Gallstones are common, and the pain and confusion they can cause shouldn’t be brushed off. Some people never feel a thing. Others get sudden, sharp pain, often right after eating that can be mistaken for indigestion or a stomach bug.

The good news: gallstones are usually very treatable once you know what you’re dealing with. This guide covers what causes them, what they feel like, how they’re diagnosed, and when surgery becomes the right call.

Quick Answer: What Are Gallstones, and When Is Surgery Needed?

Gallstones are hardened deposits that form in the gallbladder. While they do not always cause symptoms, they can cause painful attacks when they block the flow of bile. Surgery to remove the gallbladder may be recommended when gallstones cause recurring symptoms or complications.

What Are Gallstones, and Why Do They Form?

The gallbladder is a small organ beneath the liver that stores bile, a digestive fluid that helps break down fats. Gallstones form when substances in bile become too concentrated and harden into solid particles. The two primary types are:

• Cholesterol Gallstones: The most common type of gallstone. They form when bile contains more cholesterol than it can dissolve, causing the excess cholesterol to gradually harden into a stone.
• Pigment Gallstones: These form when bile contains too much bilirubin, a substance produced when the body breaks down red blood cells. Excess bilirubin can build up and form dark-colored stones.

Gallstones can be as small as a grain of sand or as large as a golf ball. Some people develop just one; others develop hundreds of tiny ones at the same time. Size and number don’t always predict how much pain they’ll cause.

What Raises Your Risk

Gallstones tend to form when the balance of substances in bile shifts, or when the gallbladder isn’t emptying the way it should. Things that can raise your risk include:

• Carrying excess body weight
• Losing a lot of weight very quickly
• A family history of gallstones
• Health conditions like diabetes, liver disease, or certain blood disorders
• Pregnancy or medications containing estrogen
• Age and biological sex

Having one or more of these doesn’t mean gallstones are guaranteed, it just means the odds are a little higher.

What Do Gallstones Feel Like?

Symptoms may occur when a gallstone blocks the gallbladder or another bile duct. A temporary blockage can cause a gallbladder attack, also known as biliary colic. Common signs include:

• Pain under the right ribs: This can range from mild discomfort to a sharp, intense ache.
• Pain in the upper-middle abdomen: Some people feel it just below the breastbone instead.
• Pain that spreads: Discomfort can radiate to the back, between the shoulder blades, or to the right shoulder.
• Nausea or vomiting especially during or right after an episode.
• Pain after eating, particularly after a high-fat meal. Eating signals the gallbladder to contract, which can trigger symptoms.

How Gallstones Are Diagnosed

Diagnosis usually starts with a conversation about your symptoms and health history, followed by a physical exam. From there, your doctor may use:

• Abdominal ultrasound typically the first imaging test used to spot gallstones
• Blood tests to check for signs of infection or inflammation
• CT scan to get a fuller picture of the abdomen and rule out other causes
• MRI to examine the bile ducts closely if a blockage is suspected

In some cases, a specialized procedure may be used to locate or treat a stone that has moved into a bile duct.

Can Gallstones Be Prevented?

Not every case can be prevented, but a few habits may help lower your risk:

• Keep a healthy weight: This can help reduce some of the underlying risk factors.
• Lose weight gradually: Slow, steady weight loss is easier on the gallbladder than rapid, restrictive dieting.
• Eat a balanced diet: Fiber and healthy fats support overall digestive health.
• Stay active: Regular movement supports overall health and may help manage risk.
• Manage related conditions: Keeping conditions like diabetes under control, with your doctor’s guidance, supports your gallbladder too.

When Is Gallbladder Surgery Needed?

Not everyone with gallstones needs surgery. If gallstones are found by accident and aren’t causing any symptoms, your doctor may simply monitor them. Surgery tends to come into play when gallstones cause:

• Repeated attacks: Recurring, significant pain often points to symptomatic gallstones.
• Gallbladder inflammation (cholecystitis): This happens when a stone blocks the gallbladder’s outlet.
• Bile duct blockages: A stone can move into the common bile duct and disrupt normal bile flow.
• Gallstone pancreatitis: A stone can block digestive fluid from reaching the small intestine, inflaming the pancreas.
• Other serious complications, such as infection.

What To Expect From Gallbladder Removal Surgery

The most common surgery for symptomatic gallstones is a cholecystectomy, which removes the gallbladder. The liver continues to produce bile after surgery, but the bile flows directly into the small intestine rather than being stored in the gallbladder. Many patients undergo laparoscopic cholecystectomy, a minimally invasive procedure that uses small incisions and specialized instruments. In certain situations, an open procedure may be recommended instead. Your surgical team can explain which approach is appropriate for you and provide guidance on recovery and returning to normal activities.

Improving Your Gallbladder Health at Florida Medical Clinic Orlando Health

At Florida Medical Clinic Orlando Health, patients can receive evaluation and treatment for gallstones and other gallbladder conditions. Providers review symptoms, medical history, diagnostic results, and overall health to determine the most appropriate next steps. When surgery is recommended, patients can receive guidance about their procedure, recovery, and ongoing care. With convenient locations throughout the region, patients can easily connect with a provider and receive personalized care. This approach can help patients better understand their condition and make informed decisions about treatment.

Meet Thushy Siva, MD, FACS

Dr. Thushy Siva specializes in minimally invasive laparoscopic and robotic-assisted surgery and is committed to combining advanced surgical techniques with compassionate patient care. She also has a special interest in breast disease management and provides care for patients with benign and malignant breast conditions. Dr. Siva is passionate about prevention and has participated in community efforts to raise awareness about breast and colon cancer prevention. Outside of medicine, she enjoys traveling, spending time with her family, baking, and reading.

Schedule a consultation with Dr. Thushy Siva today to take the next step toward understanding your gallstone symptoms and exploring the treatment options that may be right for you. Call (813) 367-0121 to get started.