A Review of the Causes, Risk Factors, Symptoms, Treatments, and Complications of Gallstones


Gallstones, known as cholelithiasis, are small pieces of hardened bile in the gallbladder or bile ducts. Bile is a digestive fluid released in the liver and stored in the gallbladder, a pear-shaped organ on the right side of the abdomen. Gallstones vary in size from grain-sized to golf ball-sized. Some patients have one gallstone, while others have many. They can get stuck in the biliary tract, blocking bile flow and requiring gallbladder surgery.


While researchers have not yet found the exact cause of gallstones, several possibilities exist.

Too much cholesterol in your bile– Bile typically has enough chemicals to break down cholesterol excreted by the liver. However, the liver might produce more cholesterol than the chemicals can dissolve, resulting in yellow cholesterol gallstones.
Too much bilirubin in the bile is a chemical byproduct of red blood cell breakdown. It passes through the liver before being excreted. Some conditions, like liver cirrhosis and particular blood disorders, can cause the liver to produce excess bilirubin that it can’t break down, causing pigment gallstones, often black or dark brown.
Concentrated bile– This happens when the gallbladder is full. Usually, the gallbladder releases bile into the small intestines for digestion. If this does not occur, the contents become concentrated, leading to gallstones.

Risk Factors

  • Being female
  • Having a Native American or Mexican Hispanic heritage
  • Being 40 and above
  • Having a gallstone family history
  • Having a high-fat or high-cholesterol diet with low fiber
  • Conditions like diabetes, obesity/ being overweight, liver cirrhosis, and liver disease
  • Blood disorders like leukemia, anemia, or sickle cell anemia
  • Rapid weight loss
  • Pregnancy
  • Being sedentary
  • Medications with estrogen, like hormone therapy medications
  • Intestinal diseases like Chron’s

Signs and Symptoms

Gallstones might not cause symptoms if they are small and pass through. However, if one or more gallstones are stuck, causing a block in your bile flow, you might experience the following symptoms: biliary colic or gallbladder attack.

  • Sudden, intensifying pain in your abdomen’s upper right part
  • Nausea or vomiting
  • Pain in the middle of the abdomen
  • Fever
  • Sweating
  • A yellow tint in your eyes or skin
  • Abdominal tenderness and swelling
  • Light-colored poop or dark-colored pee
  • Heartburn, indigestion, and gas
  • Pain in your back or lower shoulder

Gallstone pain can last between minutes and hours. It can feel like a sharp, intense stabbing, squeezing, or cramping. The pain comes in waves, and you might feel it more after eating or waking up. Once the pain starts, you cannot do much about it, but it subsides if the gallstone passes. However, you should visit the doctor if the pain lasts over two hours. When you get to the doctor, they get an accurate diagnosis through a physical exam, blood tests, a CT scan, an abdominal ultrasound, a HIDA scan, an MRCP, an ERCP, or an endoscopic ultrasound.


Many people with gallstones get a cholecystectomy, a procedure to remove the gallbladder. This is the most permanent solution to ensure you do not get them again. The surgeon can do it as a laparoscopic surgery with tiny incisions or an open procedure. You can also get non-surgical treatments, like medications with bile acids, which help break down gallstones. The most common ones are Chinex and Actigall. Some doctors also recommend shock wave lithotripsy, which involves using shock waves from a lithotripter machine to break down gallstones. Doctors can also recommend percutaneous gallbladder drainage. It involves inserting a needle in the gallbladder for drainage. However, this is the last option if you are ineligible for other options.


  • Gallbladder inflammation—Acute cholecystitis occurs when a gallstone blocks the gallbladder, keeping it from emptying. It causes fever and constant pain, and if not treated immediately, the gallbladder might burst.
  • Infected bile ducts—Also referred to as acute cholangitis, this results from a blocked bile duct. If the bacteria enters the bloodstream, it might also result in sepsis.
  • Blocked pancreatic ducts– The pancreatic duct connects to your common bile duct before getting to the duodenum. Therefore, a gallstone could pass from the common bile duct to the pancreatic duct, blocking pancreatic juices. It might result in pancreatitis, which results in severe pain.
  • Gallbladder cancer– This is rare, but individuals with a gallstone history have a higher chance of getting gallbladder cancer.

Gallstones are common, but some people might not even notice them. However, you should watch out for any symptoms indicating a gallstone attack and seek medical help immediately. At Valley Surgical RGV, we aim to provide exceptional healthcare for patients of all ages. Our competent team is led by board-certified surgeons: Dr. Ernesto Garza and Dr. Luis Reyes. We use innovative surgical techniques to ensure optimal patient comfort, safety, and recovery. We follow proven surgical guidelines, methods, and principles for safe cholecystectomies to help alleviate your stomach and back pains.

We also offer reliable follow-up care and advice to ensure a speedy and safe recovery. We evaluate every treatment option, identifying areas we can adjust to make it more effective. We also provide information to ensure clients avoid the same conditions in the future. Visit our offices, call us, or complete our online patient contact form for bookings and more information.

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