Many people with gallstones do not have any symptoms.
However, if a large stone blocks a tube or duct that drains the gallbladder, you may have a cramping pain in the middle to right upper abdomen. This is known as biliary colic. The pain goes away if the stone passes into the first part of the small intestine. Biliary colic generally refers to the pain that occurs from a temporary obstruction of the biliary tree which resolves on its own.
Prolonged obstruction of the biliary tree or complete impaction of a stone within the biliary tree will eventually lead to cholecystitis or cholangitis, at which the pain will be severe, constant, and increasing.
Symptoms that may occur include:
- Pain in the right upper or middle upper abdomen for at least 30 minutes. The pain may be constant or cramping. It can feel sharp or dull.
- Fever.
- Yellowing of skin and whites of the eyes (jaundice).
- Clay-colored stools
Causes
The cause of gallstones varies. There are two main types of gallstones:
- Stones made of cholesterol — This is the most common type. Cholesterol gallstones are not related to cholesterol level in the blood. In most cases, they are not visible on CT scans but are visible on a sonogram of the abdomen.
- Stones made of bilirubin — These are called pigment stones. They occur when red blood cells are destroyed and too much bilirubin is in the bile.
Gallstones are more common in:
- Female sex
- Native Americans and people of Hispanic descent
- People over age 40
- People who are overweight
- People with family history of gallstones
The following factors also make you more likely to develop gallstones:
- Bone marrow or solid organ transplant
- Diabetes
- Failure of the gallbladder to empty bile properly (this is more likely to happen during pregnancy)
- Liver cirrhosis and biliary tract infections (pigmented stones)
- Medical conditions that cause too many red blood cells to be destroyed
- Rapid weight loss from eating a very low-calorie diet, or after weight loss surgery
- Receiving nutrition through a vein for a long period of time (intravenous feedings)
- Taking birth control pills
Diagnosis
- Blood tests
- Ultrasound and other imaging techniques
Treatment
Surgery may be warranted to remove the gallbladder if the patient has gallstones or the gallbladder is not functioning normally. Most of the time this can be performed either laparoscopically (through small incisions) or with robotic-assisted surgery, both as outpatient procedures.
When to Contact a Medical Professional
Call your provider if you have:
- Pain in the upper part of your abdomen
- Yellowing of the skin or whites of the eyes