Gallstones - Overview

(Biliary Colic, Calculus of Gallbladder, Cholangitis, Cholelithiasis, Cholecystitis, Cholecystolithiasis, Choledocholithiasis)

Your gallbladder is a small, pear-shaped organ. It’s located in the right-hand corner of the abdomen, just below your liver. The gallbladder’s job is to store the bile produced by the liver. 

Bile is a bitter, alkaline fluid that helps digest fats. When it leaves the gallbladder, bile passes through bile ducts and into the small intestine. Bile is made up of a number of substances. When an imbalance in these substances occurs, small hard masses –called gallstones – can form.

Symptoms of Gallbladder Attacks
Types of Gallstones
Gallstone Risk Factors
Treating Gallstones

Symptoms of Gallbladder Attacks

A sudden blockage is typically referred to as a gallbladder attack. Symptoms of a gallbladder attack can include:

  • Sudden and rapidly increasing pain in the center or upper right abdomen
  • Back pain between the shoulder blades
  • Pain under the right shoulder

Gallstones can be as small as a grain of salt or as big as a golf ball. You can have one or several. Gallstones that cause no symptoms are often found during testing for other conditions. Their size and location can be determined using ultrasound.

Gallstones themselves cause no problems – unless they move into the bile ducts and block the flow of bile.
If gallstones block a bile duct for too long, it can cause serious damage to the gallbladder, liver or pancreas. In some cases, the condition can be fatal. Ongoing pain, fever and the yellowing of skin are signs of a serious problem.

Types of Gallstones

The two types of gallstones are:

Cholesterol stones are thought to result from a number of factors, including too much cholesterol in the bile. About 80% of the people who have gallstones have cholesterol stones.

Pigment stones are thought to result from an excess of bilirubin caused by conditions such as liver cirrhosis or sickle cell anemia. Bilirubin is a substance that results when the liver breaks down old red blood cells.

Risk Factors

While the exact cause of gallstones is not yet known, it is clear that a diet high in fat and cholesterol and low in fiber increases the risk.

Other risk factors appear to include:

  • Age. People over 60 are at a higher risk .
  • Genetics. If you have a family history of gallstones, you are more likely to develop them. Native Americans have the highest rate of gallstones because they genetically tend to have high levels of cholesterol in bile.
  • Excess weight/rapid weight loss. Obesity is a major risk factor, but even being a little over weight can increase the risk. Crash dieting is not the answer, though, because the liver secretes extra cholesterol into bile during rapid weight loss.
  • Excess estrogen. Women are twice as likely to develop gallstones as men because excess estrogen from pregnancy, hormone therapy and birth control pills seems to increase cholesterol levels in bile.
  • Diabetes. Diabetes usually causes high levels of fatty acids in the body.

Ironically, cholesterol-lowering drugs actually increase the risk of gallstones. These drugs cause the liver to increase the amount of cholesterol in bile.

Treating Gallstones

Gallstones that cause no symptoms require no treatment. But when gallstones do cause pain and other symptoms, surgery to remove the gallbladder is the most common treatment. Removing the gallbladder prevents further gallbladder attacks. It also prevents the gallbladder or a bile duct from rupturing. 

Fortunately, the gallbladder is considered a non-essential organ. If your gallbladder is removed, bile will travel directly from the liver to the bile ducts. Your doctor may advise you to cut back on fatty foods, but your digestive system will continue to operate efficiently.

The surgical procedure to remove a gallbladder is called a cholecystectomy. It is done either as an open procedure or as a laparoscopic procedure. Surgeons at Swedish are experts in performing both robotic, laparoscopic and open cholecystectomies.

People who cannot have surgery because of other serious medical conditions are sometimes treated with drugs to dissolve gallstones – but this treatment may not be effective.


This content was created using EBSCO’s Health Library. Edits to original content made by Swedish Medical Center. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Diagnosis and Treatment

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Swedish Digestive Health Network