How to know if your stomach pain might be gallstones

Kalpit Devani, MD

Gastroenterology

Abdominal pain is common and can be caused by everything from gas to food poisoning to stomach viruses. While many causes of stomach pain are mild and short-lived, other causes can be more serious, like gallstones. Gastroenterologist Kalpit Devani, MD, explained what you need to know about gallstones and your gallbladder.

What are gallstones?

Gallstones are deposits in the gallbladder that can be as small as a grain of rice or as large as a golf ball. The gallbladder stores bile, and every time you eat fatty foods, bile is secreted from the gallbladder into the small intestine to digest those fats. When the gallbladder squeezes to pump out bile, gallstones can go inside the bile duct and irritate it, causing a cramping type of pain.

What causes gallstones?

It’s not clear what causes gallstones to form.

“Most gallstones are a result of cholesterol stones,” Dr. Devani said. “Having a low-fat or low-cholesterol diet may prevent gallstones from forming, but if you have certain genetic factors that increase your predisposition to forming stones, then even if your diet is low in cholesterol, you can still form cholesterol stones.”

Other gallstones could be a result of disorders such as sickle cell anemia or certain leukemias which increase the risk of developing stones known as pigment stones. However, the majority of gallstones are cholesterol stones.

Who’s at risk for gallstones?

Most patients who have gallstones don’t even know they have them. Only a small percentage of people who have gallstones require treatment.

Anyone can get gallstones, but it’s more common in people who have these risk factors:

• Female
• Age 40 or older
• Overweight
• Of Native American or Hispanic heritage
• Gain or lose weight too quickly
• A diet that’s rich in fatty food or a high-cholesterol diet
• A family history of gallstones
• Medications that increase the risk of developing gallstones
• Diabetes or liver disease

What are some signs that you might have gallstones?

One of the most common signs is pain that occurs on your right side about 30 to 45 minutes after you eat.

“Patients will also complain that they feel pain in their shoulder, which is related to how the nerve distribution is in the body,” Dr. Devani said. “But most pain is on the right side or middle of the body, sometimes radiating to the back.”

Do gallstones go away on their own?

Generally, once you have gallstones, they don’t just tend to go away. Your symptoms can improve if you exercise regularly and eat a diet low in fat and high in fruits and vegetables. But symptoms can also come back a few years later.

“Big stones are less likely to go away,” Dr. Devani said. “If you have small stones, which we call gravel, or sludge-like material in the gallbladder, that’s more likely to go away on its own.”

How are gallstones treated?

If gallstones are diagnosed, you can try a low-fat diet to see if symptoms improve. If that doesn’t help, the best treatment is to remove the gallbladder through surgery, usually done laparoscopically.

“It’s a safe procedure and most patients recover very well,” Dr. Devani said.

Removing the gallbladder has no effect on your ability to digest food. The liver makes bile that is released directly into the small intestine rather than into the gallbladder.

If the stone is stuck inside the bile duct, you may need a procedure to pull the stone out endoscopically, which is done by a gastroenterologist.