Gallstones are small, hardened deposits that form in the gallbladder — a small, pear-shaped organ located just beneath the liver. Though they might not always cause symptoms, when they do, the effects can be painful and serious, sometimes even triggering conditions like acute pancreatitis.
What Are Gallstones?
Gallstones are made up mostly of cholesterol or bilirubin, substances found in bile. Bile is the digestive fluid produced by the liver and stored in the gallbladder, released into the small intestine to help break down fats. When the balance of substances in bile is off, stones can form — ranging in size from a grain of sand to a golf ball.
There are two main types:
- Cholesterol stones – the most common type, formed when there’s too much cholesterol in the bile.
- Pigment stones – made from excess bilirubin, more often seen in people with liver disease or certain blood conditions.
Why Do Gallstones Form?
Several risk factors can contribute to the development of gallstones, including:
- A high-fat, high-cholesterol, or low-fibre diet
- Obesity or rapid weight loss
- Diabetes
- Pregnancy
- Being female, especially over age 40
- Family history of gallstones
- Certain medications, such as hormone therapy or cholesterol-lowering drugs
While gallstones are common — especially in older adults — many people may have them and never know it.
Symptoms to Watch For
Gallstones don’t always cause problems. But when they block the flow of bile, they can trigger a gallbladder attack, often referred to as biliary colic. Common symptoms include:
- Sudden, sharp pain in the upper right abdomen or centre of the belly
- Pain that may spread to the back or right shoulder blade
- Nausea or vomiting
- Pain after eating fatty or greasy foods
- Fever and chills (a sign of possible infection)
- Jaundice (yellowing of the skin or eyes), if a bile duct is blocked
If symptoms persist or become severe, immediate medical attention is crucial.
Gallstones and Pancreatitis
One of the more serious complications of gallstones is acute pancreatitis. This happens when a gallstone passes out of the gallbladder and blocks the bile duct or pancreatic duct, triggering inflammation of the pancreas. This connection is important — gallstones are among the leading causes of acute pancreatitis in South Africa and globally.
If you’ve had a gallbladder attack or been diagnosed with pancreatitis, your doctor will likely investigate whether gallstones are involved.
Diagnosis and Treatment
Gallstones are often diagnosed through:
- Ultrasound – the most common and reliable imaging method
- CT scan or MRI – to detect stones and related complications
- Blood tests – to check for signs of infection, liver function, or inflammation
Treatment depends on the severity of symptoms. Options include:
- Watchful waiting – if the stones aren’t causing symptoms
- Medications – to dissolve cholesterol stones (though not commonly used)
- Surgery – a laparoscopic cholecystectomy (gallbladder removal) is the most effective treatment for recurring symptoms or complications
- Endoscopic procedures (ERCP) – to remove stones from bile ducts, especially if they’ve caused pancreatitis or infection
Living Without a Gallbladder
Many people live completely normal lives without a gallbladder. Bile will still reach the intestine, but instead of being stored, it flows continuously from the liver. Some people may experience mild digestive issues, especially with fatty meals, but these usually improve over time.
Final Thoughts
Gallstones are more than just a digestive issue — they can be silent for years or suddenly lead to serious conditions like pancreatitis. Understanding the signs and knowing when to seek help can make all the difference.
👉 Next: Recognising the Symptoms of Gallstones
Reviewed April 2025. Always consult a professional for individual guidance.
What Causes Acute Pancreatitis?
Gallstones: What You Can Do to Lower Your Risk
