All You Need To Know About Gallstones

What are gallstones?

Gallstones are a result of bile build-up inside the gallbladder. Bile or digestive fluid is produced in the liver and transported to the intestine to help digest food. The extra bile not used for digestion is transported to the gallbladder for storage and released when needed.


The release of bile occurs after eating a fatty meal through contraction of the gallbladder. Bile consists of different substances: cholesterol, small amounts of bilirubin, calcium, phospholipids, and bile salts. Stone formation happens when there is an imbalance in bile composition, bile flow is blocked, or gallbladder inactivity. When bile hardens, it forms crystals that clump together and become stones. Most bile stones are small but can go as big as marble.

What are the causes and types of gallstones?

High levels of cholesterol or bilirubin in the bile result in the development of cholesterol or pigmented stones. When the amount of cholesterol exceeds in proportion to other substances and the capacity of the bile fluid to dissolve it, the extra cholesterol hardens inside the gallbladder and forms a cholesterol gallstone. Cholesterol stone is the most common account and goes as high as 80% of cases in the US.


Pigmented stones develop when an extra amount of bilirubin is joined with calcium to form a solid precipitate calcium bilirubinate. When red blood cells break down, bilirubin is released. Bilirubin is then brought to the liver and processed into its soluble form. In cases where the liver is not functioning normally, like in cirrhosis or cancer, and if there is an increased breakdown of red blood cells due to infection or underlying illness such as hemolytic anemia, the excess bilirubin will attach to calcium and form a stone.

What are the risk of developing gallstones?

  1. Women of childbearing age are prone to developing cholesterol stones because of the presence of the hormone estrogen. Estrogen increases cholesterol production, and as women age until after menopause, the level is high.
  1. Multiple pregnancies. The hormone progesterone is high during pregnancy. Progesterone lowers the intensity of gallbladder contraction. If the gallbladder doesn’t contract normally, some of the bile remains inside the gallbladder leading to the eventual development of sludge into stones.
  1. Use of oral contraceptive
  1. Obesity is associated with increased production of cholesterol in the liver which will cause an imbalance in the bile composition.
  1. Lack of exercise and diet high in saturated fats.
  1. Diseases such as diabetes, hyperlipidemia, hemolytic anemia, and liver cirrhosis 
  1. Rapid weight loss decreases cholesterol levels creating an imbalance in bile composition and increasing the precipitation of calcium bilirubinate stone formation.


The easiest way to know who is at risk is to remember the 4 Fs: Female, Fat, Forty, and Fertile.

What food causes gallstones?

Since bile is composed of cholesterol taken from the diet and processed by the liver, eating fatty foods is restricted to prevent the imbalance of bile composition. Excess intake of processed sugar, starch, and carbohydrates not used by the body for energy will be converted into fats and stored in the adipose.


A healthy balanced diet high in fiber from fruits and vegetables and lean meat is ideal while decreasing the consumption of fast foods, sugary beverages like sodas and fruit juices in cans, and processed foods.

How do you know when you have gallstones?

Most people with gallstones do not show any symptoms. Gallstone attack happens when the stone inside the gallbladder escapes and gets dislodged in the tube connecting to the intestines or the liver, usually after a fatty meal. Symptoms occur when the bile fluid from the gallbladder or the liver is blocked, making the gallbladder contract. The pain is perceived to be in the right upper abdomen below the rib cage. Sometimes the pain radiates to the right shoulder or upper arm or vague abdominal pain associated with nausea and vomiting.


When the blockage is prolonged, it may lead to infection and inflammation, referred to as cholecystitis causing symptoms such as fever and chills, constant extreme pain in the right upper abdomen, nausea, and vomiting. But if the stone blocks the tube between the gallbladder and the liver, it causes more grim problems as it also affects the liver. Aside from abdominal pain, there will be yellowing of the skin and the white portion of the eye. This condition is called choledocholithiasis. Both conditions are considered medical emergencies, so it is imperative to recognize the signs and symptoms.

How is it diagnosed, and what are the treatment options?

Abdominal ultrasound is the diagnostic of choice and cost-effective. Modalities such as x-ray and ct-scan also detect gallstones with a much lower accuracy.


Once gallstone is incidentally discovered, no treatment is necessary unless it starts causing problems. Surgical intervention is the definitive treatment of choice for symptomatic gallstones.


Medication to dissolve stones is an option. Complete dissolution is only successful for stones made purely from cholesterol. Treatment is between 6-18 months associated with a higher incidence of recurrence. 


Types of surgical treatment for gallstones showing signs and symptoms may differ depending on the presentation, status, and size of the stones.


There are two types of surgery for gallstones:

  1.  Open Cholecystectomy: The gallbladder is taken-out through surgery by an open incision in the abdomen below the right rib cage. Recovery may take longer, and the patient is in the hospital for several days.
  1. Laparoscopic Cholecystectomy is a minimally invasive approach to removing the gallbladder with less hospital stay, and post-operative pain and can be done in an outpatient setting. 

Talk to our doctors to discuss treatment options.

Can you live without a gallbladder?

People who have their gallbladders removed can live normal life. The liver will still produce enough bile to aid in food digestion. No special diet is necessary as long as you follow a healthy balanced diet.




EVA Teleconsult can help patients who are suffering from gallstones. We have primary care physicians and specialist who is equipped to diagnose, discuss treatment options and provide appropriate management and advise for those with gallstones. Our doctors are always ready to address any questions or concerns you may have.Here is how EVA works, at EVA our patients are guaranteed to experience the following: 

  • Timely appointments – No more time wasted while waiting outside a doctor’s office. With us, appointments begin right when they’re supposed to, even if they’re made the same day.
  • Guaranteed 30-minute consultation times – No more rushing or quickly dashed off prescriptions with no explanations. Our doctors take the time needed to give you information about your concerns, and are open to answering all your questions.
  • 5-star ratings for our doctors – Because our doctors know how to explain things in a way patients can understand, we frequently get positive feedback from them.

If you feel that you may have symptoms of bacterial vaginosis but are unsure, it always best to seek medical advice from a health care professional. Get the treatment you or your loved ones need and book an online consultation today.

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