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Gallstones

What are gallstones?

Gallstones are hard, rock-like deposits that form in the gall bladder or bile duct. The gallbladder is a small organ located under the liver. The gallbladder stores bile, a digestive fluid made in the liver.

Gallstones vary in size. Some are the size of a grain of salt. Others are the size of a golf ball. Gallstones are usually not harmful. But if they block the bile duct, gallstones can cause pain and other complications.

How gallstones can affect the gallbladder

Gallstones are hardened deposits that form in the gallbladder.

How the gallbladder works

As the stomach and intestines digest food, the gallbladder releases bile. Bile is a fluid that is made by the liver to help break down fats. 

Bile moves through the bile duct. This tube connects the gallbladder and liver to the small intestine. A gallstone can block this tube. This makes it hard for the body to break down fats.

Symptoms of gallstones

Some gallstones do not cause any problems. But if they block the flow of bile, they can cause pain and other symptoms. Typical gallstone pain is sudden and severe. This is called a gallstone attack. This usually happens after eating, especially after a heavy or fatty meal. 

Signs and symptoms of gallstones include:

  • Pain in the upper abdomen, in the back between the shoulder blades, or right shoulder or arm
  • Fever
  • Nausea and vomiting
  • Fast heart rate
  • Yellowing of the skin and eyes (also called jaundice)
  • Dark urine (pee)
  • Clay-colored stool (poop)
  • Pain or swelling in the abdomen (belly)
  • Severe pain in the upper abdomen that can move to the shoulders and back 

Causes of gallstones

Gallstones can form when substances in bile harden. This may happen because of too much cholesterol or bilirubin. Gallstones can also occur when the gallbladder does not empty properly.

Certain factors may increase the risk of gallstones. These include:

  • Having sickle cell disease
  • Taking medicines that have estrogen, such as oral contraceptives or hormone therapy
  • Pregnancy
  • Obesity or being overweight
  • Rapid weight loss
  • Family history of gallstones
  • Eating a diet high in fat or cholesterol
  • Medical conditions, such as diabetes (high blood sugar) or liver disease

Gallstones and Sickle Cell Disease

Gallstones are more common in people with sickle cell disease than in people without sickle cell disease. This is because most gallstones in sickle cell disease are caused by too much bilirubin.

Bilirubin forms when red blood cells break down. People with sickle cell disease often have extra bilirubin because of how quickly their red blood cells break down. Biliary sludge (when the extra bile settles in the duct) can also led to gallstones in people with sickle cell disease.

Diagnosis of gallstones

Your health care provider will do a physical exam and health history. Tests may include blood tests to check for infection, inflammation, jaundice or other health problems. 

Imaging tests or scans are used to diagnose gallstones. These may include ultrasound (sonogram), CT scan, or MRI.

Treatment of gallstones

If gallstones are not causing problems, your care team may choose to monitor your child and wait.

Treatment for gallstones may include managing symptoms. This may include:   

  • Pain medicine
  • IV fluids to prevent dehydration
  • Medicines to relieve nausea and vomiting
  • Antibiotics for infection

Surgery to remove the gallbladder (cholecystectomy) is the main way to treat gallstones permanently. Your body can function without a gallbladder. 

If not treated, gallstones that block the bile ducts or cause inflammation can lead to complications. Complications of gallstones include:

  • Biliary colic: severe pain that happens when a gallstone temporarily blocks the bile duct
  • Cholecystitis: inflammation of the gallbladder
  • Pancreatitis: an inflammation of the pancreas that can occur when a gallstone blocks the pancreatic duct

Untreated gallstones can lead to gallbladder damage. In rare cases, chronic gallstone disease can increase the risk of gallbladder cancer.

How to prevent gallstones

Gallstones can’t always be prevented. But you can take steps to help lower the risk for gallstones. Ways to help prevent gallstones include:

  • Eat a diet low in fat, low in cholesterol, and high in fiber.
  • Exercise regularly.
  • Do not smoke.
  • Drink plenty of fluids.
  • Keep a healthy weight.

A dietitian can help you make a plan for healthy eating and weight loss if needed.

Questions to ask the care team

  • What is my child’s risk for gallstones?
  • What symptoms should we watch for?
  • What treatment options are available for gallstones?
  • What does the recovery process look like after gallbladder surgery?
  • What lifestyle changes might help my child feel better or prevent future issues?

Key points about gallstones

  • Gallstones are hard deposits that form in the bile duct or gallbladder.
  • Gallstone attacks are episodes of severe pain that happen when the bile duct is blocked. They often occur after a heavy or fatty meal.  
  • Imaging tests are used to detect gallstones.
  • Treatment for gallstones can include pain medicines, antibiotics, or IV fluids to manage symptoms.
  • Some patients may need surgery to remove the gallbladder. This is called a cholecystectomy.

—
Reviewed: September 2024

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