Signs and Symptoms of Gallstones

Problems with the gallbladder, a pear-shaped organ underneath the liver, are common. Gallbladder problems affect about 10% to 15% of the U.S. population, with women about twice as likely to be affected than men.

Think of the gallbladder as a storage tank for the digestive system. It stores bile, a digestive fluid made in the liver that helps break down fats. Most gallbladder issues are tied to the formation of gallstones, which are hardened build-ups of calcium and cholesterol that range in size from grains of sand to golf balls.

Gallstones can cause unusual gallbladder symptoms when they block the flow of bile to the small intestine. This can lead to pain after eating, nausea, and vomiting, among other symptoms.

Most people have gallstones with no symptoms, often called "silent stones." Silent stones do not require treatment, but problems can arise if these stones get lodged in the bile ducts, which secrete bile into the upper portion of the small intestine called the duodenum.

Gallstones can block the outflow of bile, which can cause both an immediate gallbladder attack—also known as gallstone attack—and more long-term symptoms. If bile duct blockage is left untreated, gallstones can become fatal. 

Abdominal Pain

The gallbladder becomes active when you eat fatty foods, so gallbladder attacks often occur after eating, typically in the evening or at night. 

When gallstones get stuck traveling to the stomach, they cause the gallbladder to spasm, which leads to sharp pain that may feel like being cut by a knife in the upper right side or center of your abdomen. Healthcare providers say the pain can be so severe that you might even mistake it for a heart attack.

This symptom is known as biliary colic, and it’s the main sign of gallstones. Gallstone-related pain may also:

• Cause cramping or a constant ache in the upper right and middle of the abdomen
• Radiating pain to the upper back and right shoulder
• Last 30 or more minutes, often several hours
• Not resolve with over-the-counter (OTC) painkillers

Pain is the primary symptom of gallbladder attacks. If these consistently follow meals, it can tip your healthcare provider off that you have symptomatic gallstones.

Nausea and Vomiting

Another common sign of gallstone attacks is intense nausea, which can lead to vomiting. This also often arises after eating and may be a sign of more serious complications of the condition, such as appendicitis, infection, and others. As with other gallstone symptoms, this can last for several hours before resolving.

Fever

Gallstone attacks can also be accompanied by fever, which can indicate  inflammation or infection of the gallbladder. In many cases, the fever is relatively low grade, and you may experience chills or sweats.

While this isn't serious in and of itself, it can be a sign of significant issues and more serious conditions, especially when arising alongside other signs of gallstones.

Jaundice

Whether caused by gallstone issues or another cause, jaundice can be a sign of a serious medical concern. Jaundice is a condition characterized by the skin and eyes turning yellow due to spikes in bilirubin, a yellowish substance in bile that’s made during your body’s normal process of breaking down old red blood cells.

When gallstones block bile ducts, the resulting bile build-up in the gallbladder and liver raises these levels in the blood.

Not only might jaundice be a sign of gallstone complications, it can also occur with liver problems (such as hepatitis and chronic liver disease), blood diseases, genetic conditions, and others. 

Sudden Weight Loss

Gallstones don't cause sudden loss of weight in and of themselves, but they can accompany it. Obesity raises the risk of gallstone formation, and rapid weight loss can further increase that risk.

When you go without food for a prolonged period, or experience sudden weight loss, the liver produces bile with higher cholesterol content. In turn, this can spur the development of gallstones.

For this reason, people who've had weight loss surgery procedures, such as gastric bypass, are particularly prone to gallstones. These may also develop when people adopt very restrictive, low-calorie diets.

Clinical Signs

Since most people with gallstones don't experience symptoms—and since these symptoms can also accompany other diseases—many people learn they have gallstones only after medical evaluation. 

Signs that prompt diagnosis of gallstones include:

• Abnormal levels of bilirubin levels in the blood
• Signs of gallbladder, pancreas, or liver infection and inflammation found after blood tests
• Appearance of gallstones in ultrasound imaging, which relies on sound waves to locate gallstones in the gallbladder
• Gallstones seen using other imaging methods, such as magnetic resonance imaging (MRI) or X-ray
• Gallstone formation visible using cholescintigraphy, an imaging approach that relies on injecting small amounts of radioactive material in the blood

Certain populations are at increased risk of developing gallstones:

• Those over the age of 40
• People assigned female at birth
• People with obesity
• Those who have rapidly lost or gained weight

When to See a Healthcare Provider

Most people with gallstones don't experience any symptoms. According to a recent review, between 80% to 90% of those diagnosed experience no signs within five to 10 years of diagnosis. And thankfully, only about 1% of those who experience symptoms end up with complications.

However, asymptomatic cases can later become symptomatic. If you have gallstones, you and your healthcare provider can determine whether going ahead with treatment is the best option.

Generally, if you experience any gallstone symptoms, you should seek care and call your healthcare provider. Signs of gallstone complications, such as infection and inflammation in the gallbladder, pancreas, or liver are of particular concern.

You should contact a healthcare provider as soon as possible if you experience:

• Persistent abdominal pain that lasts several hours
• Pain resistant to over-the-counter medicine
• Nausea and vomiting
• Fever or chills
• Jaundice (yellowing of the eyes or skin)
• Very dark, brown-colored urine
• Light-colored stools

These symptoms can also show up due to other gastrointestinal problems, such as ulcers, appendicitis, pancreatitis, and others, and need immediate medical attention.

A Quick Review

Gallstones rarely become a serious issue, however, they can be difficult to live with. 

Gallstones can cause bouts of persistent abdominal pain, nausea, and vomiting, and are often associated with fever, jaundice, and other symptoms. 

If you're experiencing signs of gallstones, it's critical to seek out a diagnosis and get medical help. Talk to your healthcare provider to learn your options for treating and managing this condition.