Key Points about Gallstones (Cholelithiasis)

  • Gallstones are a common condition that occur when there is excess accumulation of digestive fluid.
  • Many people who develop gallstones will have them multiple times in their lifetime.
  • Treatment for gallstones include surgical removal of the stones, surgical removal of the gallbladder or medicine to dissolve the stones.
  • Eating too much fat or cholesterol, not getting enough exercise and other factors can increase your risk of developing gallstones.
Common related conditions
Anal Fistula Anal Fissure Barrett's Esophagus Bloody Stool Colonic Diverticulosis Hemorrhoids Ulcerative Colitis

Overview

Gallstones are accumulations of digestive fluid that can form in your gallbladder as hard pieces. The formation of gallstones is also known as cholelithiasis. Gallstones can be as small as a single grain of sand, or as large as a golf ball. You may develop one gallstone or several at the same time. Some people with cholelithiasis won’t experience any symptoms and, therefore, you probably won’t need any treatment. Others with gallstones can experience extreme pain and other symptoms, and may need to undergo surgery to remove or break up the stones. 

Gallstones causes 

Experts haven’t pinpointed the exact cause of gallstone formation, but they believe that the following contributes:

  • Bile containing too much bilirubin (chemical that’s produced when red blood cells are broken down)
  • Bile containing too much cholesterol
  • Gallbladder not emptying correctly

Gallstones risk factors

The following factors can increase your risk for developing gallstones:

  • Having family members who’ve had gallstones
  • Being female
  • Being over age 40
  • Being Native American or Mexican American
  • Being overweight or obese
  • Being pregnany
  • Eating a high-fat, high-cholesterol and/or low-fiber diet
  • Having a history of liver disease
  • Having a sedentary lifestyle
  • Having diabetes
  • Having leukemia
  • Having sickle cell anemia
  • Losing weight quickly
  • Taking medications containing estrogen, including oral contraceptives (“the pill”) or hormone therapy drugs

Gallstones symptoms

Many with gallstones won’t experience symptoms. When symptoms do occur, they may include:

  • Back pain that you feel between your shoulder blades
  • Nausea or vomiting
  • Pain in the right shoulder
  • Sudden, extreme pain in the center of your abdomen, right below the breastbone
  • Sudden, extreme pain in the upper right area of your abdomen

Gallstones diagnosis

Your gastroenterologist may use one or more of the following diagnostic tools to diagnose your cholelithiasis:

Abdominal ultrasound. Your doctor make order an ultrasound. This is a painless imaging test of your abdomen.

Endoscopic ultrasound (EUS). Your specialist may use EUS to check for smaller stones can an abdominal ultrasound can miss.

Other imaging scans. Your specialist may use another type of imaging scan – such as cholecystography, hepatobiliary iminodiacetic acid (HIDA) scan, computerized tomography (CT) scan or endoscopic retrograde cholangiopancreatography (ERCP) scan – to closely check for the location and size of the gallstone.

Blood tests. Your specialist can use results from a blood test to check for infection, jaundice or pancreatitis, which can all be caused by gallstones.

Gallstones treatment

If you aren’t experiencing symptoms related to your gallstones, you probably won’t need treatment. If you are experiencing symptoms or your specialist determines that you need treatment, treatment options include:

Cholecystectomy. In this procedure, your surgeon removes the gallbladder. Because gallstones often reoccur, your surgeon may recommend this treatment even if you aren’t currently experiencing symptoms.

Medications. Your specialist may prescribe a medicine to try to dissolve the gallstones.

Removal during ERCP. Your specialist may identify, and then remove, gallstones during an ERCP imaging scan.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a gastroenterologist for more specialized treatment.