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Q&A: Why do gallstones form?

Gallstones are hardened deposits of bile, and they form when bile contains more cholesterol than the gallbladder can dissolve.

Gallstones are hardened deposits that form when bile contains more cholesterol than the gallbladder can dissolve.
Gallstones are hardened deposits that form when bile contains more cholesterol than the gallbladder can dissolve.Read moreGetty Images

The gallbladder is a small, pear-shaped organ located below the liver in the right side of the abdomen. The gallbladder stores bile, fluid that breaks down fat from food, and sends it to the small intestine.

Gallstones are hardened deposits of bile, and they form when bile contains more cholesterol than the gallbladder can dissolve. Excess cholesterol hardens and forms a small stone, usually between the size of a grain of rice and an almond.

Small gallstones can be present and asymptomatic in the gallbladder for years. However, larger gallstones can cause damage if they block bile from leaving the gallbladder or liver and entering the small intestine. The buildup of bile can lead to an inflamed or infected gallbladder, also known as gallbladder disease. Bile buildup in the liver can cause jaundice and inflammation of the bile duct system. Gallstones also are able to travel through the bile ducts and block the opening of the pancreas, causing inflammation called pancreatitis.

Symptoms of gallbladder disease include:

  1. Pain in the right upper part of the abdomen, possibly radiating to the back and right shoulder

  2. Abdomen pain that worsens during and after meals

  3. Nausea and vomiting

  4. Fever and chills

Oftentimes, doctors can detect gallstones or gallbladder disease through a physical exam, as gallstones can cause tenderness in the abdomen. Ultrasounds and blood tests also can help identify gallstones or confirm a diagnosis.

If gallstones are causing pain, a doctor may recommend gallbladder removal surgery, known as cholecystectomy. About 600,000 Americans have their gallbladders removed each year, making the procedure one of the most common surgeries performed. Those who undergo gallbladder removal surgery usually return home and perform their normal activities within a day.

Laparoscopic cholecystectomy, a minimally invasive surgery option, is the most common and safest type of gallbladder surgery. If the gallbladder becomes too inflamed, the stone has gone through the bile duct, or the individual has delayed care for too long, open gallbladder removal surgery may be necessary.

Gallstones are much more common in young women than young men, but by age 60, men and women experience gallstones at similar rates. Gallstones can occur in children, and children with sickle cell disease are especially at risk. Native Americans and Mexican Americans also have higher rates of gallstones than other people of other ethnic groups.

Lifestyle factors contribute to increased risk for gallstones. Frequent consumption of foods high in fat can lead to gallstones; a healthy diet and lifestyle are the best methods to limit risk for gallbladder issues.

Do not wait until symptoms worsen. If you are experiencing symptoms of gallstones, seek medical care immediately.

Leon Clarke is the vice chairman of surgery and chairman of the cancer committee at Mercy Catholic Medical Center.