Pinpointing the Pain: Gallstones & The Places They Get Stuck (Infographic)

A small bag containing gallstones

Did you know you could have gallstones and not even know it? Gallstones are pretty common, but only a fraction of the people who have them even know they are there. General surgeon Mitchel McKenzie, MD, UnityPoint Health, explains gallstone symptoms, treatment, causes and the difference between gallstones vs. kidney stones.

Gallbladder Function

The gallbladder is a storage organ connected to the liver by a network of bile ducts.

“The liver is constantly producing bile, which is a liquid used in the absorption of fats in our diet,” Dr. McKenzie says. “When we are fasting, the bile isn’t release into our bowel and fills the gallbladder where it is stored. When we eat a meal containing fats, our bowel sends a signal to the gallbladder that it’s time to release bile.”

Dr. McKenzie says certain things can cause an imbalance in the bile stored in the gallbladder or lead to decreased emptying of the gallbladder, which results in gallstone formation.

Gallstone Causes

“Gallstones are very common. Roughly 20 percent of the population will develop gallstones in their life. However, only 20-30 percent will develop symptoms from them,” Dr. McKenzie says.

What causes gallbladder stones may include:

  • Fasting
  • Rapid weight loss
  • High cholesterol
  • Obesity
  • Chronic illness
  • Pregnancy
  • Multiple pregnancies
  • Hemolytic blood issues (blood disease resulting in anemia)
  • Genetics

“Classically, gallstones are most typical in those over age 40. However, with the current obesity issues, younger individuals are developing gallstones as early as their teens,” Dr. McKenzie says.

Gallstone Pain & Symptoms

If you develop gallstones, Dr. McKenzie says you’ll likely get multiple firm stones at one time all varying in size. Remember, only 20-30 percent of people who get gallstones will notice any pain or symptoms associated with the stones. Those who do experience symptoms often complain of:

  • Right upper quadrant pain. This is the area to the right of your belly button, under your right ribs down to your pelvis. The classical symptoms are pain in this area following a fatty or greasy meal.
  • Back pain. The pain can radiate from the right upper quadrant through the right hip (right flank) to the back.
  • Chest pain & indigestion. Those with gallstones might even notice chest pain and indigestion.
  • Nausea and vomiting. Both can be gallstone symptoms.
  • Steatorrhea. Some people develop very loose, greasy, foul-smelling stools.

“Gallstone pain can vary person to person. Some only have indigestion, while others feel they are having a heart attack and describe it as the worse pain in their life,” Dr. McKenzie says.

Gallstones vs. Kidney Stones

Dr. McKenzie says while they are both stones, gallstones and kidney stones are two very different things.

Infographic explaining gallstones

Passing Gallstones

The good news is you can pass small gallstones. Dr. McKenzie says some small gallstones leave your gallbladder and pass into your bile ducts. The stones that don’t get stuck move into the small bowel and are passed in your stool. However, the stones that get stuck are the ones that cause problems.

Gallstones can get stuck in the gallbladder itself (acute cholecystitis), causing inflammation and even infection in the gallbladder. Stones can also become stuck outside of the gallbladder in the bile ducts, causing an infection (ascending cholangitis), which can be life threatening.

Gallstone Treatment

No matter if the gallstones get stuck in the gallbladder or in the bile ducts, the gallbladder is normally removed in order to prevent future complications from stones. A gallbladder removal (cholecystectomy) usually takes about 30 minutes, and it’s performed laparoscopically. That means there are only three or four small (1 centimeter) cuts.

If there are also gallstones in the bile ducts, Dr. McKenzie says a surgeon or gastroenterologist will take a scope through the patient’s mouth into the small bowel and the duct in the small bowel to access the stone and remove it. This is called an ERCP.

Gallbladder Diet

Dr. McKenzie says there are no specific foods that will cause gallstones to form. If you want to avoid gallstones, he suggests maintaining a healthy lifestyle and focusing on avoiding high cholesterol and weight gain.

“Gallstone formation is a complex process that can lead to a need for surgery in those who have gallstones. If you are concerned you may have a gallbladder problem or are experiencing symptoms, make an appointment with your primary care provider or general surgeon for assessment,” Dr. McKenzie says.


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