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

Gallstones

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.

Language note: Some search queries about gallstones appear in non-English languages. This article presents medically verified information in English only.

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.

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

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

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.

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.

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.

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

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.

When to See a Doctor

Seek Medical Advice If You Experience:

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

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.

Frequently Asked Questions

What do gallstones look like?

Gallstones vary in size and appearance. Cholesterol stones are often yellow-green, while pigment stones are dark brown or black.

Do gallstones always cause symptoms?

No. Many gallstones are “silent” and do not cause symptoms.

How are gallstones treated?

Treatment ranges from no intervention for symptom-free gallstones to surgical removal of the gallbladder when symptoms or complications occur.

Do gallstones go away on their own?

There is no high-quality evidence showing that gallstones reliably disappear without treatment.

Are gallstones dangerous?

Gallstones can lead to serious complications, but not all gallstones are dangerous.

Are gallstones an emergency?

Some gallstone complications require urgent medical care.

Can gallstones cause chest pain?

There is no high-quality evidence supporting this.

Are gallstones contagious?

There is no high-quality evidence supporting this.

Can birth control or estrogen cause gallstones?

Estrogen exposure is associated with an increased risk of gallstones.

APA References List

American Gastroenterological Association. (n.d.). Gallstones. Retrieved December 26, 2025, from https://patient.gastro.org/gallstones/

Cleveland Clinic. (2024, January 15). Gallstones (cholelithiasis): Symptoms, causes & treatment. https://my.clevelandclinic.org/health/diseases/7313-gallstones

Johns Hopkins Medicine. (n.d.). Gallstones. Retrieved December 26, 2025, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/gallstones

Mayo Clinic Staff. (2024, February 28). Gallbladder cleanse: A “natural” remedy for gallstones? https://www.mayoclinic.org/diseases-conditions/gallstones/expert-answers/gallbladder-cleanse/faq-20058134

Mayo Clinic Staff. (2025, April 16). Gallstones: Symptoms & causes. https://www.mayoclinic.org/diseases-conditions/gallstones/symptoms-causes/syc-20354214

National Health Service (NHS). (2025, August 11). Gallstones. https://www.nhs.uk/conditions/gallstones/

NHS England. (2023, November). Making a decision about gallstones (Patient decision support tool) [PDF]. https://www.england.nhs.uk/wp-content/uploads/2023/11/PRN00250-dst-making-a-decision-about-gallstones.pdf

National Institute of Diabetes and Digestive and Kidney Diseases. (2017, November). Definition & facts for gallstones. https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/definition-facts

National Institute of Diabetes and Digestive and Kidney Diseases. (2017, November). Treatment for gallstones. https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones/treatment

Sebghatollahi, V., Parsa, M., Minakari, M., & Azadbakht, S. (2023). A clinician’s guide to gallstones and common bile duct (CBD): A study protocol for a systematic review and evidence-based recommendations. Health Science Reports, 6(9), e1555. https://doi.org/10.1002/hsr2.1555

U.S. National Library of Medicine. (2016, November 1). Gallstones (MedlinePlus Health Topic). https://medlineplus.gov/gallstones.html

U.S. National Library of Medicine. (2025, April 21). Gallstones (MedlinePlus Medical Encyclopedia). https://medlineplus.gov/ency/article/000273.htm

U.S. National Library of Medicine. (2025, July 31). Ursodiol (MedlinePlus Drug Information). https://medlineplus.gov/druginfo/meds/a699047.html