What are Gallstones?

Gallstones are solid deposits of various sizes in a patient’s gallbladder. The deposits are composed of either cholesterol or bile salts that accumulate and harden in the body, though medical researchers are still unsure about what causes gallstones to form. Gallstones made of cholesterol are the more commonly diagnosed type of gallstone diagnosed in the Unites States—but as far as research shows, their formation has little to do with a patient’s blood cholesterol levels. The other type of gallstones, called bilirubin or pigment stones, occur when excess salt in bile collects and hardens in the gallbladder.

You have a greater chance of developing gallstones if you are female, Hispanic, Native American or over 40 years old. There is also evidence that suggest gallstones may be passed down genetically, in families. Lastly, gallstones have been reported to develop in patients who have undergone organ or bone marrow transplant, patients who have diabetes and patients who have a history of other biliary disease, such as liver cirrhosis and anemia.

Are There Symptoms of Gallstones in the Gallbladder?

Many people who have gallstones do not display any symptoms; the gallstones are merely detected during a routine exam, such as CT scan or ultrasound. In general, experts agree that surgical treatment, such as gallbladder removal, is only necessary in gallstones patients who display symptoms. Asymptomatic patients for whom the gallstones are causing no trouble usually will not undergo surgery.

If gallstones are causing duct blockage between your liver and your gallbladder, you may feel slight pain or cramping on the right-hand side of your abdomen. This condition is specifically referred to as choledocholithiasis, and the pain patients feel is called biliary colic. Biliary colic usually goes away once the stone passes, but if it’s too big to pass through, you may need to surgically remove it. Pain associated with gallstones varies greatly from person to person—it can be sharp and sudden or constant and dull.  If a blockage such as this occurs for considerable amount of time you can develop fevers or chills, which can be a sign of infection in the gallbladder or common bile duct and needs immediate evaluation in an emergency department.

Sometimes gallstones also affect a person’s bowel movements, causing stool to look chalky. You may also feel nauseous and experiencing vomiting. Since gallstones form in the gallbladder, where bile is formed, people with gallstones might also display symptoms of jaundice (yellow coloring around their eyes and in the whites of their eyeballs). See your doctor if you think you may be experiencing symptoms of gallstones.

Gallstones that get stuck in the common bile duct or choledocolithiasis can be removed through endoscopic means by ERCP, which is much more minimally invasive than any surgical procedure, even laparoscopic surgery.  Occasionally a stone will be too large to be removed by this means and surgery may be required anyway.


Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014