Gallstones
Hard lumps in the gallbladder. Most never cause trouble. When one blocks the exit, you get a steady, severe upper-tummy pain, often after a fatty meal. Then surgery is usually the answer.
The gallstones ladder
Silent stones stay at step 1. Painful stones usually end up at step 5, because attacks tend to come back.
- Step 1 · Self-careLeave silent stones aloneStones found by chance on a scan, with no symptoms.
- Works
- Only about 1–2 in 10 ever cause symptoms over 10–15 years
- Cost
- Free
- How long
- No follow-up needed unless symptoms start
- Watch for
- Know the attack symptoms (below) so you recognise one.
Not every scan finding needs a scalpel.
- Step 2 · Self-careLower-fat, regular mealsSmaller, lower-fat meals while you wait for assessment or surgery.
- Works
- Not tested in trials; may reduce attacks, but won’t remove stones
- Cost
- Free
- How long
- Until surgery, or ongoing if you’re not having it
- Watch for
- Crash diets and long fasts raise the risk of new stones.
A diet won’t dissolve a stone. It might keep the peace for a while.
- Step 3 · PharmacyAnti-inflammatory pain relief for attacksIbuprofen-type medicines; in hospital, often as an injection or suppository.
- Works
- About 70% fewer left in pain than with a dummy treatment; work as well as opioids (Cochrane)
- Cost
- About $5–15 a pack
- How long
- For the attack only
- Watch for
- Stomach and kidney problems. Pain lasting more than a few hours needs the emergency department.
If the pain isn’t settling after a few hours, it’s not a pharmacy problem any more.
- Step 4 · PrescriptionStone-dissolving tablets (ursodeoxycholic acid)For small cholesterol stones in people who can’t have surgery.
- Works
- Fully dissolves stones in about 1 in 3 over 6+ months; stones return in about half within 5 years
- Cost
- Not PBS-subsidised for gallstones: private script roughly $80–150 a month
- How long
- 6 months to 2 years
- Watch for
- Diarrhoea. Doesn’t work for calcified or large stones.
The slow, expensive route. Mostly for people who can’t have an operation.
- Step 5 · ProcedureKeyhole surgery to remove the gallbladderThe usual treatment once stones cause pain or complications.
- Works
- Stops attacks for most, but a 2023 UK trial found quality of life no better than watchful waiting at 18 months
- Cost
- Free as a public patient (waits vary); privately, often little out of pocket with hospital cover beyond your excess
- How long
- Often day surgery or one night; back to most things in 1–2 weeks
- Watch for
- Bile leak or bile duct injury (rare). Looser stools afterwards, especially after fatty meals, usually settle.
You don’t need a gallbladder. It’s a storage cupboard, not a factory.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Gallbladder or liver flushThe ‘stones’ you pass after the olive oil and lemon juice are soapy blobs made from the oil itself, not gallstones. Science fair, not surgery.
- Apple cider vinegarNo evidence it dissolves stones or prevents attacks. It does dissolve tooth enamel.
- Herbal stone dissolvers (milk thistle and friends)No good evidence they dissolve gallstones or prevent attacks, and some herbs interact with medicines.
- Cutting out fat completelyNot needed, and too little fat may even encourage stones. Lower-fat and regular, not fat-free.
What you can do
- Aim for a healthy weight, but lose it gradually: rapid weight loss, including on some weight-loss medicines, raises the risk.
- Regular meals rather than long fasts, with plenty of fibre, fruit and veg.
- Stay active.
- After gallbladder removal, looser bowel motions are common at first and usually settle over a few months.
See your GP if
- You’ve had an episode of upper tummy pain after eating
- Attacks are happening more often
- Indigestion, bloating or nausea that doesn’t settle
Go to the emergency department for tummy pain lasting more than a few hours or not eased by pain relief, fever or shivers, yellow skin or eyes, dark urine, pale stools, or ongoing vomiting.
Common questions
What does a gallstone attack feel like?
A steady, severe pain in the upper right or middle of the tummy, often after a fatty meal, lasting 30 minutes to several hours. Pain lasting longer, fever or yellow skin needs the emergency department.
Do gallstones always need surgery?
No. Stones found by chance usually need no treatment, as only about 1 to 2 in 10 cause symptoms over 10 to 15 years. Once they cause pain or complications, keyhole surgery to remove the gallbladder is the usual treatment.
Can you live normally without a gallbladder?
Yes. Looser bowel motions are common afterwards, especially after fatty meals, and usually settle over a few months.
Can weight-loss medicines cause gallstones?
Rapid weight loss, including on some weight-loss medicines, raises the risk. Losing weight gradually and eating regular meals helps.
What foods trigger gallbladder attacks?
Large or fatty meals are the classic trigger because they make the gallbladder squeeze. Smaller, lower-fat meals may reduce attacks, but diet doesn’t dissolve stones, so frequent attacks usually need surgery.
Can gallstones go away on their own?
Rarely. But most gallstones never cause trouble: around 4 in 5 people with stones found by chance never get symptoms and don’t need treatment.
How long is recovery after gallbladder removal?
After keyhole surgery most people go home the same or next day, return to desk work within 1 to 2 weeks and to heavy lifting after about 4 to 6 weeks. Some have looser poos for a few weeks.
Helpful resources
- NHS dietitians: Gallstone dietPractical lower-fat swaps, regular meals and safe weight loss, plus what to expect after surgery. Free leaflet.
- NHS: Recovering from gallbladder removalThe first weeks after keyhole surgery: pain, wounds, eating, driving and getting back to work. Free.
- healthdirect Symptom CheckerPain after a meal and not sure whether it’s an emergency? Answer a few questions for advice on what to do next. Free, Australia; or call 1800 022 222, 24/7.
Evidence and more information
- Healthdirect: Gallstones
- Healthdirect: Laparoscopic cholecystectomy
- NICE: Gallstone disease
- Cochrane: NSAIDs for gallstone pain (2016)
- BMJ: C-GALL trial, surgery vs watchful waiting (2023)
maladywise.com/gallstones/