Drs. Simpson, Yen and Ahmed are from the Department of Medicine, Division of Gastroenterology, Stanford University School of Medicine, Stanford, California and *Division of General Internal Medicine and Geriatrics Veteran's Administration Medical Center, San Diego, California University of California, San Diego School of Medicine, San Diego, California.
We all have a gallbladder but most of us do not spend much time thinking about it. Those that do are probably among the 25 million or so Americans who suffer from gallstones.
The pear-shaped gallbladder sits below the liver in the upper right-hand corner of the abdomen. It is connected to the liver and to the small intestine by several tubes called bile ducts. Its purpose is to store bile, a liquid which is produced by the liver that helps us digest fat. After a meal, the gallbladder contracts and sends bile into the intestine. Once a meal has been digested, the gallbladder stops sending bile and returns to its old job of storing up bile for our next steak dinner.
What is a Gallstone?
Bile is a brown liquid made up of bile salts, cholesterol, bilirubin and lecithin. Bile salts and lecithin help break up fat so that it can be digested more easily. Bilirubin, which gives both bile and stool their characteristic color, is a waste product.
Problems begin when some of the components of bile form hard crystals (or stones). Most gallstones are made up of either cholesterol or bilirubin but not both. Because they range in size from as small as a grain of sand to as large as a golf ball, a gallbladder may contain anywhere from one stone to hundreds. These gallstones may cause problems in the gallbladder or in the bile duct, or they may cause no problems at all.
We are not sure why gallstones happen but we do know that people with high levels of cholesterol in their bile are more likely to develop cholesterol stones and those with high levels of bilirubin are more likely to develop bilirubin stones. Problems with the gallbladder muscle, causing incomplete emptying of the gallbladder, also seem to play a part in gallstone development. Exactly how diet affects gallstone formation is not well understood but it is suspected that a diet high in cholesterol and fat can increase a person's risk of developing gallstones
Really Bad Pain
The most typical first sign of gallstones is pain — sometimes excruciating pain — in the upper abdomen or right side. This is sometimes accompanied by fever, vomiting or sweating. The most common treatment is surgical removal of the gallbladder, although there are other treatments, depending on the type of gallstone, the severity of a person's attacks and the presence of complications such as infection.
Most treatments are much more successful if they are given early on. Anyone who thinks they might have gallstones should see a doctor as soon as possible.
- steady pain in the upper abdomen that worsens rapidly and lasts as long as several hours
- pain in the back between the shoulder blades
- pain under the right shoulder
- nausea or vomiting
- abdominal bloating
- recurring intolerance of fatty foods
- low-grade fever
- yellowish color of the skin or whites of the eyes
- clay-colored stools
Risk Factors for Cholesterol Gallstone Formation.
- Increasing age, female sex
- Ethnicity: Pima Indians, Scandinavians
- Family history of gallstones on the mother's side
- Obesity, rapid weight loss, fasting, tube feeding or total parenteral nutrition (TPN)
- Drugs: fibric acid derivatives, cholesterol-reducing drugs, contraceptive steroids (birth control pills) and postmenopausal estrogen, progesterone, octreotide, ceftriaxone (hormone replacement therapy)
- Crohn's disease, certain types of surgery involving the digestive system, hyperlipidemia (excess fat in the bloodstream) and diabetes.
NOTE: We regret that we cannot answer personal medical questions.
(43) Comments have been made
I'm 17 and I have lots of gallstones. I had been suffering from this horrid pain since I was 15. It wasn't untill just before thes Christmas of 2013 when I could keep any food down and was in complete agony I realised that it wasn't IBS that they diagnosed me with years before it was something different. 2 weeks ago I had a scan where they found many gallstones. I am planned to have an operation in the next month or so. However I'm so ill. I keep getting colds and flu like symptoms why is this? It seems that I'm always ill could this be down to gallstones or is my immune system just complete rubbish?
Posted Fri, Feb. 28, 2014 at 7:16 pm EST
I have been sick for the past 3 weeks.. I thought it was a terrible
Stomach virus.. Which I do believe I had... But now I think being
Sick has triggered my galbladder attacks.. My symptoms are nausea,headache.. Pain in mid breasts (low)..
Vomiting.. Then constipated.. Then diariah .. I am so tired of this feeling.. I am 32 years old I have 2 children. But no insurance.. This sux so bad knowing I need to go the doctor but can't afford to..:(
Posted Tue, Aug. 27, 2013 at 11:41 pm EDT
i have multiple gallstones. i have done a flush method also. but still after that i have to face a severe pain again. what should i do?? should i take care of my diet or to flush again.
Posted Sun, Aug. 18, 2013 at 12:34 am EDT
I have 12 mm 1 Grad Gallblader stone but no pain shall i remove it or not plz suggested me
Posted Sun, Aug. 4, 2013 at 3:34 pm EDT
Right out of the bottom right corner of the severe pain is like a crystal. How to get rid of this problem?
Posted Thu, Jul. 18, 2013 at 2:30 am EDT
I was told I may have gallstones and now I feel unwell and I am quite shaky can u tell me what to do
Posted Fri, Jun. 28, 2013 at 3:03 pm EDT
anybody getting these bad pains because of gallstones..look up this book.. The Amazing Liver and Gallbladder Flush by andreas moritz..There is no need for surgeries just follow through on exactly what it says and hopefully it works for like it did me.. Or go to google and put The Amazing Liver And Gallbladder Flush pdf free download.. check it out = )
Posted Thu, Jun. 27, 2013 at 8:06 pm EDT
Rukhsana Shaheen Sroey
I am 54 and had diabeties since last 23 years. From 7 years am on Insuline. On 1st June, 1913 I got operated Gallbladder stone (open surgery) 1st night I had 104 temp. 2nd day Dr's removed tube from the side and that night I also got 104 temp and Darrioah all the night my daughters changes the pampers. 4th day leakage started from the whole where was tube removed with severe pain. Dr. called the surgeon to clean and dressing, during this period facing lot of pain and hospital was discharged me after one week, now at home I feel that my right side abdomen dead feeling. pls let me know what is this and what happend to me and what s the treatment, pls reply soon.
Posted Tue, Jun. 11, 2013 at 2:32 am EDT
I'm experiencing pain that is to the point of difficulty to do anything but focus on the pain. I also have many migraines that will not go away. I hope that after my scheduled gallbladder surgery this up coming week that I will feel better. I am sick of my stomach feeling nauseated, and burning/aching feeling through out my right rib cage, and shoulder blade. Best of Luck to all of you who are in the same boat.
Posted Sat, May. 4, 2013 at 9:05 pm EDT
Hello - Hello! I had my gall bladder removed in an ER surgery - after being sick most of the fall of 2012 and it not being recognized as my gallbladder. This time I had stones, that were lodged and my pancreas was struggling to function. The drop me to my knees pain from my gallbladder is gone, but I remain having a hard time eating, as my pancreas is still strugging - my lipase is up. So I have been ebb and flow in a clear diet to some solids. I didn't have insurance at the time of my surgery but it was needed - life threatening...so with close to $90 grand in medical bills.....I can say- it was worth it to end the gallbladder pain, the journey of getting healthy continues, but I am grateful for everything and will continue to get healthy - - back to BETTER THAN I was.....My prayers are with all of you who are struggling with this....HANG IN THERE....FIND YOUR WAY THROUGH IT...GOD LOVES YOU!
Posted Fri, Apr. 12, 2013 at 9:50 am EDT
Nice article; Must say. But I was looking for a quick , may be temporary, solution or medicine to relieve the unbearable abdomen pain.
Posted Sun, Mar. 24, 2013 at 3:30 pm EDT
I have been reading about the recent and new tool from china that will suck out the stones and leave the gallbladder intact,I am wondering when this will be available in the UK and worldwide.I really don't want to have my gallbladder removed
Posted Fri, Feb. 10, 2012 at 6:38 am EST
i am due to have my gallbladder removed on thursday alot of familiy have had the same problems on my mothers and farthers side im only 29 and im worried will my pain go ive hd jaundice and been hospitalise 3 times in the last month
Posted Mon, Nov. 28, 2011 at 9:05 am EST
Hi everyone. I was diagnosed with gall stones a year and a half ago when I was pregnant with my daughter. They told me they could not do surgery due to me being pregnant, and that if I had more pain after I had my daughter I should seek help from a doctor for surgery. My baby is now 1 and the pains have started again, but only worse. I feel like I'm having contractions but have no meds to take. I have just currently moved to Woodstock IL and have no doctor here at the moment, and when i try scheduling appointments with doctors, they give me appointments a long time from now. I have been in pain for 3 days now, but it goes and comes. Should i go to the emergency room and could they help me at all for gallstones pain?
Posted Fri, Aug. 19, 2011 at 7:08 pm EDT
I had the surgery done last year to remove my gallbladder. It was the best thing I ever did. I was suffering from constant "attacks" at least 3 at week sometimes they would disappear and than reappear. No way do i wish this pain on anyone. It is like labor pains... with no medication to ease the pain. So if you are suffering just have the surgery done and you will live a happier life.
Posted Tue, Jun. 28, 2011 at 1:30 pm EDT
I'm a 19 year old female and I have a 5 month old son and when he was 2 months old I started feeling stomach pains that I thought was because I was on an empty stomach. So I would feel them mostly in the mornings and thought all I had to do was eat something or drink a cup of milk to make the pain go away, but it was mild. So one morning I felt the usual pain and went to drink some milk but it kept getting worse and I couldn't go back to bed..I felt fain and hot, and since I can't open the window in my room because of my son I told my husband to accompany me to the kitchen for fresh air. I ended up on the kitchen floor moaning and gasping for breath because I felt I couldn't breathe. My body was very cold but soaking wet in sweat and my husband wanted to take me to the hospital but I couldn't move. eventually it started going away and I fell asleep..best sleep I've ever had! When I woke up though my whole abdomen was sore specially on my right upper side. I went to see a doctor and he put me on antibiotics. I could NOT sleep in my bed for a few days so I slept sitting down on the couch. The next time I got an attack I got diagnosed with gallstones after an ultrasound and blood test. They gave me oxycodone for the pain, put me on a low fat diet and told me to follow up with my doctor. I decided I wanted surgery..So I scheduled an appointment with a surgeon and one day after I was supposed to go my insurance got discontinued..so now I'm out of oxycodone, no surgery and getting severe pain attacks every now and then..it helps a little to drink some advil though. I had an attack last night but it wasn't as bad as the one on saturday because I had drank 2 advils a couple hours before as precaution..so I drank 2 motrin and waited for the pain to subside..I fear for what can happen to me for not getting the surgery..
Posted Wed, Jan. 12, 2011 at 4:20 pm EST
i had my gallbladder removed a week ago and so far I'm ready to work. I feel good! I was thinking of not doing the surgery, but lI couldn't eat the food that I used to eat before. I had been asking friends that had the surgery and they said they were doing well instead of dealing with that pain. Hope everything's good.
Posted Thu, Dec. 9, 2010 at 8:35 pm EST
You stated that cholesterol-reducing drugs may enhance formation of bile stones. Lipitor is a prime drug that reduces cholesterol. Can Lipitor cause formation of bile stones? Are Drs. in love with the anti-cholesterol action of Lipitor and have a blind eye to its bile stone formation?
Posted Sun, Nov. 7, 2010 at 10:06 pm EST
6 Days past after I ate my Lunch (Fried Chicken, 2 Cup of rice and 8oz of Pop Cola), more or less after 30 minutes I felt severe pain in my right upper quadrant of my abdomen.. When I rub my ribs I fill the pain so intense with a pain scale of 5~7 out of 10.. I fell asleep due to the pain.. and when I woke up the pain is lessen but I when I move the pain started again around 3~5 pain scale.. aside from that pain, I have constipation also and when I defecate my stool is in clay color and an small amount.. So I try to search it what is really the problem I'm suffering and the result was Gallstones.. I'm afraid consulting doctors because I'm thinking they will suggest for an Laparoscopic Cholecystectomy. and I read some Journals of a post Laparoscopic Cholecystectomy and they have saying that they still have some discomforts like Diarrhea, flatulence etc.. And I'm seeking for an alternative treatment.. So I changed my diet.. I eat Vegetables and Fruit Juices and totally avoid fatty foods like meats etc.. And good thing for the first time I defecate a Yellow stool with some tiny rounded white color.. but still the pain is present when I'm moving quickly.. Do I have really to consult to my Doctor? I don't have Fever, nor Vomiting etc.. It's just the pain and the Stool Clay in color.. Please Reply ASAP..
Posted Sun, Nov. 7, 2010 at 5:43 am EST
what are the chances of gallstone reoccurrence once the gallbladder is removed? What type of diet do i need in order to prevent reoccurrence?
Posted Mon, Oct. 25, 2010 at 6:22 am EDT
I had an 'attack' one night almost 2 weeks ago where (3 hours after eating a bacon sandwich and a small piece of cheesecake)I had sudden pain across the middle of my back which quickly progressed across my front under my ribs. I thought I was just having a severe attack of indigestion which I get every few months, but this pain became excruciating and then I vomited. This relieved the pain momentarily, but then it came back even worse. I knew I needed to go to the hospital but I don't have health insurance, so it was a few hrs before I got to see a nurse. I was in so much pain that I was on the floor of the emergency waiting room writhing around. I was given 2 Nurofen which 20 minutes later I threw up. After vomiting the second time the pain subsided. When I was finally seen by a nurse she told me (without examination) that I had Gallbladder Reflux Gastritis and that I'd probably be fine now. The next afternoon I felt a little sore on my right side so I went to my GP who suspected gallstones and sent me for an ultrasound. Gallstones were confirmed, and I was referred to a surgeon. Since the incident, I have avoided all fatty foods and am eating sm meals every 3 hrs (I have always been a fairly healthy eater but recently dieted to lose 5kg I am 58kg and aged 34). I have been booked for surgery 4 wks from now but am wondering if gallbladder removal is the answer when I have had no pain really, just a bit of discomfort now and then since the incident??? I have been hearing of side effects from surgery such as urgent bowel movements (the specialist told me this is a short term aftereffect but my friend is still having this 2 yrs after surgery) and increasing risks of certain cancers etc... My aunt has had gallstones for about 20 years with only a handful of attacks. The research I have done seems so conflicting, I'm so confused as to what is the right decision for me (my GP seems to think the surgery is no big deal). Is it likely to be life threatening if I don't have it removed?
Posted Fri, Sep. 17, 2010 at 1:09 am EDT
i just found out I have gallstones. I am 24. I have had severe pain since 2009. I am sick after each attack, My symptoms are rapid heartbeat and pain in my collar bone and in the chest I can't move at all with the pain; it's crippling, and it happens all the time. I've have about 5 attacks a week. I don't want to eat because every time I eat, the pain starts up, and I have two little kids.
Posted Sun, Sep. 12, 2010 at 3:09 am EDT
I totally agree with the article. I also think more people need to learn about gallstones natural treatments. Surgery should only be the last resort. I once had gallstones. I found a natural solution to mine, maybe others can too.
Posted Sat, Jul. 17, 2010 at 5:07 pm EDT
I posted back in March about my fears of having my gallbladder removed. Anyway I had my surgery in March. The surgery went very well, no complication a little pain only from the co2 gas they used to inflate my stomach. I have to say my biggest complaint has to be the lose stools. I already eat a very low fat diet including lots of fruits and vegetables and lean chicken turkey and fish...no red meat. I'm wondering if there is something I can do...I haven't had a normal bowel movement since the surgery. :(
Posted Sun, Jun. 13, 2010 at 10:23 pm EDT
According to the American Gastroenterological Association, it's not understood why some people develop gallstones and others don't. But the following factors are known to increase a person's risk:
* Having diabetes or liver disease
* Being obese
* Not getting enough exercise
* Being female
* Having high levels of cholesterol or billirubin in your bile
* Being older than age 40.
* Having a family history of gallstones
Posted Tue, May. 25, 2010 at 9:44 am EDT
Where does a gall stone go once it passes through the bile duct? If it goes into the pancreas, is this a serious condition? What happens to the gall stone?
Posted Mon, May. 17, 2010 at 7:46 pm EDT
i just found out i have gallstones. I am 25. I have had severe pain since 2006. I am sick after each attack, which lasts 2 to 6 hours. My symptoms are rapid heartbeat and pain in my collar bone. I cant move at all with the pain; it's crippling, and it happens all the time. I've have about 5 attacks a week.
Posted Thu, May. 6, 2010 at 10:16 am EDT
Phil Mc Devitt
My wife is currently suffering gallstone problems which flared up for the first time about 3 weeks ago, on holiday.
The symptoms are severe nausea, but not pain.
Whist in hospital abroad, the patient in the next room was also in with gallbladder problems. He had suffered similar milder symptoms two years previously and was advised to seek treatment. He recovered and did not pursue treatment. However during the current attack, he suffered excruciating pain and required emergency surgery to remove the gallbladder, which was severely inflamed and gangrenous.He subsequently suffered blood poisoning and the surgeons confirmed that if he had waited another 12 hours, he may not have survived.
Anyone who has symptoms or is thinking twice about following doctors advice, please don't take any risks.It's not worth it.
My wife attended the doctor as soon as we came home and is now awaiting further treatment.
Posted Tue, May. 4, 2010 at 2:36 am EDT
I recently was sleeping and I woke up with a pain. I thought I was having a heart attack, so I stood up to see if the cramp would go away and it got worse. It was under and between my breasts the pain was so bad I started to sweat and called 911 but I took a aspirin in case it was a heart attack and it went away. It only lasted about 10 minutes total and now I get sick every time I eat. I feel very gassy and afraid of eating I want to start juicing my food and eat a better diet will that help? Right now we don't have any insurance and I know it will cost a lot if I look in to it. I was wondering if I could control it with diet or if that is even the problem at all.
Posted Thu, Apr. 22, 2010 at 1:39 am EDT
I have one 12 mm stone and multiple stones in my gall bladder, but I have no problem. Do I need to have my gall bladder removed?
Posted Sat, Apr. 17, 2010 at 4:52 am EDT
I had my first gall stone attack about 2 years ago and only mild discomfort since. However today I'm having quite a bit of pain and next week I'm scheduled for a tummy tuck. What are my chances of getting thru that with gall stones??? Can anyone tell me?
Posted Tue, Apr. 6, 2010 at 3:09 pm EDT
i wonder if you could help in october i got scan on my stocamch and they said i has gallstones im now in a bit of pain do yopu fink it could be the gallstones playin up
Posted Mon, Mar. 15, 2010 at 12:43 pm EDT
I had a gall bladder attack on March 3 2010. I didnt have the usual symptoms that go with an attack. I had chest pains and thought it was a heart attack. BP was normal so I went through the next day in pain, then I went to the ER. X-rays showed several stones with blockage. I had the gall bladder removed and have had no ill effects. I would have never guessed it was my gall bladder. It turned out the best thing was having it removed.
Posted Mon, Mar. 8, 2010 at 10:13 pm EST
I'm having a minor attack at the moment, is there a way to rid of the pain? Please! Any answers are appreciated... OWWW!
Posted Sat, Mar. 6, 2010 at 2:15 am EST
I had my gallbladder out 2 years ago. Now, it turns out that I had been passing gall stones for over 30 yrs about 1-3 times a week.
Yes, I have a high pain tolerance. The only reason I went to the hospital this time, was because of the different levels of pain going deep in my abdomen. It turns out that I had gravel, stones and sludge dislodge all at the same time and some stopped for a rest in my pancreas. The surgeon discovered in the operating room that I had gangrene. My grandmother many years ago, was sick for 2 years until someone listened to her and she went to the hospital with a solid chalk gallbladder.
It turns out, mine was probably from mineral deficiency as my cholesterol has usually been about 130.
My only recommendation, is to get all the information and then make your choice, but if you do not have it removed, make sure you know the warning signs to watch for.
All the best for everyone. Thank you doctor for being here email@example.com
Posted Sun, Feb. 28, 2010 at 12:47 am EST
I'm due to have surgery on the 12 of March. This will be my first surgery and I'm really worried. I've been reading about all the side affects of having your gallbladder removed and I'm a little scared! I lost 109 lbs 3 years ago. Since losing the weight I have run 4 1/2 marathons. I'm worried the surgery is going adversly affect my life. I have had 4 attacks in 6 months. The pain occurs in my chest and feels like I'm having a heart attack. When I went to the doctor they ordered blood work and an ultra sound. The blood work showed that my liver enzyme count was off the chart and the ultrasound showed that I had small gallstones. I've been reading a lot about alternatives to surgery. The doctor told me to avoid fatty greasy food. That's the funny thing... since I lost the weight 3 years ago I don't touch those kinds of foods. I'm wondering if the gallstone attacks (which are very infrequent) and high liver enzyme count are dangerous.
Posted Sat, Feb. 20, 2010 at 6:51 pm EST
Gary M. Gray, M.D.
It depends on the nature of the "attack". Although the simple presence of gallstones without symptoms is NOT an indication for surgery, attacks of so-called biliary colic (severe pain that prompts visits to a hospital Emergency Room) may be very dangerous in terms of inflammation, systemic infection, and even perforation and death. But minor discomforts or pains that are non-specific should not be attributed to the gallstones and are usually due to another cause. If the severe colic occurs, and especially if it is associated with abnormal liver function blood tests (aminotransferases, alkaline phosphatase, bilirubin) then it should prompt the recommendation for a cholecystectomy. It's done by relatively non-invasive laparscopic surgery, often not requiring even an overnight admission. Alternatives such as synthetic bile acid medications or ultrasound breaking of stones have additional attendant risks and, by and large, have been abandoned.
### Dr. Gary M. Gray, Professor of Medicine Emeritus, Stanford University School of Medicine, and President of the Celiac Sprue Research Foundation is TheDoctor's specialist in gastroenterology.
Posted Thu, Feb. 11, 2010 at 10:57 am EST
I had my gallbladder out on the 3rd. I had only had one severe attack in the last 6 months. I def noticed that certain foods affected it. I too thought about putting off the surgery. Fortunately I did not. When the doctors removed my gallbladder they indicated that it was very very inflamed. Recovery has been pretty easy. No major problems. I feel ready to return to work. Good Luck.
Posted Mon, Feb. 8, 2010 at 5:55 pm EST
i have been diagnosed with uncomplicated gall stones in gallbladder. whether it is necessary to remove the gallbladder
Posted Sun, Feb. 7, 2010 at 12:50 pm EST
Dr. Gary Gray, our specialist in gastroenterology, has responded to this concern about gallbladder operations in the Question of the Week.
Posted Tue, Feb. 2, 2010 at 9:50 am EST
It must be that time of year! I am having my gallbladder removed on Feb. 10. Val - they try laparoscopic (keyhole) surgery first on everyone - but if there are any complications, they may need to switch to "open" surgery. You should definitely prepare for that. Also, for those of you reconsidering - I was as well. I'm not a fan of surgery - and wasn't happy with the high percentage of people who had severe issues post-surgery. HOWEVER, the fact remains that if you do have stones - and they get lodged in the wrong places - you'll be in a life threatening situation. Also, depending on your age/choices - the attacks tend to flare up when you're pregnant. I decided on a pre-emptive strike before the stones could threaten my life - or a baby's.
Posted Sun, Jan. 31, 2010 at 8:41 pm EST
I am also due to have my gallbladder removed by keyhole surgery on feb 4th 2010 and I am also having second thoughts about the whole process, I suppose the nerves are getting to me just like linda jackson, all I can say is good luck linda and I'm sure everything will be okay
Posted Fri, Jan. 29, 2010 at 2:59 pm EST
i am due to have my gallbladder removed on feb.10,2010. after reading up on it, i am really reconcidering it..i have gall stones. i have had 3 attacks in 2 yrs. am i better off leaving the gallbladder in or takng it out? i dont know if or when i will have another one and what the time span will be between the attacks.i am really concerned about what to do..your return answer would be greatly; appreciated..thank you
Posted Sun, Jan. 17, 2010 at 10:05 pm EST