Gallstones
Gallstones are hardened deposits that form in the gallbladder. Most never cause symptoms, but stones that block the cystic duct or common bile duct can trigger biliary colic, acute cholecystitis, jaundice or pancreatitis.
At a glance
Quick facts
- Category
- Biliary / gallbladder condition
- Often asymptomatic
- Yes
- Typical attack
- Upper-right abdominal pain
- First-line imaging
- Ultrasound
- Usual treatment when symptomatic
- Cholecystectomy
- Important complications
- Cholecystitis, duct stones, pancreatitis
Dr. Francis Chibueze Nwokpoku
Medical Officer · 9th Division Hospital, Nigerian Army
Reviewed for clinical accuracy, important omissions and patient-facing safety wording.
Names & terminology
How this entity may be named or searched
- Gallstones
- Solid deposits formed from components of bile.
- Cholelithiasis
- Medical term for gallstones in the gallbladder.
- Biliary colic / gallbladder attack
- Pain caused by temporary blockage of bile flow, usually by a stone.
- Choledocholithiasis
- A gallstone located in the common bile duct rather than the gallbladder.
Structured entity profile
Clinical profile
Overview
Gallstones form when bile components crystallize inside the gallbladder. NIDDK estimates that 10–15% of the U.S. population has gallstones, roughly 25 million people. Most are silent. [1]
Symptoms begin when a stone blocks bile flow. A transient blockage can produce biliary colic; persistent obstruction can cause acute cholecystitis or other complications. [2]
Symptoms and warning signs
A typical gallbladder attack causes pain in the upper right abdomen and may last several hours. Nausea or vomiting can accompany the pain. Fever, jaundice, dark urine, pale stool or pain that persists for hours can indicate a complication. [2]
SYMPTOM MATRIX
Silent gallstones and complicated gallstone disease are very different
Persistent pain, fever or jaundice needs medical assessment rather than routine self-care.
- Upper-right abdominal pain
- Pain after a heavy meal
- Pain lasting minutes to hours
- Nausea or vomiting
- Recurrent episodes
- No symptoms at all
- Upper-middle abdominal pain
- Pain radiating toward back or shoulder
- Bloating or food-related discomfort
- Pain lasting several hours
- Fever or chills
- Jaundice
- Dark urine or pale stools
- Persistent vomiting
These features can indicate gallbladder inflammation, bile-duct obstruction or pancreatitis.
Diagnosis
History and examination are followed by laboratory and imaging tests when gallstone disease is suspected. Ultrasound is the preferred imaging test for gallbladder stones. Blood tests can show infection, inflammation or liver and pancreatic abnormalities. [3]
MRCP or endoscopic ultrasound can evaluate the bile ducts when common-bile-duct stones are suspected. ERCP is generally reserved for therapeutic management of duct stones rather than routine diagnosis. [3] [4]
Diagnostic pathway
Start with ultrasound and assess for duct obstruction
The key distinction is between uncomplicated gallbladder stones and stones causing inflammation or obstruction.
Ultrasound is the usual first-line gallbladder test; CT is useful for some complications but can miss certain gallstones. Source [3]
Complications of gallstones
Gallstones can cause acute cholecystitis, common-bile-duct stones, cholangitis and gallstone pancreatitis. Fever, jaundice, persistent severe pain or systemic illness changes the problem from routine biliary colic to urgent gallstone disease. [2] [3]
Treatment and management
Silent gallstones usually do not need treatment. For symptomatic gallbladder stones, the usual definitive treatment is laparoscopic cholecystectomy. People can live without a gallbladder because bile flows directly from the liver to the intestine. [4]
Stones in the common bile duct may be removed with ERCP, often in connection with cholecystectomy. Treatment timing depends on whether there is cholecystitis, pancreatitis, cholangitis or another complication. [4] [5]
Treatment & care hub
Treat symptoms and complications, not silent stones
Management is driven by whether stones are causing pain, obstruction or inflammation.
No routine treatment for asymptomatic stones
Incidentally found gallstones in an otherwise normal gallbladder usually do not require treatment.
Remove the gallbladder
Laparoscopic surgery is the usual definitive treatment for recurrent symptomatic gallbladder stones.
Clear the common bile duct
Endoscopic treatment can remove obstructing common-bile-duct stones in selected patients.
Treat infection or pancreatitis
Cholecystitis, cholangitis and gallstone pancreatitis require hospital-based assessment and treatment.
Living without a gallbladder
The gallbladder is not essential. After removal, bile flows continuously from the liver into the intestine. Most people return to a normal diet, although some have temporary digestive changes during recovery. [4]
United States estimate
Gallstones affect about 10–15% of the U.S. population
NIDDK estimates nearly 25 million people in the United States have gallstones.
Common questions
Frequently asked questions
No. Most silent gallstones do not need treatment unless they begin causing symptoms or complications.
It commonly causes steady pain in the upper right abdomen, often after a meal, and may last for several hours.
Ultrasound is the preferred first-line imaging test for gallbladder stones.
Laparoscopic cholecystectomy is the usual definitive treatment for symptomatic gallbladder stones.
A stone can obstruct the shared drainage area of the bile and pancreatic ducts, triggering pancreatic inflammation.
Sources
- NIDDK, NIH — Definition & Facts for Gallstones
- NIDDK, NIH — Symptoms & Causes of Gallstones
- NIDDK, NIH — Diagnosis of Gallstones
- NIDDK, NIH — Treatment for Gallstones
- NICE — Gallstone disease: diagnosis and management (CG188)
This article is based on trusted medical sources and has undergone clinician review. It is not a substitute for personalized medical advice.