Published April 28, 2025
You just ate a bacon cheeseburger with fries and a milkshake. You’re feeling bloated and nauseated. Now there’s an ache in your abdomen underneath your rib cage. What’s going on?
According to the experts at Yale New Haven Health, you may have a gallstone.
“Your gallbladder is an organ that holds bile, the greenish-yellow liquid that helps you digest food. Gallstones are hard deposits of bile that form in your gallbladder,” said Shannon Small, MD, a general surgeon at Lawrence + Memorial Hospital and assistant professor of Surgery at Yale School of Medicine.
There are two types of gallstones: pigment stones and cholesterol stones. Pigment stones are made of bilirubin, which is what gives bile its distinct color. Cholesterol stones – the most common type of gallstone – can form in patients who have high levels of cholesterol in their blood.
“Gallstones can range in size from a grain of sand to a golf ball,” Dr. Small said.
You can have gallstones and not know it. Gallstones that don't cause any symptoms typically don't need treatment. “Many small stones will pass out of the gallbladder and into the biliary system and cause no problem,” she said.
However, if a stone gets stuck and blocks the flow of bile from your gallbladder to your small intestine, it can cause symptoms such as:
Dr. Small suggests making an appointment with your doctor if you have any signs or symptoms that concern you. However, if you have sudden and severe pain that lasts for hours or any yellowing of the skin or eyes, seek medical help immediately.
“This could indicate a serious blockage in the biliary system,” she said.
Because most gallstones don’t hurt or cause health problems, you may be surprised to learn you have them.
“Many gallstones are found incidentally on a CT scan of the abdomen, or by an ultrasound of the abdomen that was ordered looking for something else,” Dr. Small said. If you have cholesterol gallstones, your doctor may prescribe a medication that can dissolve them. However, the medication is not always effective — and the gallstones may return, she added.
Most people who experience symptoms usually require surgery. “The main treatment for symptomatic gallstones is to have the gallbladder surgically removed with a procedure called a cholecystectomy. This can be done a few different ways: by traditional open surgery; or a laparoscopic procedure; or by using a robotic surgical system, which is minimally invasive and results in a shorter hospital stay and faster recovery for patients,” Dr. Small said.
If gallstones are present in the main bile duct, a gastroenterologist can perform a procedure called an Endoscopic Retrograde Cholangiopancreatography (ERCP) to remove them. They can also be removed surgically from the bile duct at the time of the cholecystectomy if needed, Dr. Small said.
Studies estimate that at least 10 percent of U.S. adults have gallstones. Risk factors for gallstone include:
It's not clear what causes gallstones to form, and you might not be able to avoid them. But certain lifestyle changes might help lower your risk.
“The best prevention for gallstones is to eat a balanced diet low in fat, maintain a healthy weight, avoid rapid weight loss and exercise regularly,” Dr. Small said.
