Most gallstones don't cause symptoms for a long time. If they remain in the gallbladder, they may never cause symptoms. However, sometimes large stones can break down the wall of the gallbladder and get into the intestines causing a blockage. This is known as gallstone ileus.
Usually, the stones pass from the gallbladder into the bile ducts. They may remain there without blocking the flow of bile or causing symptoms, or they may pass on into the small intestine without being noticed.
However, if the gallstones cause a blockage in a bile duct, a person will have pain. The pain tends to come and go (this is sometimes called colic). Usually, the pain builds up to a certain level and then gradually falls. It can be sharp and intermittent for several hours.
Where the pain is felt can vary. Usually it is in the upper right part of the abdomen, which may be tender to touch. The pain may be felt in the right shoulder blade. A person may feel nauseated and throw up. If the blocked bile duct becomes infected, a person may develop a fever, chills and a yellowish cast to his or her skin.
Gallstones can block the cystic duct, causing the gallbladder to become inflamed (acute cholecystitis). Stones may block the pancreatic duct causing inflammation of the pancreas (pancreatitis).
Symptoms such as indigestion, an inability to tolerate fatty foods, belching, bloating, a feeling of fullness and nausea are some times believed to be gallstones. However, these symptoms are also common to indigestion or peptic ulcer disease. If a person feels pain in the right upper part of the abdomen after eating fatty food, this may be a sign of gallstones.
Causes and Risk Factors
High levels of estrogen, usually from multiple pregnancies or birth control pills (or both), are thought to be one cause of gallstones in women. Other factors that put a person at higher risk of developing gallstones are:
- Being overweight
- Age. About 20% of American older than 65 have gallstones, but most never experience problems
- A Western diet
- Being a Native American or Hispanic
- Having sickle cell anemia
- Crash dieting