4 Surprising Gallstone Symptoms Women Should Never Ignore, According to a Top GI Doctor
Gallstones often go unnoticed—until they don’t. Catch symptoms early with these doctor-backed tips
You likely already know that gallstones can be notoriously painful and disproportionately affect women. But if you’re wondering what their symptoms look like—and how some can be relatively mild while others require urgent attention—keep reading for a few surprising signs of the two major types of gallstones. Plus get doctor-approved, easy-to-follow guidance on when to seek medical care.
What are gallstones?
“Gallstones are essentially calcified bile,” says Anish Sheth, MD, gastroenterologist and Chief of Gastroenterology at Penn Medicine Princeton Medical Center. “They’re much more common in women [in large part due to hormones, as estrogen can promote gallstone formation]. They develop when lithogenic bile—which just means more viscous [cholesterol-laden] bile that’s prone to forming stones—creates microcrystals.”
What causes gallstones? 4 risk factors
According to Dr. Sheth, every medical student learns the four main risk factors that can increase your odds of developing gallstones:
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- Obesity
- Being female
- Being fertile
- Being over 40
“Women who have been pregnant or who have had multiple pregnancies are at higher risk for gallstones,” he explains. “And while people do form them at younger ages, the 40s are the classic decade when gallstones symptoms tend to appear.”
Another risk factor worth noting: rapid weight loss, which can happen when taking GLP-1 drugs like Ozempic. (Learn how to avoid gallstones during weight loss.)
4 symptoms of common gallstones
The first thing to know? “Millions and millions of women have gallstones and don’t realize it,” reveals Dr. Sheth. “It’s important to get across that unless they’re getting an ultrasound on their gallbladder or stomach for some other reason, women can have gallstones for years, even decades, without knowing it, because most of them are asymptomatic.”
Except when they’re not. Here, Dr. Sheth points out a few signs to watch for in people with gallstones:
- Chronic, intermittent abdominal pain
- Nausea after meals, particularly fatty foods
- Pain in the middle of the belly or upper right abdomen
- Pain in the upper back underneath the right shoulder blade, as the discomfort radiates from the abdomen
Sometimes gallstone symptoms will strike 30 minutes to an hour after a meal, then improve on their own and may not return for months. This is known as biliary colic, he explains, a temporary blockage of the cystic duct by a gallstone. “But when the cadence of symptoms increases, people will typically see their doctor for an ultrasound.”
4 symptoms of severe gallstones
That said, there is a more acute form of gallstones that requires immediate, emergency care, Dr. Sheth continues. “It’s called acute cholecystitis. This happens when a gallstone obstructs the gallbladder and it needs to be removed.”
“As opposed to pain that usually eases within an hour or two, this pain is severe and comes on suddenly,” he explains. “Hour by hour, it gets worse.” Acute gallstones symptoms to watch for include:
- Intense abdominal pain
- Fever
- Chills
- Vomiting
Treatment for gallstones: When to consider surgery
In the case of biliary colic, you might consider elective gallbladder removal surgery. “It largely depends on how often the episodes occur,” notes Dr. Sheth. “If women go from having symptoms once every couple of months to once a week, and the attacks become increasingly frequent, they may decide they’ve had enough and choose to have the gallbladder removed with laparoscopic surgery.”
The bottom line on gallstones: Go easy on yourself
In case you’re kicking yourself thinking there’s something you did to cause gallstones, let yourself off the hook. “The foods you eat are not responsible for the formation of gallstones,” says Dr. Sheth. “They’re just responsible for the symptoms—they act as a trigger or an exacerbating factor.”
“For example, if your attacks are infrequent, simply avoiding very fatty foods, especially rich or greasy meals, can often prevent an episode from occurring and help you feel more comfortable day to day,” he adds. Other lifestyle changes, such as losing weight, may help reduce your risk of a future flare-up.
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