SurgiSense

---

What are gallstones?

Gallstones can be very small, like grains of sand, or larger, like a marble. Some people may have just one stone, while others may have several.

They can be yellow-green if made mostly of cholesterol, dark brown or black if made from bile pigments, or a mix of both. Essentially, they are hardened “stones” of the materials your body normally uses to digest food.

---

How do they form?

Gallstones form when there is a misbalance in the components of bile.

• Cholesterol stones occur when bile has too much cholesterol, which cristalizes and gradually grows into stones.
• Pigmented stones form when bile has too much bilirubin – a pigment from broken-down red blood cells – which clumps together to make solid particles.

Stones are more likely if the gallbladder doesn’t empty properly, so bile sits too long and allows crystals or particles to stick together. 

---

Who is more likely to get gallstones?

Certain factors increase the risk: 

Being overweight

Obese people often have higher cholesterol in their body, which can increase cholesterol in the bile beyond what bile salts can dissolve, allowing stones to form. Obesity also slows gallbladder emptying, so bile stays longer and gives crystals more time to grow.
Even if blood cholesterol is normal, these changes in gallbladder function and bile composition can still increase the risk of gallstones.

Being a woman

Women are more likely to develop gallstones because female hormones – especially estrogen – increase cholesterol in bile and can slow gallbladder emptying. This is why gallstones are more common during pregnancy or in women taking hormonal therapy.

Age

As we get older, the gallbladder tends to empty more slowly and changes in bile composition make stones more likely to form over time.

Diet

Eating a lot of sugary or highly processed foods can increase the risk of gallstones, mainly because they can lead to weight gain, higher cholesterol in bile and changes in how your body handles fat. A balanced diet with plenty of fiber, vegetables, fruits and healthy fats can help lower the risk.

Rapid weight loss

Surgery may carry a slightly higher risk because weight loss is often faster and food intake is more limited immediately afterward.

This happens because bile becomes more concentrated with cholesterol. When the body burns fat quickly, the liver releases extra cholesterol into the bile, which can crystallize into stones. At the same time, the gallbladder empties less often, especially when food intake is low, so bile can sit longer and give crystals more time to form and stick together.

Diet composition can influence risk slightly: very low-calorie diets or diets extremely low in fat can slow gallbladder emptying, increasing the chance of stone formation. Diets with moderate fat encourage normal gallbladder contractions.

Genetics

Some people inherit traits that make them more likely to form gallstones, like higher cholesterol or bilirubin in the bile, or a gallbladder that empties more slowly. If gallstones run in your family, your risk is higher too, even if you live a healthy lifestyle.

---

What are the symptoms?

Gallstones are quite common — about 10–20% of adults have them, but the vast majority never have any symptoms and might not even know they have them.

When gallstones do cause problems, the most common symptom is pain in the upper right part of your tummy, which can come and go and sometimes spread to your back or right shoulder. This is called biliary colic. Other symptoms include feeling sick, vomiting, bloating, or discomfort, especially after fatty meals.

Gallstones are often discovered by chance when you have a test, particularly an ultrasound done for another reason.

---

Biliary colic

Biliary colic is a pain in your upper tummy caused by a gallstone temporarily blocking the flow of bile. When you eat, the gallbladder contracts to release bile into your intestine. Sometimes a stone moves and blocks the exit, causing pain. The discomfort comes from the body’s reaction to the blockage and the extra contractions the gallbladder makes to try to push the stone through. This can also trigger nausea or vomiting, because the gallbladder signals the body that something is wrong.

Most of the time, the gallbladder unblock itself and the stone drops back in, so the pain goes away.

However, sometimes the gallbladder contractions push the stone further into the bile duct or even block the pancreas, which can lead to more serious complications that need urgent medical attention.

---

Cholecystitis

Cholecystitis simply means inflammation of the gallbladder, and it often ends up involving infection as well. The most common cause is gallstones.

What usually happens is that a stone gets stuck at the outlet of the gallbladder (the cystic duct), which blocks bile from flowing out. When that happens, bile starts to build up inside, increasing pressure and irritating the lining of the gallbladder. That irritation is what triggers the inflammation.

As things progress, the trapped bile creates an environment where bacteria can grow, so what starts as inflammation can turn into infection. The gallbladder wall can become swollen and thickened, and in more severe cases its blood supply can be affected. This explains why the pain is different from simple gallstone pain—it tends to be more constant and severe, and is often accompanied by fever and tenderness. If not treated, it can lead to complications.

The treatment involves pain relief and antibiotics. In most cases, the best option is to remove the gallbladder, usually with a keyhole operation, which removes both the infection and its source and helps prevent future problems.

---

Do gallstones mean surgery?

Not necessarily. Many people have gallstones and never have any symptoms, so no treatment is needed in those cases. If the stones aren’t causing pain or complications, your doctor will usually recommend simply monitoring things rather than surgery.

---

Life without a gallbladder

You can live perfectly well without a gallbladder. Its main job is to store bile, but your liver will still produce bile even after the gallbladder is removed. Instead of being stored, the bile simply flows directly into your digestive system.

Most people don’t notice much difference after surgery and can return to a normal diet over time. Some may experience mild digestive changes at first, like looser stools – especially after fatty meals, but this usually settles. Overall, people go on to live normal, healthy lives without a gallbladder.