.
Causes and Risk Factors
Gallstones form when substances in bile, such as cholesterol or bilirubin, become imbalanced and crystallize. Risk factors include:
- Being female
- Age over 40
- Obesity or rapid weight changes
- Family history of gallstones
- Diabetes or high cholesterol
- Pregnancy or hormone therapy
- Certain blood disorders
These factors may increase cholesterol levels in bile or reduce gallbladder contraction, promoting stone formation.
Signs and Symptoms
Many gallstones are silent and cause no symptoms. When gallstones block a bile duct or irritate the gallbladder, symptoms may include:
- Sudden, intense pain in the upper right or middle abdomen
- Pain that radiates to the back or right shoulder
- Nausea or vomiting
- Indigestion, bloating, or gas after meals
- Fever and chills (suggesting infection)
Such episodes are commonly referred to as biliary colic when temporary, or cholecystitis when inflammation occurs.
Diagnosis
Gallstones are usually diagnosed with imaging and clinical evaluation. Common diagnostic tools include:
- Abdominal ultrasound — the most common test to visualize stones
- CT scan or MRI — used when ultrasound results are unclear
- Blood tests — to check for signs of inflammation, infection, or bile duct obstruction
These studies help confirm the presence of stones and assess any complications such as inflammation or blockage.
Treatment Options
Treatment for gallstones depends on symptoms and complications:
- Observation — silent gallstones without symptoms may not require immediate treatment.
- Medications — oral bile acids may dissolve certain cholesterol stones in select patients, though this approach is slow and not widely used.
- Cholecystectomy — surgical removal of the gallbladder is the definitive treatment for symptomatic gallstones, most often performed laparoscopically for faster recovery.
When gallstones cause repeated pain, inflammation, or complications like pancreatitis or choledocholithiasis (stones in the bile duct), surgery is typically recommended.
