Gallstones - Symptoms

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What are the symptoms of gallstones?

The majority of people with gallstones have no signs or symptoms and are unaware of their gallstones. (The gallstones are "silent.") The gallstones often are found as a result of tests (for example, ultrasound or X-ray examination of the abdomen) performed while evaluating medical conditions other than gallstones. Symptoms can appear later in life, however, after many years without symptoms. Thus, over a period of five years, approximately 10% of people with silent gallstones will develop symptoms. Once symptoms develop, they are likely to continue and often will worsen.

Gallstones are blamed for many symptoms they do not cause. Among the symptoms gallstones do not cause are:

  • dyspepsia (including abdominal bloating and discomfort after eating),
  • intolerance to fatty foods,
  • belching, and
  • flatulence (passing gas or farting).

When signs and symptoms of gallstones occur, they virtually always occur because the gallstones obstruct the bile ducts.

The most common symptom of gallstones is biliary colic. Biliary colic is a very specific type of pain, occurring as the primary or only symptom in 80% of people with gallstones who develop symptoms. Biliary colic occurs when the bile ducts (cystic, hepatic ducts or common bile duct) are suddenly blocked by a gallstone. Slowly-progressing obstruction, as from a tumor, does not cause biliary colic. Behind the obstruction, fluid accumulates and distends the ducts and gallbladder. In the case of hepatic duct or common bile duct obstruction, this is due to continued secretion of bile by the liver. In the case of cystic duct obstruction, the wall of the gallbladder secretes fluid into the gallbladder. It is the distention of the ducts or gallbladder that causes biliary colic.

Characteristically, biliary colic comes on suddenly or builds rapidly to a peak over a few minutes.

  • It is a constant pain, it does not come and go, though it may vary in intensity while it is present.
  • It lasts for 15 minutes to 4-5 hours. If the pain lasts more than 4-5 hours, it means that a complication - usually cholecystitis - has developed.
  • The pain usually is severe, but movement does not make the pain worse. In fact, patients experiencing biliary colic often walk about or writhe (twist the body in different positions) in bed trying to find a comfortable position.
  • Biliary colic often is accompanied by nausea.
  • Most commonly, biliary colic is felt in the middle of the upper abdomen just below the sternum.
  • The second most common location for pain is the right upper abdomen just below the margin of the ribs.
  • Occasionally, the pain also may be felt in the back at the lower tip of the scapula on the right side.
  • On rare occasions, the pain may be felt beneath the sternum and is mistaken for angina or a heart attack.
  • An episode of biliary colic subsides gradually once the gallstone shifts within the duct so that it is no longer causing obstruction.

Biliary colic is a recurring symptom. Once the first episode occurs, there are likely to be other episodes. Also, there is a pattern of recurrence for each individual, that is, in some individuals the episodes tend to remain frequent while in others they are infrequent. The majority of people who develop biliary colic do not go on to develop cholecystitis or other complications.

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See what others are saying

Comment from: curly, 45-54 Female (Patient) Published: February 20

I experienced severe pain in the chest, and abdomen one night in Jan 2013 after I had dinner as usual not a heavy one. The episodic pain reduced after an inflammatory injection at home. Initially I thought it to be a cardiac pain. But next day when I went to the emergency room to find out the cause, a CT scan was suggested which revealed tiny multiple gallstones. Since then I am watching my diet. I have no pain but experience bloating and gas. I am scared to undergo surgery as I am diabetic, hypertensive, had an attack of arrhythmia and have hypothyroidism and on medication.

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Comment from: mz Williams, 25-34 Female (Patient) Published: June 04

I noticed severe pain under my right breast while I was pregnant with my second baby. It was sharp and consistent. I was unable to walk standing straight up and moaned during the attack. It wasn"t until she was 2 months that I got an ultrasound and was told about the gallstones. I have noticed that if I eat greasy food such as collard greens, fried chicken, macaroni and cheese I will normally have an attack. The attack involves that same pain under my breast, nausea, and chills. I try very much to watch what I eat.

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