Compared to the rest of the digestive system, the gallbladder doesn’t receive a ton of airplay.
Gallstones occur in up to 20 percent of American women by the age of 60, and women between 20 and 60 years old are three times more likely to develop gallstones than men, according to the American College of Gastroenterology. This is likely due to pregnancy and oral contraception, says Gillespie, as fluctuations in sex hormones (think: estrogen and progesterone) may trigger an uptick in gallstone production.
The tricky thing is that most people with gallstones have “silent stones,” meaning they simply don’t experience any gallstone symptoms. “Since silent gallstones don’t cause symptoms, they don’t need to be treated,” says Gillespie, noting that these gallstones are typically found on a CT scan or ultrasound that was done for other reasons.
However, some people who have gallstones experience very real symptoms. Gallstone symptoms can vary in frequency and severity, and since, if you do experience symptoms, they are likely to keep happening, surgery to remove the gallbladder is the most common treatment. If you’re not a candidate for surgery, other treatments—such as bile acid pills to dissolve the gallstones or shock wave lithotripsy to break them up—may be recommended, she says.
If you experience any combination of the below gallstone symptoms, it’s time to check in with your doc for a consult:
The biggest tipoff that you might have gallstones? Abdominal pain that comes and goes (especially after fatty meals). “Gallstone pain is described as an intense, dull discomfort located in the right upper quadrant of the belly,” says Matthew Mintz, M.D., board-certified internist in Bethesda, Maryland. “It can also radiate to the back and right shoulder.” When the gallbladder contracts in response to eating or other normal stimuli, it tries to force the stone out of the gallbladder in the process, causing pesky pain that can last anywhere from five minutes to a few hours.
“Imagine you have a gallstone the size of a golfball trying to pass through an opening the size of a straw,” says Holland. “You would definitely be in pain.”
Many people can have gallstones and just experience abdominal pain, which often goes away on its own. “If it doesn’t occur too frequently and isn’t particularly disruptive, many patients elect to not have surgery,” says Gillespie. However, frequent episodes of abdominal pain, severe pain, or pain in addition to other symptoms calls for a checkup.
If the stone gets stuck in one of the ducts that keep your digestive enzymes flowing—causing inflammation, swelling, and worsening pain—nausea and vomiting are likely to make an appearance, says Mintz.
If you experience unexplained nausea and vomiting, or frequently find yourself sick after eating, it’s worth talking to your doc.
Because many gallstone symptoms mimic that of indigestion—heartburn, acid reflux, cramping—it’s easy to ignore the signs, says Robby Holland, M.D., emergency physician and medical director at The Colony ER Hospital in Texas.
But if these symptoms strike repeatedly after meals (and things like movement, rest, passing gas, or going number two don’t relieve the discomfort), it could be a sign that a gallstone is blocking the exit of your gallbladder.
If a gallstone blocks the bile duct, which is the pathway the gallbladder uses to send bile to the small intestines, the entire system backs up. This buildup increases the concentration of bilirubin in the gallbladder—a yellowish substance that’s normally processed by the liver and turned into bile.
“As bilirubin concentrations increase in the bloodstream, it starts to deposit in the skin, turning it yellow,” says Jonathan Zipkin, M.D., urgent care specialist at Northwell Health-GoHealth Urgent Care in New York. With jaundice, the whites eyes often also turn a yellowish hue.
The breakdown of bilirubin during the digestive process is also what makes your pee yellow and your poop brown, says Zipkin. If you experience dark urine (despite being hydrated) and light-colored stools when you’re on the throne, it could be a sign of a bile duct blockage.
A fever, chills, and rapid heartbeat—especially combined with abdominal pain that just won’t quit—could mean the gallbladder outflow is completely blocked and has caused an infection, says Gillespie. Infections can become life-threatening if ignored, so it’s uber-important to seek immediate medical attention if you suspect your gallbladder’s the culprit.