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Digestive Disorders > Lower Abdomen

Gallstones: The most important things at a glance

Dr. med. André Sommer

Dr. med. André Sommer

Gallstones, like appendicitis, are typical common diseases. They often go unnoticed as long as there are no complaints. Anyone who feels pain and suffers from ongoing complaints should see a doctor. They can clarify whether drugs or surgery are necessary.

What are gallstones?

Gallstones - also known as cholelithiasis - are solid structures that are deposited in the gallbladder or bile ducts and can cause constipation there. If they are in the gallbladder, it is called cholecystolithiasis. If they get stuck in the bile ducts, it is called choledocholithiasis.

The deposits consist of clumped bile. Doctors call these clumps stones. Gallstones often contain the substances cholesterol or bilirubin, As long as the stones are only a few millimeters in size, they are called grains. Most of them are larger versions of up to several centimeters.

How many gallstones can you have?

They can appear individually or in groups. How many stones are normal cannot be said generally and depends on the state of health of the person concerned. Few and very small gallstones often cause no symptoms. Many or particularly large structures, on the other hand, can hardly be ignored because they cause pain and thus severely limit well-being.

What are the symptoms of gallstones?

Acute symptoms do not always occur. Many of those affected are not even aware that foreign bodies have formed in their bodies - they have so-called silent gallstones.

Typical symptoms of gallstones include the following:

  • Pressure or pain in the right upper abdomen
  • Flatulence
  • Burping
  • Nausea / vomiting
  • Feeling of fullness
  • Sudden sensitivity to regularly consumed foods (especially coffee, fatty or flatulent food).

The diagnosis is not always clear. The symptoms mentioned often also suggest other diseases. If the symptoms persist, it is therefore important to clarify the cause.

When does pain occur?

The gallbladder releases bile into the intestine during the digestive process in the body. It contracts for this purpose. If gallstones have formed in the gallbladder, it is no longer able to deliver the necessary bile to the intestine. The biliary tract is blocked, but the muscles there try with pressure and movement to push the gallstones out of the way. The consequence is bilious colic, which causes pain and severe abdominal cramps. In this context, people suffering from gallstones also experience symptoms such as back pain, since the aching cramps can radiate up to the back or the right shoulder.

Why does the skin turn yellow?

If the bile ducts become blocked, the bile cannot flow normally into the intestine. The result is that the typical yellow color of the bile is deposited in the surrounding tissue. Fever and jaundice occur with biliary colic. In the course of jaundice, the skin and the white part of the eye change color to yellow. At the same time, the urine becomes darker and the stool lighter than normal.

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What types are there?

The cause is a change in the contents of the bile. This causes the usual composition to become out of balance. Too much cholesterol in the bile often plays a crucial role because the substance is not water-soluble. If there is no suitable compensation by bile acid, bright clumps - so-called cholesterol stones - form.

Darker pigment stones are rarer. They develop when there is too much bilirubin in the bile. Bilirubin is a breakdown product of the red blood pigment, hemoglobin. Mixed forms of both types of gallstones are also possible.


Do you suspect you have gallstones? See your doctor. Only they can determine the severity and which treatment options are possible.

How can gallstones be recognized?

For a correct diagnosis, the doctor first needs sufficient information on the patient's history. If you have had biliary colic in the past, you may have new gallstones. Severe liver diseases can also favor gallstones. And if family members have biliary disorders or diabetes, there is a high probability that the patient could also be affected.

The doctor first palpates the patient's stomach. If there is pain in the right upper abdomen, this can indicate gallstones. The final step is examination with an ultrasound device (sonography). If there are clumps in the gallbladder, this can be seen on the ultrasound image - for example in the form of an enlarged gallbladder.

If there is a gallstone in the biliary tract, acute inflammation of the biliary tract (cholangitis) can occur. A blood test is necessary to determine this. In rare cases, further examinations are necessary, for example computer tomography (CT), an ultrasound of the gallbladder from the inside (endosonography) or magnetic resonance imaging (MRI).

What treatments are possible?

If there are minor complaints, pain relievers and antispasmodic medicines provide quick relief. Those affected should be aware that these remedies do not dissolve the gallstones. When and how they have to be removed depends primarily on the size of the stones. You may be able to take medication with ursodeoxycholic acid to ensure that they can be removed without surgery. The active ingredient can dissolve the unwanted clumps. A prerequisite for successful therapy is that the gallstones are quite small (maximum 15 mm). However, the drug does not prevent gallstones from forming again.

With large gallstones, the symptoms are often worse or occur frequently. Then surgery is usually inevitable. The doctor usually removes the entire gallbladder or does further examinations.

How can you prevent gallstones?

A balanced and healthy diet can reduce the risk of gallstones. A diet of certain food groups can be useful in this context. What is important is to design a diet low in fat and high in fiber. In addition, exercise and sport can prevent the formation of gallstones. On the other hand, those who eat unhealthy and have excess weight increase the likelihood. With increasing age, it is also advisable to regularly check your cholesterol levels in the blood in order to avoid cholesterol stones.

Dr. med. André Sommer

Dr. med. André Sommer

I’m André, a medical doctor from Berlin. Together with a team of medical doctors, nutritionists and data scientists we empower people to understand digestive issues with our app Cara Care.

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