What Are the Symptoms of Gallstones?

Women develop gallstones more frequently than men.
Gallstones are small crystals that form in the gallbladder.
An ultrasound can confirm the presence of gall stones.
Seek medical attention if gallstones occur in conjunction with a high fever or intense pain.
Nausea can be an early symptom of gallstones.
Article Details
  • Originally Written By: S. Mithra
  • Revised By: Emma Lloyd
  • Edited By: L. S. Wynn
  • Last Modified Date: 02 August 2014
  • Copyright Protected:
    2003-2014
    Conjecture Corporation
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Gallstones are small clusters of crystals that form in the gallbladder. If they become large or numerous enough, they can block the organ’s ducts and prevent digestive bile from reaching the small intestine. Most gallstones are tiny and cause no harmful effects, but stones that are large enough to warrant removal cause symptoms such as indigestion, bloating, nausea, and pain. Severe symptoms of gallstones, which include chills, fever, and intense pain, indicate an emergency situation.

How Gallstones Form

Stored in the gallbladder, bile is made up of water, cholesterol, salts, and bilirubin, a substance formed from the breakdown of red blood cells. In some cases, the cholesterol or bilirubin can stick together, forming small "stones" and becoming trapped in the mucus within the organ. Worldwide, between 10% and 20% of adults have gallstones, but fewer than half will ever experience any effects because they never grow large enough to cause harm. Stones that do get bigger over time may block the ducts of the organ, causing pain and other forms of discomfort. People are more likely to experience these symptoms as they grow older, because the stones continue to form and grow throughout life.

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Minor Symptoms

When the signs of gallstones first appear, they may include indigestion, bloating, nausea, gas, and abdominal pain, which is known as biliary colic. Collectively, these are referred to as a gallbladder attack. Symptoms usually develop within an hour of eating a fatty meal, and occur when stones block the cystic duct of the gallbladder. Fatty foods provoke an attack because bile is what allows fat digestion to occur in the stomach. The gallbladder contracts as it secretes bile, increasing the likelihood that stones will become trapped in the cystic duct.

The abdominal pain associated with this disease is typically felt in the upper right quadrant of the abdomen, and sometimes radiates to the right shoulder. Usually, the pain will go away within 60 to 90 minutes, but it can sometimes last for several hours. Mild pain can be relieved by over-the-counter medications. Pain and other effects gradually fade as the gallbladder stops contracting, allowing the stones to move out of the duct.

People who experience mild symptoms of gallstones during an attack have a 3% to 9% chance of the disease progressing to a more severe state. Anyone who experiences these symptoms regularly should seek medical advice so that the condition can be monitored. Diagnosing the problem early allows for more treatment options, including non-surgical procedures.

Major Symptoms

As stones grow larger or more numerous, the gallbladder often becomes inflamed and irritated, worsening the effects of an attack. The range of symptoms includes all of those in the mild category, as well as vomiting, chills, and fever. In an acute attack, the pain is more severe, and might extend to cover the mid-abdominal area, the right shoulder, and the upper back.

This level of pain does not always respond to common pain medications, but should respond to analgesics prescribed by a medical professional. People with severe pain are usually unable to find a comfortable sitting or lying position, and tend to shift positions repeatedly as a coping mechanism. These symptoms do not necessarily signify an emergency situation, but someone who experiences them is most likely a candidate for gallbladder removal in the future.

Contributing Factors and Treatments

For someone who progresses beyond the mild symptoms of gallbladder disease, the effects he or she experiences will worsen with age, simply because stones grow larger over time. Most people with major symptoms will eventually require some kind of medical treatment. Laparoscopic cholecystectomy, a procedure for removing the gallbladder, is quite common and typically relieves all symptoms, but it's not always required.

Diet

Most symptoms of gallstones develop after eating fatty foods, making diet one of the most important ways to control them. The more fat there is in any single meal, the greater the likelihood of an attack, and the worse the effects are likely to be. Adopting a reduced-fat diet won’t eliminate the disease altogether, but it will usually reduce the frequency and severity of painful episodes.

Exercise

The effects of an attack, particularly the level of pain, can be made worse by exercise, because deep breathing and vigorous movement can put additional pressure on the contracting organ. Regular exercise does improve a person’s general health, but physical exertion during or after an episode should be avoided. Any movement during an attack should be slow and careful, not only to avoid worsening the pain, but because the symptoms of a severe attack can be slightly disorienting.

Menstruation

While there is no hard evidence to prove a connection, some women find that their symptoms worsen during menstruation, to the point where minor gallbladder pain is sometimes felt in the absence of any other symptoms. Women have a higher risk of developing stones than men, because estrogen promotes cholesterol secretion in the bile. If there is a connection between menstruation and gallbladder attacks, it might be due to the effect that estrogen levels have on stone formation. When this phenomenon does occur it is no cause for alarm unless the symptoms are at emergency level.

When Do Symptoms Indicate an Emergency?

In extreme cases, nausea, sharp upper abdominal pain, and vomiting might occur in conjunction with a high fever, violent chills, or excessive perspiration. These symptoms indicate an emergency situation where immediate medical attention is required. This is especially true when symptoms are accompanied by jaundice, a condition in which the skin and the whites of the eyes appear yellowish in color. These very severe symptoms develop when the gallbladder has stopped working correctly, leading to the build-up of high toxin levels in the body and bloodstream. This can occur as a result of gallbladder disease alone, or in conjunction with complications, such as an infection.

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Discuss this Article

anon178886
Post 7

My husband got home from the hospital two days ago. He was admitted to the hospital last week with jaundice and brown urine. His bilirubin values were extremely high and his liver was enlarged. The ddx was acute ETOH hepatitis, possible cirrhosis. On the fourth day, an MRI study showed a large gall stone, which was causing a blockage. A few hours later he was released. In the two days he's been home, he's continued to have yellow watery diarrhea and has developed symptoms he didn't have while in the hospital: painful abdominal bloating and pain in the upper right abdomen, which one time last night he described as severe.

Considering these new symptoms and his dx of a blockage due to the gall stone and acute ETOH hepatitis, should he go to the ER or can he wait until he sees his regular doctor in three days?

anon92977
Post 6

The pain under your ribcage could most definitely be gallstones. I had pain starting with mild soreness to severe chronic pain that wrapped around my abdomen for 5 years before doctors found out it was gallstones. Demand an ultrasound! Surgery is not always necessary! They told me I needed surgery and I proved them wrong with a dietary gallbladder flush and flushed them out of my digestive system!

anon23838
Post 5

anon19351: Have you tried taking a pregnancy test? Just kidding. In my experience, it can cause extreme bloating.

anon19115, superdad199, & anon5913: That could be gallstones. Go to your doctor and have a full work up done. Also, 5913, your stools and skin will be normal unless you have acute cholecystitis.

anon19351
Post 4

Can gallstones create bloating within about 5 minutes from a fairly flat stomach to the appearance of a full term pregnancy - that lasts for weeks at a time?

anon19115
Post 3

I have pain underneath my ribcage to the side and it extends all the way to the middle of my stomach. It is not a sharp pain. More like a soreness with some pain. What could this be?

superdad199
Post 2

I have pain on the right side just below the rib extending to the center of my abdomen. Once a month I become ill for 36-48 hours w/ vomiting and diarrhea. what is this????? Any clue? Going on for past 6 weeks. Respond if you have a clue. Thanks

Moderator's reply: i'd recommend seeing a doctor for a complete checkup to rule anything serious out as soon as possible.

anon5913
Post 1

hi, recently after or during a meal, i would feel pain about 1-2 cm below the right of my ribs, is it because of gallstones? I am 14 this year and i have normal stools. I do not have any other of the other symptoms and i have a huge appetite. The pain is not very severe and would last for less then 10 mins each time though it only occurs sometimes. What is the cause??? I have no idea so can anyone tell me why??? It would be very much appreciated...Thank you

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