Gallstones are very common and most never cause trouble. Stones that cause no symptoms usually need no treatment. When they do cause pain or complications, keyhole removal of the gallbladder is the standard and effective treatment.

What are they?

The gallbladder is a small pouch under the liver that stores bile and squeezes it into the gut after meals. Gallstones form when substances in bile, mainly cholesterol, harden into stones. They can be as small as sand grains or several centimetres across.

Many gallstones are found by chance on an ultrasound done for another reason. These 'silent' stones usually stay silent.

Who gets them?

• Women more than men, and risk rises with age
• Excess weight, and also rapid weight loss, including after weight-loss surgery
• Pregnancy
• Diabetes and raised blood fats
• A family history of gallstones
• Blood conditions that break down red cells, such as sickle cell disease and thalassaemia, which are relatively common in the Gulf region and can cause gallstones at a young age

What problems can they cause?

• Biliary colic: a steady, severe pain in the upper abdomen or under the right ribs, often after a meal or at night, sometimes spreading to the back or right shoulder blade. It usually lasts from about half an hour to a few hours and then settles
• Acute cholecystitis: inflammation of the gallbladder, with pain lasting more than several hours, tenderness, and often fever
• A stone in the bile duct: can block bile flow and cause jaundice, dark urine and pale stools, or infection of the bile duct (cholangitis) with fever and shivering
• Acute pancreatitis: a small stone passing through the duct can inflame the pancreas, causing severe pain into the back and vomiting

Tests

An abdominal ultrasound is the main test for gallstones. Blood tests check liver function and the pancreas. If a stone in the bile duct is suspected, an MRI of the bile ducts (MRCP) or an endoscopic ultrasound (EUS) may be used to confirm it.

Treatment

Silent stones usually need no treatment. Removing the gallbladder is considered only in a few special situations, for example in some people with sickle cell disease or other conditions that make complications more likely, which your doctor will discuss.

• Painful stones: laparoscopic (keyhole) cholecystectomy is the standard treatment. Most people go home the same day or the next day and return to normal activity within one to two weeks
• Acute cholecystitis: treated in hospital, and the gallbladder is usually best removed early, during the same admission when possible
• Stones in the bile duct: usually removed by ERCP, an endoscopic procedure through the mouth, before or after the gallbladder operation, or sometimes by the surgeon during the operation itself
• Dissolving tablets and shock-wave treatment work only rarely and are not routinely used. Stones tend to return if the gallbladder is left in place
• After weight-loss surgery, ursodeoxycholic acid tablets are often prescribed for about 6 months to help prevent gallstones. If you have been given them, keep taking them as advised

Eating before and after surgery

While waiting for surgery, smaller meals with less fried and very fatty food may reduce attacks for some people, but diet does not dissolve stones. After the gallbladder is removed, bile flows directly into the gut, and most people return to a normal diet. Some notice looser stools after fatty meals for a few weeks; this usually settles. If it persists, your doctor can help.

Common questions

This leaflet is general information and does not replace advice from your own doctor. Version 1.0, October 2026. Next review October 2028.