Gallstones can lurk inside your gallbladder. Many people have gallstones and never know it. Gallstones are hard deposits in your gallbladder, a small organ that stores bile, which is a digestive fluid made in the liver. Gallstones may consist of cholesterol, salt, or bilirubin, which is discarded red blood cells. Gallstones range in size. They can be as small as a grain of sand or as large as an apricot.

What Causes Gallstones?

The components in bile can crystallize and harden in your gallbladder, leading to gallstones. According to Harvard Health Publications, 80 percent of gallstones are made of cholesterol. The other 20 percent of gallstones are made of calcium salts and bilirubin. These are known as pigment stones.

Cholesterol Stones:

Gallstones may develop when there is too much cholesterol in the bile secreted by your liver. Bile usually dissolves or breaks down cholesterol. However, if your liver makes more cholesterol than your bile can dissolve, hard stones may develop.


Bilirubin is a chemical produced when your liver destroys old red blood cells. Some conditions, such as cirrhosis of the liver and certain blood disorders, cause your liver to produce more bilirubin than it should. Stones form when your gallbladder cannot break down the excess bilirubin. These hard substances are also called pigmented stones.

Concentrated Bile:

Your gallbladder needs to empty bile to be healthy and function properly. If it fails to empty its bile content, the bile becomes overly concentrated, which causes stones to form.

Who Is at Risk for Gallstones?

While your body produces cholesterol naturally, you can also take in excess cholesterol through your diet. Many risk factors for gallstones are related to diet.

These include:
  • being overweight or obese
  • eating a diet that’s high in fat or cholesterol
  • rapid weight loss within a short period of time
  • eating diet that’s high in fiber having diabetes mellitus
Other risk factors include:
  • being pregnant
  • having a family history of gallstones
  • being age 60 or older
  • having cirrhosis of the liver
  • taking certain medications for lowering cholesterol
  • taking medications that have a high estrogen content
  • Don’t stop taking any medicines unless you have discussed it with your doctor.

What Are the Symptoms of Gallstones?

You may not experience any symptoms if you have gallstones. According to the American College of Gastroenterology (ACG), 80 percent of people who have gallstones don’t have any pain at all. These are called “silent” gallstones. Your doctor may find these stones in your gallbladder from X-rays or performing surgery on your abdomen.

Some people do have gallstone symptoms. The most common symptom of gallstones is pain in the right upper quadrant of your abdomen. The pain often radiates to your back or right shoulder or shoulder blade.

Other symptoms include:
  • Fever
  • A yellowish tint in your skin or eyes, which can indicate jaundice
  • Nausea or vomiting
  • Clay-colored stools

How Are Gallstones Diagnosed?

Your doctor will perform a physical examination that includes checking your eyes and skin for visible changes in color. A yellowish tint in your skin or eyes may be signs of jaundice. Too much bilirubin in your body causes jaundice.

The examination may involve using diagnostic testing to see inside your body.

These tests include:

Ultrasound tests produce images of your abdomen. This is the preferred imaging method to initially confirm that you have gallstone disease.

Abdominal CT Scan

This is an imaging test that takes pictures of your liver and abdominal region.

Gallbladder Radionuclide Scan

This is a very important scan that takes about one hour to complete. A specialist injects a radioactive substance into your veins. The substance travels through your blood to the liver and gallbladder. It highlights any infection or blockages in these organs.

Blood Tests

Your doctor may order blood tests that measure the amount of bilirubin in your blood. The tests also help determine how well your liver is functioning.