Gallstones

What are gallstones?

Gallstones are hard deposits that form in the gallbladder, a small organ beneath the liver that stores bile. The NHS estimates they are very common, and Guts UK puts the figure at roughly 10 to 15 out of every 100 people in the UK. Many people never know they have them because gallstones often cause no symptoms at all.

When gallstones do cause problems, the most common presentation is biliary colic — upper-abdominal or right-sided pain that may radiate to the back or shoulder, often starting after a meal (especially a fatty one) and lasting from minutes to hours. The NHS and NICE CG188 both describe this pattern.

Common symptoms

• Sudden, intense pain in the upper abdomen or right side
• Pain that may spread to the back or right shoulder
• Pain that often follows meals, especially fatty foods
• Nausea and vomiting
• Fever or shivering (possible infection)
• Jaundice (yellowing skin or eyes)

Not all upper-abdominal pain is gallstones. The pain pattern overlaps with functional dyspepsia and IBS, so proper investigation matters.

How gallstones are diagnosed

• Ultrasound scan of the upper abdomen is the first-line test. It is quick, non-invasive, and widely available on the NHS.
• Blood tests check for inflammation, infection, or jaundice.
• MRCP or ERCP may be used if a stone is suspected in the common bile duct.

Treatment options

• No treatment needed for silent gallstones that are found incidentally and cause no symptoms.
• Laparoscopic cholecystectomy (keyhole removal of the gallbladder) is the standard treatment for recurrent symptomatic gallstones. NICE CG188 supports this approach. It is one of the most common operations in the UK.
• ERCP can remove stones from the common bile duct when present. It carries a small risk of pancreatitis and bleeding and is done in specialist units.

After gallbladder removal

Guts UK states that around 13 in 100 people may develop diarrhoea after having their gallbladder removed. If this diarrhoea persists, it should be investigated for bile acid diarrhoea (BAD) rather than assumed to be IBS or a food intolerance.

Risk factors

• Increasing age
• Female sex
• Obesity
• Rapid weight loss
• Some hereditary conditions (for example, sickle cell disease)

Red flags — seek urgent care

The NHS advises seeking urgent medical attention if you develop jaundice, severe unremitting abdominal pain, or fever with shivering. These can signal complications such as bile duct blockage or infection (cholangitis) that need prompt treatment.

Approaches people discuss

Gallstones are managed by clinicians. The community themes below sit alongside, not in place of, medical assessment.

• Established Observation for silent gallstones with no symptoms. The NHS and NICE agree that removing the gallbladder is not routinely recommended if you have no symptoms. Sources: NHS gallstones; NICE CG188.
• Established Laparoscopic cholecystectomy for recurrent biliary colic or complications. NICE CG188 recommends this as standard care. Sources: NICE CG188; NHS.
• Established Investigating persistent post-cholecystectomy diarrhoea for bile acid diarrhoea (BAD), not assuming IBS or food intolerance. Sources: Guts UK; BAD page.

What not to self-manage

These are cautions, not approaches people discuss:

• Do not use “gallbladder flushes”, “liver cleanses”, or other unproven remedies — there is no good evidence these dissolve or remove gallstones (NHS; NICE CG188).
• Do not self-manage red-flag symptoms at home — jaundice, severe unremitting abdominal pain, or fever with shivering need urgent assessment for possible bile duct blockage or infection (NHS).