Symptoms and causes

Gallstones may cause no signs or symptoms. If a gallstone lodges in a duct and causes a blockage, the resulting signs and symptoms may include:

  • Sudden and rapidly intensifying pain in the upper right portion of your abdomen
  • Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone
  • Back pain between your shoulder blades
  • Pain in your right shoulder
  • Nausea or vomiting

Gallstone pain may last several minutes to a few hours.

When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you.

Seek immediate care if you develop signs and symptoms of a serious gallstone complication, such as:

  • Abdominal pain so intense that you can't sit still or find a comfortable position
  • Yellowing of your skin and the whites of your eyes
  • High fever with chills

It's not clear what causes gallstones to form. Doctors think gallstones may result when:

  • Your bile contains too much cholesterol. Normally, your bile contains enough chemicals to dissolve the cholesterol excreted by your liver. But if your liver excretes more cholesterol than your bile can dissolve, the excess cholesterol may form into crystals and eventually into stones.
  • Your bile contains too much bilirubin. Bilirubin is a chemical that's produced when your body breaks down red blood cells. Certain conditions cause your liver to make too much bilirubin, including liver cirrhosis, biliary tract infections and certain blood disorders. The excess bilirubin contributes to gallstone formation.
  • Your gallbladder doesn't empty correctly. If your gallbladder doesn't empty completely or often enough, bile may become very concentrated, contributing to the formation of gallstones.

Types of gallstones

Types of gallstones that can form in the gallbladder include:

  • Cholesterol gallstones. The most common type of gallstone, called a cholesterol gallstone, often appears yellow in color. These gallstones are composed mainly of undissolved cholesterol, but may contain other components.
  • Pigment gallstones. These dark brown or black stones form when your bile contains too much bilirubin.

Factors that may increase your risk of gallstones include:

  • Being female
  • Being age 40 or older
  • Being a Native American
  • Being a Mexican-American
  • Being overweight or obese
  • Being sedentary
  • Being pregnant
  • Eating a high-fat diet
  • Eating a high-cholesterol diet
  • Eating a low-fiber diet
  • Having a family history of gallstones
  • Having diabetes
  • Losing weight very quickly
  • Taking medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
  • Having liver disease

Complications of gallstones may include:

  • Inflammation of the gallbladder. A gallstone that becomes lodged in the neck of the gallbladder can cause inflammation of the gallbladder (cholecystitis). Cholecystitis can cause severe pain and fever.
  • Blockage of the common bile duct. Gallstones can block the tubes (ducts) through which bile flows from your gallbladder or liver to your small intestine. Jaundice and bile duct infection can result.
  • Blockage of the pancreatic duct. The pancreatic duct is a tube that runs from the pancreas to the common bile duct. Pancreatic juices, which aid in digestion, flow through the pancreatic duct.

    A gallstone can cause a blockage in the pancreatic duct, which can lead to inflammation of the pancreas (pancreatitis). Pancreatitis causes intense, constant abdominal pain and usually requires hospitalization.

  • Gallbladder cancer. People with a history of gallstones have an increased risk of gallbladder cancer. But gallbladder cancer is very rare, so even though the risk of cancer is elevated, the likelihood of gallbladder cancer is still very small.
July 29, 2017
References
  1. Gallstones. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/gallstones/Pages/facts.aspx. Accessed June 15, 2016.
  2. Understanding gallstones. American Gastroenterological Association. http://www.gastro.org/info_for_patients/2013/6/6/understanding-gallstones. Accessed June 15, 2016.
  3. Choi Y, et al. Biliary tract disorders, gallbladder disorders and gallstone pancreatitis. American College of Gastroenterology. http://patients.gi.org/topics/biliary-tract-disorders-gallbladder-disorders-and-gallstone-pancreatitis/. Accessed June 15, 2016.
  4. What are the risk factors for gallbladder cancer? American Cancer Society. http://www.cancer.org/cancer/gallbladdercancer/detailedguide/gallbladder-risk-factors. Accessed June 16, 2016.
  5. Feldman M, et al. Gallstone disease. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed June 16, 2016.
  6. Picco MF (expert opinion). Mayo Clinic, Rochester, Minn. June 23, 2016.