Gallstones (Cholelithiasis)

• What does the gallbladder do?+−

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  The liver produces bile continuously. The gallbladder stores and concentrates it, then releases it after meals — especially fatty meals — to help fat absorption. Stones, inflammation, or duct blockage disrupt that rhythm.

• How stones form — and who is at higher risk+−

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  When the balance of cholesterol, bilirubin, and bile salts is disturbed, crystals form and grow into stones. Cholesterol stones are most common. Risk rises with female sex, age, overweight, rapid weight loss, pregnancy, family history, and some metabolic conditions. Not every stone hurts.

• Typical symptoms+−

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  Classic biliary colic is pressure or pain in the right upper abdomen or epigastrium, often after a fatty meal, lasting 30 minutes to a few hours, sometimes radiating to the back or right shoulder. Nausea, vomiting, and bloating may accompany it.

  • Right-upper or epigastric pain after fatty meals
  • Pain radiating to the back or right shoulder
  • Nausea, vomiting, bloating
  • Fever, jaundice, or dark urine — complication warning
• Diagnosis+−

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  Abdominal ultrasound is usually the first step: stones, wall thickness, and duct diameter. Blood tests look for inflammation and cholestasis. Suspected duct stones or complications may need MRCP, CT, or ERCP.

• Treatment options+−

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  Asymptomatic stones are often observed; prophylactic cholecystectomy is not for everyone. Recurrent colic, cholecystitis, pancreatitis, or duct stones usually lead to cholecystectomy. Most cases are laparoscopic; selected anatomy may use robotics. Oral dissolution or shock-wave therapy has narrow indications — lasting cure for most symptomatic patients is surgery.

• Life without a gallbladder+−

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  Digestion remains possible. Early on, fatty meals may cause temporary sensitivity or looser stools; most people adapt. Lifelong special diets are not mandatory — balanced eating is enough for most.

• When to seek urgent care+−

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  Severe unrelenting pain, fever, rigors, jaundice, dark urine, pale stools, relentless vomiting, or diffuse abdominal tenderness need urgent evaluation — possible cholecystitis, cholangitis, or pancreatitis.

More chapters in this hub

• Acute Cholecystitis

  Fever and continuous RUQ pain — early surgery pathways

• Bile-Duct Stones

  Jaundice and cholangitis risk — ERCP then gallbladder removal

• Gallbladder Polyps

  Size, growth, and when surveillance becomes surgery

• Gallbladder Cancer

  Rare cancer — staging and tumor-board planning

• Laparoscopic Cholecystectomy

  Laparoscopic cholecystectomy: what the procedure aims to do and who it fits

• Robotic Gallbladder Surgery

  Robotic surgery: what the procedure aims to do and who it fits