Gallstones are hard, solid deposits that form in the gallbladder, a pear-shaped organ in the upper right abdomen beneath the liver. When you eat, the gallbladder stores bile from the liver and empties it into the upper part of the small intestine (duodenum), helping digest and absorb fats. Gallstones develop when bile has excess cholesterol (fat) or bilirubin (a byproduct of the normal breakdown of red blood cells).

Some gallstones don’t cause symptoms, and many people are unaware they have them. These are “silent” gallstones and don’t require treatment.

When gallstones block bile flow in the gallbladder or bile ducts, they can cause a gallbladder attack, leading to symptoms like severe abdominal pain, nausea and vomiting, and sweating. While surgery is the most effective option, alternatives like medications and therapies can also improve symptoms.

Surgery

Surgical removal of the gallbladder, medically known as a cholecystectomy, is the most common and effective treatment for gallstones. The gallbladder is not essential for survival. Without it, the liver continues to produce bile, which flows directly into the small intestine rather than the gallbladder.

Depending on the size of gallstones and your overall health, your healthcare provider may perform gallbladder removal surgery using laparoscopic cholecystectomy or open cholecystectomy.

laparoscopic cholecystectomy
This is the most common surgical procedure for gallbladder removal. It is minimally invasive, and you are under general anesthesia during the procedure so that you will be asleep and pain-free. The surgeon makes several small incisions in the abdomen and inserts a laparoscope—a thin tube with a light and a camera—through one incision to view the gallbladder. Surgical tools are inserted through the remaining incisions to carefully remove the gallbladder. Most people can go home that day or the following day and usually return to normal activities within a week.

Though generally safe, laparoscopic cholecystectomy carries risks such as bile leakage, infection, or injury to surrounding organs and tissues. Some people develop post-cholecystectomy syndrome (PCS), which includes digestive symptoms like diarrhea and indigestion. Despite these risks, it has a high success rate and quick recovery.

open cholecystectomy
This is a more traditional approach to gallbladder removal, usually recommended for severe infection, inflammation, or scarring from previous abdominal surgery. Under general anesthesia, the surgeon makes a large incision in the right side of your abdomen, usually below the ribcage, to access and remove the gallbladder.

Because of the larger incision, you may need to stay in the hospital for 3–5 days, and recovery may take about a month. Risks include infection, bleeding, and injury to nearby organs like the liver, pancreas, and intestines. Some people may also have difficulty digesting fats after gallbladder removal, experiencing heartburn, indigestion, nausea, or abdominal pain.

Nonsurgical Treatments

For people who cannot undergo surgery due to health risks or specific gallstone types, nonsurgical treatments are available. Though effective, gallstones may return if the gallbladder is not removed.

endoscopic retrograde cholangiopancreatography (ERCP)
ERCP helps diagnose and treat conditions affecting the bile ducts, pancreas, and gallbladder. It is often recommended when gallstones are lodged in the common bile duct. Using an endoscope passed through the mouth into the small intestine, dye and X-ray imaging locate gallstones, which can then be removed with small instruments.

Recovery takes a few hours, and side effects may include sore throat, bloating, or nausea. While ERCP effectively removes bile duct stones, it does not remove gallstones from the gallbladder itself. Complications can include infection, bleeding, or pancreatitis.

oral dissolution therapy
This involves medications like ursodiol or chenodiol, which dissolve cholesterol gallstones. It is only effective for small cholesterol stones. Treatment may take 6–24 months, and stones often return within five years. Side effects include gastrointestinal discomfort, headache, dizziness, or flu-like symptoms.

extracorporeal shock wave lithotripsy (ESWL)
This noninvasive procedure uses high-energy sound waves to break gallstones into smaller fragments that can pass naturally. It is effective for small, solitary stones but less successful for large or multiple stones. Since recurrence is common, ESWL is not widely used.

Lifestyle Changes

Healthy habits can reduce the risk of gallstones and prevent attacks.

dietary changes

  • Increase fiber intake from fruits, vegetables, legumes, and whole grains

  • Incorporate healthy fats such as olive oil, avocados, and fatty fish

  • Limit refined sugars and processed foods

  • Avoid unhealthy fats from fried foods and desserts

exercise
Regular activity reduces the risk of gallstones by improving digestion and bile flow. Aim for at least 30 minutes of moderate-intensity exercise five days a week. Daily physical activity can reduce gallstone risk by up to 70%.

weight management
Excess body weight increases the risk of gallstones, especially in people assigned female at birth. Slow and steady weight loss (5–10% over six months) is recommended, as rapid weight loss can trigger gallstone formation.

Prognosis and Life Expectancy

Gallstones are generally not life-threatening. Around half of people never develop symptoms. For those who undergo gallbladder removal, mild digestive issues may occur, but overall life expectancy and quality of life remain normal.

Living With and Managing Gallstones

Gallstones can be managed with healthy lifestyle adjustments. A high-fiber, low-processed diet, regular exercise, and weight management are key. If surgery is not an option, work with your healthcare provider to choose the right nonsurgical treatment.

Safe weight loss strategies and early treatment when symptoms occur can prevent complications and improve quality of life.