Gallstones are hardened deposits that form in the gallbladder. The gallbladder is a small organ below the liver that stores and concentrates bile. This bile helps to digest fat. From components of the bile, above all cholesterol, stones can form over time, from tiny to several centimetres in size.
Gallstones are very common: about one in ten adults has them, women more often than men. The most important point up front: the vast majority of gallstones never cause symptoms, and then they usually do not need to be treated.
Free app
Keep symptoms and medicines in view.
Whether painkillers during colic or medicines around an operation: brite reminds you to take them, helps you record symptoms, and checks for interactions. So you are well prepared for your next appointment.
With gallstones, one distinction is decisive, because it determines the treatment:
Silent (asymptomatic) stones: about 80 percent of all gallstones never cause symptoms. They are often found by chance on an ultrasound scan. Such silent stones usually do not need to be treated or operated on. Each year, only a small proportion of them become symptomatic at all.
Symptomatic stones: if a stone causes symptoms, above all biliary colic, things are different. The symptoms then often recur, and the risk of complications rises. Here treatment is sensible, more on this below.
A stone does not automatically mean surgery
If a silent gallstone was found in you by chance and you have no symptoms, watchful waiting is usually right. Only when stones cause symptoms is treatment usually carried out. There are exceptions only in special situations, more on this in the treatment section.
Symptoms: from biliary colic to bloating
When gallstones do cause symptoms, the typical sign is biliary colic:
severe, often persistent pain in the right upper abdomen or the stomach area, which can radiate into the back, the right shoulder or the right flank. More on this: Flank pain.
the pain often occurs after fatty or large meals, frequently in the evening or at night, and can last from a few minutes to several hours.
often accompanied by nausea or vomiting.
Besides this, non-specific symptoms are sometimes named, such as bloating, a feeling of fullness or pressure in the upper abdomen after eating. More on this: Bloating. Important: such symptoms are very common and usually have other causes. They are not a reliable sign of gallstones.
When gallstones become dangerous
Symptomatic gallstones can cause complications, and that is exactly why they are treated. The most important ones are:
gallbladder inflammation (cholecystitis): a stone blocks the outlet of the gallbladder, and it becomes inflamed. Persistent severe pain over several hours and fever are typical.
a stone in the bile duct (choledocholithiasis): if a stone moves into the main bile duct, it can block the flow of bile. This can cause jaundice, that is a yellowing of the skin and eyes, dark urine and pale stool. More on this: Jaundice.
an infection of the bile ducts (cholangitis): if an infection backs up behind the stone, fever and chills are added. This can become dangerous.
pancreatitis (inflammation of the pancreas): if a stone blocks the shared outlet of the bile and pancreatic ducts, the pancreas can become inflamed. This is a serious emergency.
When these warning signs need to be assessed at once is described below in the section “When to see a doctor”.
Diagnosis: how is it determined?
The most important test if gallstones are suspected is an ultrasound of the abdomen. It reliably shows stones in the gallbladder and is painless.
In addition there are usually:
blood tests, above all liver and bile values (for example bilirubin, GGT and ALP) as well as the pancreatic value lipase.
if a stone in the bile duct is suspected, further examinations, for example a special magnetic resonance scan (MRCP) or an endoscopic examination (ERCP), with which bile duct stones can also be removed right away.
Treatment: a clear surgery indication, not diet myths
How treatment is done depends above all on whether the stones cause symptoms.
Silent stones: usually no treatment, but watchful waiting. Surgery here is only sensible in special situations, when there is an increased risk of gallbladder cancer, for example with a so-called porcelain gallbladder, with very large stones (over about 3 centimetres) or with certain gallbladder polyps.
Symptomatic stones: here removing the gallbladder (cholecystectomy) is the standard treatment. Today it is almost always done minimally invasively through small incisions (laparoscopic, “keyhole surgery”). The reason: after the first colic, the symptoms often recur, and the risk of complications rises. You can live normally without a gallbladder, the bile then flows directly from the liver into the gut. In some of those operated on, milder digestive symptoms remain at first.
Complications such as gallbladder inflammation or a stone in the bile duct are treated in a targeted and often rapid way, for example with timely surgery or endoscopic stone removal (ERCP).
What about “eating low-fat”?
Contrary to what is often heard, existing gallstones cannot be dissolved by a diet, and there is no special “gallstone diet” that removes the problem. For those with symptomatic stones, removing the gallbladder is the lasting solution. Very large, fatty meals can trigger colic in some people, and avoiding them can reduce symptoms, but it is not a cure. Medicines to dissolve the stones are only an option in rare exceptional cases.
Medication plan
Keep the overview around colic and surgery.
Whether painkillers in the acute situation or medicines before and after an operation: brite reminds you to take them, checks for interactions and keeps your medication plan ready for your appointment.
Seek medical advice if you have biliary colic for the first time (severe pain in the right upper abdomen), if such symptoms recur or if a silent stone has been found and you are unsure how to proceed.
Have these warning signs assessed at once
With severe abdominal pain that lasts longer than about five hours, with fever or chills together with abdominal pain, or with a yellowing of the skin and eyes (jaundice), you should go to the emergency department at once or call the emergency number (112, in the US: 911). Behind this can be gallbladder inflammation, an infection of the bile ducts or pancreatitis, which need to be treated quickly.
Keep the overview around gallstones with brite
Whether painkillers in the acute situation or medicines around an operation: brite helps you remember to take them and keep the overview.
Intake reminders: for painkillers or medicines before and after an operation.
Symptom diary: record colic episodes and possible triggers, helpful for your next appointment.
Interaction check: see at a glance whether your medicines work well together.
Medication plan: all medicines in one place, ready for the next appointment.
No. Silent gallstones that cause no symptoms usually do not need to be treated. Only when stones cause symptoms is surgery usually sensible.
Severe, often persistent pain in the right upper abdomen that can radiate into the back or right shoulder, often after fatty food and frequently with nausea. It arises when a stone blocks the flow of bile.
No. Existing stones cannot be dissolved by a diet, and there is no special diet that removes the problem. Avoiding very fatty meals can reduce colic, but it is not a cure.
With symptomatic stones (for example after biliary colic) and with complications. With silent stones only in special situations with an increased cancer risk, such as a porcelain gallbladder or very large stones.
Usually minimally invasively through small incisions (laparoscopic). You can live normally without a gallbladder, the bile then flows directly from the liver into the gut.
With severe, long-lasting abdominal pain, with fever and abdominal pain, or with a yellowing of the skin and eyes. Then seek medical help at once, because serious complications can be behind it.
From components of the bile, above all cholesterol. Contributing factors include female sex, excess weight, age, a family predisposition and very rapid weight loss.
Usually not. Bloating, gas or pressure in the upper abdomen are very common and often have other causes. They are not a reliable sign of gallstones.
Important note: This article is for general information and does not replace medical advice, diagnosis or treatment. With severe abdominal pain, fever or a yellowing of the skin and eyes, you should seek medical help promptly. Which treatment is right for you depends on your individual situation. Last updated: June 2026.
