Gallstones: What They Are and What to Watch For

Gallstones are hard bits that form in your gallbladder. Most are made of cholesterol; others are pigment stones. A lot of people have gallstones and never know it. But when a stone blocks a bile duct, pain and complications can follow fast.

Symptoms and when to get help

Many gallstones cause no symptoms. When they do, the classic sign is a sharp pain in the upper right belly or under the right rib cage. The pain can last from minutes to several hours and often starts after a heavy meal.

Watch for these warning signs: steady severe pain, fever, yellowing of the skin or eyes (jaundice), dark urine, pale stools, or nausea and vomiting that won’t stop. Those signs can mean cholecystitis, a blocked bile duct, or pancreatitis — conditions that need prompt medical care.

What causes gallstones and who’s at risk

Gallstones form when bile components get out of balance. Common risk factors include being female, over 40, overweight, rapid weight loss, pregnancy, and certain meds or conditions like diabetes. Family history also raises the chance. Dietary patterns matter: very low-calorie diets and extreme weight cycling can increase risk.

Not all gallstones are the same. Cholesterol stones are the most common and linked to diet and metabolism. Pigment stones form from excess bilirubin and are more common with certain blood disorders and liver disease.

Diagnosis usually starts with an ultrasound. It’s quick and reliable for spotting stones in the gallbladder. If doctors suspect a stone in the common bile duct, they may order blood tests, an MRCP (MRI for the bile ducts), or ERCP, which can also remove a stone during the same procedure.

Treatment depends on symptoms. If stones don’t cause problems, doctors often recommend watchful waiting. For pain or complications, the usual treatment is laparoscopic cholecystectomy — removal of the gallbladder. It’s a common, low-risk surgery and most people recover in a week or two.

When a stone is stuck in the common bile duct, ERCP can remove it without major surgery. For people who can’t have surgery, a medication called ursodeoxycholic acid can sometimes dissolve cholesterol stones, but it takes months and doesn't work for all stones.

Simple lifestyle changes can help lower risk: lose weight slowly (no crash diets), eat more fiber and healthy fats, avoid very high-fat meals, and stay active. If you’ve had gallbladder pain, keep a record of triggers — certain foods or big meals — and share that with your doctor.

If you suspect a gallstone attack or have persistent belly pain, call your healthcare provider or go to urgent care. Quick treatment prevents complications and gets you back to normal faster.