Gallstones: Symptoms, Causes, Treatment, and When to Seek Care

Overview

Gallstones are hardened deposits of bile that can form in the gallbladder or bile ducts. Many people with gallstones have no symptoms, while others develop sudden abdominal pain when a stone blocks the normal flow of bile. Gallstones can sometimes lead to serious complications that require medical attention.

How Common Are Gallstones?

Gallstones are quite prevalent worldwide, affecting millions of people each year. In fact, an estimated 10–15% of adults in the United States will develop gallstones at some point in their lives. However, the majority of individuals with gallstones remain unaware of their presence, since most stones do not cause symptoms or require treatment.

What Are Gallstones?

Gallstones are solid particles that form from bile, a digestive fluid produced by the liver and stored in the gallbladder. Stones can range in size from very small (similar to grains of sand) to much larger formations. Gallstones may occur in the gallbladder itself or within the bile ducts.

Many gallstones cause no symptoms and are sometimes discovered incidentally during imaging tests performed for other reasons.

Gallstones vs. Kidney Stones: What’s the Difference?

It’s common to confuse gallstones with kidney stones, but these are two distinct conditions affecting different parts of the body. Gallstones develop in the gallbladder or bile ducts from components of bile, such as cholesterol and bilirubin. In contrast, kidney stones form within the urinary tract, usually composed of minerals like calcium or uric acid.

The main differences include:

• Location: Gallstones reside in the gallbladder, while kidney stones form in the kidneys and move through the urinary tract.
• Pathways: Gallstones travel within the digestive system’s biliary tract; kidney stones follow the urinary tract.
• Symptoms: Kidney stones can cause painful urination and blood in the urine, but these are not signs of gallstones. Gallstones are more likely to cause upper abdominal pain, especially after eating fatty foods.

In summary, although both are called “stones” and can be quite uncomfortable, gallstones and kidney stones involve different organs and symptoms.

Types of Gallstones

Medical sources consistently describe two main types of gallstones:

Cholesterol Gallstones

• The most common type
• Composed mainly of hardened cholesterol
• Often yellow or yellow-green in color

Pigment Gallstones

• Less common than cholesterol stones
• Dark brown or black in color
• Made primarily from bilirubin, a substance produced when red blood cells break down

Symptoms and Pain Patterns

Common Symptoms

Many people with gallstones experience no symptoms. When symptoms do occur, they usually begin suddenly and may include:

• Pain in the upper right or upper middle abdomen
• Pain that may spread to the back or right shoulder
• Nausea or vomiting

Are Gallstone Symptoms Different in Females?

While gallstone symptoms are generally similar across all adults, there are some subtle differences observed in females. For example:

• Females are somewhat more likely to experience “referred pain,” where discomfort is felt not just in the abdomen, but also in the back, chest, right shoulder, or even down the arm.
• Chronic or fluctuating pain—such as that seen with biliary colic—may be more commonly reported or overlooked in females. This can occasionally lead to delays in seeking treatment, particularly if symptoms seem mild or intermittent.

Regardless of gender, any severe or recurring abdominal pain deserves medical attention, especially if it’s associated with nausea or other digestive symptoms. After an initial gallstone episode, the chance of further attacks increases, so timely evaluation is important.

Can Gallstones Cause Fatigue or Dizziness?

While tiredness (fatigue) and dizziness are not classic symptoms of gallstones, they can occasionally occur when complications arise. The typical presentation of gallstones involves abdominal pain, but if a gallstone leads to significant inflammation or infection in the gallbladder or bile ducts, other symptoms may develop.

For example, serious complications such as a severe infection (cholangitis) or inflammation (cholecystitis) can disrupt normal blood circulation. In these cases, some people may experience low blood pressure, which can cause both dizziness and general weakness or fatigue. These symptoms tend to signal a more severe issue requiring prompt medical assessment.

If you are experiencing fatigue or dizziness along with abdominal pain, fever, or jaundice (yellowing of the skin or eyes), seek immediate medical attention.

Biliary Colic

Pain caused by gallstones is often referred to as biliary colic. It typically:

• Begins suddenly and intensifies quickly
• Lasts from several minutes to several hours

This pain occurs when a gallstone temporarily blocks the normal flow of bile, usually by becoming lodged in the biliary tract. In many cases, the pain is felt most acutely after eating—especially following a rich, heavy, or fatty meal. This is because the small intestine senses the presence of fat and signals the gallbladder to contract and release bile to aid in digestion. When a blockage is present, the contraction increases pressure within the system, triggering pain. If the blockage is complete, the pain may be intense and appear rapidly; if partial, discomfort may develop more gradually as the gallbladder works harder to move bile past the obstruction.

Symptoms often subside once the stone moves or the gallbladder relaxes, but recurring episodes are common if the underlying cause is not addressed.

Gallstones vs. Kidney Stones: How Symptoms Differ

It’s easy to confuse gallstones and kidney stones since both can cause severe pain, but they affect different parts of the body and present distinct symptoms.

• Gallstone Symptoms: As described above, gallstones most commonly trigger pain in the upper right or middle abdomen, sometimes radiating to the back or right shoulder. Nausea and vomiting are frequent companions. Importantly, gallstones do not cause pain with urination.
• Kidney Stone Symptoms: In contrast, kidney stones develop in the urinary tract and typically cause sharp pain in the back or side, often moving toward the lower abdomen or groin. Kidney stones may also cause blood in the urine or painful, frequent urination—symptoms not seen with gallstones.

Recognizing the location and type of pain, along with associated symptoms, can help distinguish between gallstones and kidney stones.

What Does Passing a Gallstone Feel Like?

Passing a gallstone is usually not something you notice. Most gallstones are small enough—typically less than 5 millimeters—to move through the common bile duct and into the intestines without causing any obvious sensations. However, as a stone moves through the bile duct, some people experience a brief episode of sharp abdominal pain, known as biliary colic. This discomfort can be sudden and intense, but it often fades once the stone has passed.

In many cases, there may be no noticeable symptoms at all. If pain does occur, it is typically short-lived and subsides as the stone clears the duct. Larger stones, or those that become lodged and block the flow of bile, are more likely to produce prolonged pain and complications requiring medical attention.

Causes of Gallstones

The exact cause of gallstones is not always clear. Evidence shows that gallstones may form when:

• Bile contains too much cholesterol
• Bile contains too much bilirubin
• The gallbladder does not empty completely or often enough

Multiple factors can contribute to gallstone formation.

Does Eating Less Cholesterol Lower My Risk for Gallstones?

Reducing cholesterol in your diet may help decrease the risk of developing cholesterol gallstones, which are the most common type. While dietary choices alone cannot guarantee prevention, limiting foods high in cholesterol and saturated fat may lower your overall risk. However, it’s important to note that lowering cholesterol intake does not prevent pigment gallstones, which form through different mechanisms.

If you are concerned about gallstone risk, adopting a balanced diet and maintaining a healthy weight can contribute to overall gallbladder health.

Risk Factors

Factors associated with a higher risk of developing gallstones include:

• Increasing age
• Female sex
• Pregnancy
• Estrogen exposure, including hormone therapy or birth control pills
• Overweight or obesity
• Rapid weight loss
• Family history of gallstones
• Certain medical conditions, such as diabetes or specific blood disorders
• Certain medications, including some cholesterol-lowering drugs

Having risk factors does not guarantee that gallstones will develop.

Can Gallstones Be Prevented?

While there is no guaranteed method to prevent gallstones, certain lifestyle choices may help lower your risk—especially when it comes to cholesterol stones, which are the most common type.

Strategies to Reduce Risk:

• Maintain a healthy weight: Being overweight or having obesity increases the likelihood of developing cholesterol stones. Gradual weight loss is preferable; very rapid weight loss can actually increase the risk.
• Follow a balanced diet: A diet that’s high in fiber and healthy fats and low in saturated fats and refined sugars may help lower your chances of forming cholesterol gallstones.
• Stay active: Regular physical activity supports healthy weight management and digestion.
• Be mindful with weight loss: If you are planning to lose weight, aim for steady, gradual changes rather than strict crash diets or very low-calorie regimens.
• Medical considerations: For individuals undergoing rapid weight loss, such as after weight-loss surgery, a healthcare provider may recommend medications to reduce gallstone risk.

Although diet and lifestyle modifications can help reduce the likelihood of cholesterol gallstones, these steps may not prevent all types, such as pigment stones. Gallstone formation can occur for several reasons, and not all risk factors are within your control.

Weight Loss and Gallstone Risk

Losing excess weight can lower your risk of developing cholesterol gallstones, the most common type. However, the way you lose weight matters. Losing weight gradually—such as through a balanced diet and regular physical activity—appears to be protective. In contrast, rapid weight loss or very low-calorie diets may actually increase your risk of gallstones, especially in the months following significant weight reduction.

If you plan to lose a substantial amount of weight, especially due to surgery or a medically supervised program, discuss this with your healthcare provider. In some situations, specific medications may be recommended to reduce gallstone risk during periods of rapid weight loss.

Medications to Reduce Gallstone Risk During Rapid Weight Loss

Rapid weight loss—whether from bariatric surgery, strict diets, or certain medical treatments—can increase the risk of developing cholesterol gallstones. When significant weight is lost over a short time, changes in bile composition can encourage stone formation.

For individuals undergoing rapid weight loss, some healthcare providers may recommend preventive medications. Ursodeoxycholic acid (ursodiol), for example, may be prescribed to help reduce cholesterol saturation in bile and lower the likelihood of gallstones forming. This medication is not suitable for everyone, and should only be used under a doctor’s guidance.

Preventive medication is usually considered in specific scenarios, such as:

• After certain types of weight loss surgery (e.g., gastric bypass)
• During medically supervised rapid weight loss programs
• If you have additional risk factors for gallstones

It’s important to discuss your individual risk and whether preventive treatment might be appropriate with your healthcare provider. Lifestyle measures—such as gradual, steady weight loss and healthy eating—remain the cornerstone for lowering gallstone risk, but medication can be a useful option in select cases.

Complications

Gallstones can cause serious complications if they block bile ducts, including:

• Cholecystitis (inflammation of the gallbladder)
• Blockage of the common bile duct
• Pancreatitis (inflammation of the pancreas caused by gallstone blockage)
• Infection of the bile ducts

Some complications may require urgent medical care.

While many people live with gallstones and never know they have them, trouble often begins when these small, pebble-like stones start to move. Once a gallstone becomes lodged in a duct—a narrow passage within your biliary system—it can quickly trigger problems. The resulting blockage not only causes pain but can lead to inflammation or infection in nearby organs. If left untreated, these complications can become severe and, in some cases, life-threatening.

Prompt attention is especially important if you develop symptoms such as persistent abdominal pain, fever, jaundice (yellowing of the skin or eyes), or vomiting. These may be signs that a gallstone has caused a blockage or infection requiring immediate medical evaluation and treatment.

Diagnosis

How Gallstones Are Identified

Gallstones may be identified using:

• Medical history and physical examination
• Imaging tests, particularly abdominal ultrasound
• Blood tests to look for signs of infection, inflammation, or bile duct blockage

Additional imaging or procedures may be needed if complications are suspected.

Treatment Options

When No Symptoms Are Present

• Many people with asymptomatic gallstones do not need treatment
• Monitoring may be recommended in some cases

When Symptoms or Complications Occur

• Surgery to remove the gallbladder (cholecystectomy) is the main treatment
• Cholecystectomy is commonly recommended when gallstones cause symptoms or complications

Gallstones will not go away on their own. Even if a gallstone passes out of your body or is removed from a bile duct, others may remain, and new stones can still form. Removing the gallbladder is the only way to prevent gallstones from returning permanently.

Non-Surgical Approaches

• Medications may be used in limited cases to dissolve certain cholesterol gallstones
• This approach is not suitable for everyone

There is no high-quality evidence supporting gallbladder “cleanses” or flushes as effective treatments.

Prognosis After Gallstone Treatment

Following treatment—especially surgical removal of the gallbladder (cholecystectomy)—most individuals do not experience recurrent gallstone issues. Long-term outcomes are generally favorable, and serious complications are rare.

A small number of people may notice ongoing digestive changes, such as mild or chronic diarrhea, due to the continuous flow of bile into the intestines after surgery. If this occurs, symptoms can often be managed with dietary adjustments or, if necessary, medications such as bile acid-binding agents.

Overall, most people can expect a good recovery and a return to normal activities after appropriate treatment for gallstones.

Prognosis After Gallbladder Removal Surgery

Most people recover well after gallbladder removal surgery (cholecystectomy). The procedure is considered safe and is commonly performed using minimally invasive techniques. For the majority of patients, symptoms such as pain and nausea resolve soon after the gallbladder is removed. Recovery times can vary, but many individuals return to normal activities within a week or two.

Serious complications are uncommon, and long-term outlook is generally excellent. The body adapts to life without a gallbladder, with bile finding new pathways from the liver to the intestine to support digestion. While some people may notice temporary changes in digestion, lasting problems are rare.

Can Gallstones Pass Through the Bile Duct and Be Eliminated Naturally?

It is possible, though uncommon, for a gallstone to travel from the gallbladder through the bile duct and eventually be passed in the stool. This may occur if a small stone moves into the common bile duct and continues on to the intestines without becoming lodged.

However, it is not something that can be intentionally triggered or relied upon as a form of treatment. There are currently no proven methods, dietary changes, or home remedies that can force gallstones to pass safely through the bile duct. Most gallstones remain in the gallbladder or may become stuck in the bile ducts, potentially leading to pain or complications.

Because a gallstone lodged in the bile duct can cause significant problems—such as severe pain, infection, or pancreatitis—medical evaluation is recommended if you suspect a stone has moved or if you develop symptoms. Attempting to self-manage or “flush” gallstones is not advised and may carry risks.

Professional guidance is the safest approach if you are concerned about gallstones or experiencing symptoms.

Can Gallstones Pass Naturally in Stool?

In some rare cases, a gallstone that moves from the gallbladder into the bile duct may continue traveling into the intestines and eventually be passed in stool. However, this scenario is uncommon and unpredictable. Most gallstones remain in the gallbladder or may become stuck within the bile ducts, which can lead to pain or complications.

There are currently no proven methods or medications that reliably encourage gallstones to pass naturally through stool. Passing a gallstone without intervention does not guarantee that all stones have been removed, as others can remain or new ones may form. The only way to permanently resolve gallstones is by removing the gallbladder through surgery.

Attempting to wait for gallstones to pass on their own is not recommended, especially given the risks if a stone becomes lodged and causes a blockage. If you experience symptoms or complications, medical evaluation and appropriate treatment are advised.

When to See a Doctor

Seek Medical Advice If You Experience:

• Abdominal pain associated with gallstones
• Nausea or vomiting related to pain episodes

Biliary colic—sudden, cramping pain in the upper right abdomen—can be the only warning sign that gallstones are present. This pain often comes and goes, appearing when a gallstone temporarily blocks the bile duct before moving out of the way. Even if the pain subsides, it’s important to recognize these episodes as a red flag. Gallstones that cause symptoms once are likely to do so again, and repeated episodes can signal that more stones are forming or that an existing stone is lingering in a tight spot.

Seek Urgent or Emergency Care If You Have:

• Severe abdominal pain that is intense or worsening
• Fever or chills along with abdominal pain
• Yellowing of the skin or eyes (jaundice)

These symptoms may indicate a serious complication.  A gallstone that becomes permanently stuck can block bile flow completely, leading to infection or more severe conditions—these are medical emergencies that require prompt attention.

Frequently Asked Questions

If you suspect you have passed a gallstone or notice unusual changes in your stool, discuss your concerns with your healthcare provider.

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