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If you’re experiencing severe abdominal pain, fever, or heavy bleeding, call 911.

Gallstones

Gallstones Explained

Gallstones can form when bile contains too much cholesterol, bilirubin, or not enough bile salts. Most are “silent” and discovered incidentally. When a stone gets stuck in the cystic duct or common bile duct, it can cause a gallbladder attack (biliary colic), inflammation (cholecystitis), jaundice, pancreatitis, or infection of the bile ducts.

Symptoms

Typical gallstone pain is sudden, severe, and located in the upper right or upper middle abdomen, often after a fatty meal. Some people never have symptoms.

Symptoms include:
Sudden, steady pain in the right upper abdomen or mid-upper abdomen
Pain that may radiate to the right shoulder or back
Nausea or vomiting during attacks
Sometimes fever, chills, or jaundice if complications develop

When to call

Call the office if you have recurring upper right abdominal pain, especially after meals, or if you have known gallstones and symptoms are changing or more frequent.

Seek emergency care for severe right upper abdominal pain lasting more than a few hours, fever and chills, jaundice, persistent vomiting, or if you suspect a gallbladder attack that isn’t improving.

Evaluation & Tests
Management & Treatment

Diagnosis is usually made with an ultrasound of the gallbladder and bile ducts. Blood tests help look for infection or blockage of the bile ducts or pancreas.

History of characteristic pain episodes (timing, triggers, duration)
Physical exam focused on the right upper abdomen
Abdominal ultrasound as the first-line imaging
Blood tests for liver enzymes, bilirubin, pancreatic enzymes, and white blood cell count
Additional imaging (MRCP, CT, or ERCP) in complicated cases

Silent gallstones often need no treatment. Symptomatic gallstones are usually treated with gallbladder removal (laparoscopic cholecystectomy), which prevents recurrent attacks. Urgent treatment is needed for complications like infection or pancreatitis.

Observation only for asymptomatic stones in most cases
Laparoscopic cholecystectomy for recurrent pain or complications
Pain control and antibiotics when inflammation or infection is present
ERCP to remove stones blocking the common bile duct when needed
Diet and lifestyle adjustments as advised after surgery
This information is for general educational purposes only and is not a diagnosis or personalized medical advice. It does not replace a visit with your own healthcare provider. Always follow the specific recommendations given by your medical team. If you have urgent or worsening symptoms, contact your provider or seek emergency care right away.

At-a-glance

Abdominal painNausea / vomiting

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Information on this website is for education only and not a substitute for medical advice.

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