Symptoms of Gallstones

Last Updated: June 1, 2003

Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. The liquid, called bile, is used to help the body digest fats. Gallstones can be as small as a grain of sand or as large as a golf ball. The gallbladder can develop just one large stone, hundreds of tiny stones, or almost any combination.

Symptoms of gallstones are often called a gallstone “attack” because they occur suddenly. A typical attack can cause:
- Steady pain in the upper abdomen that increases rapidly and lasts from 30 minutes to several hours
- Pain in the back between the shoulder blades
- Pain under the right shoulder
- Nausea or vomiting

Gallstone attacks often follow fatty meals, and they may occur during the night. Other gallstone symptoms include:
- Abdominal bloating
- Recurring intolerance of fatty foods
- Colic
- Belching
- Gas
- Indigestion

People who also have the above and any of following symptoms should see a doctor right away:
- Sweating
- Chills
- Low-grade fever
- Yellowish color of the skin or whites of the eyes
- Clay-colored stools

Many people with gallstones have no symptoms. These patients are said to be asymptomatic, and these stones are called “silent stones.” They do not interfere in gallbladder, liver, or pancreas function and do not need treatment.

How are gallstones diagnosed?
Many gallstones, especially silent stones, are discovered by accident during tests for other problems. But when gallstones are suspected to be the cause of symptoms, the doctor is likely to do an ultrasound exam. If stones are present, the sound waves will bounce off them, too, showing their location. Ultrasound is the most sensitive and specific test for gallstones.

Gallstone symptoms are similar to those of heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, and hepatitis. So accurate diagnosis is important.

Surgery
Surgery to remove the gallbladder is the most common way to treat symptomatic gallstones. (Asymptomatic gallstones usually do not need treatment.) Each year more than 500,000 Americans have gallbladder surgery. The surgery is called cholecystectomy.

The most common operation is called laparoscopic cholecystectomy. Because the abdominal muscles are not cut during laparoscopic surgery, patients have less pain and fewer complications than they would have had after surgery using a large incision across the abdomen. Recovery usually involves only one night in the hospital, followed by several days of restricted activity at home.

Don’t people need their gallbladders?
Fortunately, the gallbladder is an organ that people can live without. Losing it won’t even require a change in diet. Once the gallbladder is removed, bile flows out of the liver through the hepatic ducts into the common bile duct and goes directly into the small intestine, instead of being stored in the gallbladder. However, because the bile isn’t stored in the gallbladder, it flows into the small intestine more frequently, causing diarrhea in about 1% of people.

Gallstones may cause pancreatitis. Read what Dr. Jeffrey Schenck says about this potentially serious disease.

Source: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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