Eight Frequently Asked Questions About Gallstones

February 19, 2026

Each year, approximately one million adults nationwide are diagnosed with gallstones. According to Rachel Gordon, MD, a general and colorectal surgeon at Episcopal Health Services, gallstones often cause no symptoms, but when they do, their presence can become cause for concern.

“Symptoms suggests the presence of a related infection, which could lead to more severe health complications if left untreated,” Dr. Gordon explains. “Early diagnosis is key to achieving the best possible outcomes.”

Because gallstone symptoms are frequently overlooked or mistaken for other conditions, understanding the warning signs and knowing when to seek medical care is essential for timely and effective treatment.

1. What are gallstones?

Gallstones, medical referred to as cholelithiasis, are hardened deposits of excess bile materials, such as cholesterol or bilirubin, that develop in the gallbladder. The gallbladder stores bile produced by the liver, releasing it into the bile ducts and small intestine during digestion to aid in the breakdown of fats in foods. Over time, an imbalance in bile composition can lead to the formation of one or many gallstones, which may vary in size from as small as a grain of sand to as large as a golf ball.

2. What factors increase the risk for developing gallstones?

• Obesity: Excess body fat can increase cholesterol levels in the bile or impact gallbladder contractions, slowing the release of bile into the small intestine
• Age: The risk for developing gallstones increases with age, particularly among individuals 40 and older
• Gender: Females are more likely to develop gallstones than males, with estimates suggesting that they account for 75 percent of diagnoses
• Pregnancy: Progesterone produced during pregnancy slows the release of bile in the gallbladder, which can lead to the formation of gallstones
• Hematological disorders: Conditions such as sickle-cell disease and thalassemia increase risk due to breakdown of red blood cells
• Intestinal disorders: Conditions such as Crohn’s disease increase risk for development of gallstones by impacting the small intestine’s ability to absorb bile salts
• Rapid weight loss or long periods of fasting: This can cause the liver to release excess cholesterol into the bile
• Family history of gallstones: Genetics can contribute to higher cholesterol levels in bile

3. Are gallstones serious?

In many cases, gallstones are harmless and do not cause symptoms. Many individuals are unaware they have gallstones and require no treatment. When symptoms do occur, however, they are often associated with larger stones or stones that become lodged in the bile ducts or the neck of the gallbladder, leading to a blockage.

These blockages can cause intense, episodic pain known as biliary colic, which may last from minutes to several hours and typically resolves only when the obstruction shifts and bile flow resumes. Because blockages often recur, they can progress to more serious conditions such as inflammation of the gallbladder (acute cholecystitis) or gallstone pancreatitis, in which the gallstone travels into the pancreatic duct and blocks the opening where it meets the intestine. If left untreated, these complications may lead to significant health risks, including liver damage, underscoring the importance of prompt diagnosis and treatment.

4. What are symptoms of gallstone blockages?

Common gallstone blockage symptoms include:

• Recurring, acute pain in the upper right quadrant of the abdomen, typically under the ribs, starting approximately 30 minutes after eating
• Discomfort when inhaling
• Nausea, sometimes accompanied by vomiting
• Other symptoms may include sweating, fever, heart rate increase, yellowing of skin

Given that these symptoms usually occur after eating and are similar to those associated with acid reflux or indigestion, they are often easily overlooked or misinterpreted.

5. How are gallstones diagnosed?

For cases not involving symptoms, gallstones are typically diagnosed incidentally during ultrasound or computer-assisted tomography imaging for other medical conditions. In cases involving symptoms, diagnosis is performed using imaging and blood tests to identify signs of infection or increased levels of liver enzymes.

6. How are gallstones treated?

Treatment usually involves laparoscopic removal of the gallbladder, a surgical procedure known as cholecystectomy. This is a low-risk, common procedure that is performed 1.2 million times each year nationwide.

7. What can I expect during recovery from gallstone surgery?

Patients who have undergone cholecystectomy should avoid heavy lifting (any item more than 10 to 15 pounds) for four to six weeks. In the first two weeks of recovery, some patients may experience diarrhea, which is caused by bile trickling through the common bile duct into the intestines. Maintaining a low-fat diet during this time will help the body adjust to changes in the release of bile. Patients may notice that they have additional daily bowel movements with looser stools. This is normal and there is no need to make any changes in nutrition.

8. Is it possible to treat gallstones using medication?

Although there are medications such as ursodiol that dissolve gallstones, the process can take months, even years, and they are typically only effective among patients who have very small stones that do not contain calcium. In most cases, patients who are treated with medication subsequently undergo surgery, making cholecystectomy the preferred approach for treatment.

If you have reason to believe you are experiencing gallstone blockage-related symptoms, contact your Primary Care Physician for a referral to a specialist for diagnosis and treatment to prevent more serious health issues from developing.