If youâve ever had sudden, intense pain under your right rib cage that came out of nowhere and lasted for hours, you might have experienced biliary colic. Itâs not just a stomachache. Itâs your gallbladder screaming because a stone is blocking the flow of bile. And if it keeps happening, youâre not just dealing with discomfort-youâre at risk for something far worse: cholecystitis, infection, or even pancreatitis.
What Actually Happens When You Have Gallstones?
Gallstones arenât like kidney stones you can pass. They form inside your gallbladder, a small pear-shaped organ tucked under your liver. About 80% of them are made of cholesterol, the same kind that builds up in your arteries. The rest are pigment stones, made from bilirubin, a waste product from old red blood cells. These stones donât just sit there. They move. And when one gets stuck in the cystic duct-the tube that lets bile leave your gallbladder-it causes biliary colic.The pain hits fast. Itâs steady, not crampy. It doesnât get better with burping, pooping, or vomiting. It usually starts in the upper right side of your belly or just below your breastbone, and it can radiate to your right shoulder or back. It peaks within an hour and can last anywhere from one to five hours. Then, as the stone shifts, the pain fades. It feels like a miracle⌠until it comes back.
Hereâs the scary part: if youâve had one episode of biliary colic, youâre very likely to have another. More than 90% of people will get it again within 10 years. Two out of three will have another attack within just two years. And each time, the risk of complications grows.
When Biliary Colic Turns Into Cholecystitis
Biliary colic is temporary. Cholecystitis is not. When a gallstone blocks the duct for more than a few hours, the gallbladder starts to swell and get inflamed. Thatâs cholecystitis. The pain doesnât go away. It becomes constant. You might run a fever. Your belly might feel tender to the touch. Nausea and vomiting stick around. This isnât just bad pain-itâs an emergency.About 20% of biliary colic episodes turn into cholecystitis. And if itâs not treated quickly, the gallbladder can rupture. Thatâs life-threatening. Thatâs why the Society of American Gastrointestinal and Endoscopic Surgeons says: if you have acute cholecystitis, get your gallbladder removed within 72 hours. Waiting increases the chance your surgery will need to be done the old-fashioned way-with a big cut instead of small keyhole incisions. And recovery? It takes weeks longer.
Why Surgery Is Usually the Answer
Thereâs no magic pill that reliably gets rid of gallstones. Ursodeoxycholic acid can dissolve small cholesterol stones, but only in about 30-50% of cases-and it takes months. Even then, half the people who get rid of their stones with medication get them back within five years. Shock-wave therapy? It used to be popular, but itâs rarely used now. The stones come back. The procedure is expensive. And it doesnât work for most people.Thatâs why surgery-specifically, laparoscopic cholecystectomy-is the gold standard. Itâs not a big deal anymore. In the U.S., 90% of gallbladder removals are done this way. Surgeons make four tiny cuts, insert a camera and tools, and remove the gallbladder in under an hour. Most people go home the same day. Recovery? About a week. Compare that to open surgery, which requires a 4-6 week recovery and a 6-inch scar.
Studies show 95% of patients are happy with the results. The pain vanishes. No more midnight emergencies. No more dreading meals. One woman in Cleveland Clinicâs patient newsletter had 17 attacks over 18 months. After surgery, she was back to running and cooking within two weeks.
Who Shouldnât Have Surgery?
Not everyone needs it. If you have gallstones but never have symptoms, you donât need surgery. Thatâs true for about 80% of people who have them. But if youâve had even one episode of biliary colic, the odds shift. The American Academy of Family Physicians found that 64% of people who waited ended up needing surgery within 5.6 years.But thereâs an exception: older adults with other health problems. For someone over 75 with heart disease, diabetes, or lung issues, the risk of surgery goes up. The 30-day death rate jumps from less than 0.1% in healthy people to nearly 3% in those with three or more chronic conditions. Thatâs why doctors now weigh risk carefully. For a frail 80-year-old with no symptoms, watching and waiting might be the safer choice. But if that same person starts having pain? The calculus changes. Surgery is still often the best option-but it needs to be done by a team experienced in high-risk cases.
What to Expect Before and After Surgery
Before surgery, youâll likely have an ultrasound. Thatâs the best test. Itâs quick, safe, and shows stones with 95% accuracy. Blood tests might be done to check for infection or liver problems. If youâre overweight or have diabetes, your doctor might ask you to lose a few pounds or get your blood sugar under control first. That lowers surgical risk.On the day of surgery, youâll be under general anesthesia. You wonât feel a thing. Most people wake up with mild soreness around the incisions and some bloating from the gas used during the procedure. Youâll be encouraged to walk within four hours. Eat a light meal within six. Most go home the next day.
After surgery, you might notice changes in digestion. About 12% of people get diarrhea, especially after fatty meals. Itâs usually temporary, lasting a few weeks to months. A small number-around 6%-get something called post-cholecystectomy syndrome: ongoing pain, bloating, or nausea. This isnât always due to leftover stones. Sometimes, itâs bile reflux or a problem with the bile ducts. If it lasts more than three months, youâll need more tests.
The Real Cost of Waiting
In the U.S., about 700,000 gallbladder surgeries are done every year. Thatâs $6.2 billion in healthcare spending. But the real cost isnât just money. Itâs missed work. Emergency room visits. Sleepless nights. The 2022 Healthline survey found that 65% of patients waited until they were in the ER, screaming in pain, before deciding to get surgery. Four out of ten saw three or more doctors before getting the right diagnosis.Delaying surgery doesnât save money-it just moves the cost to the emergency system. And it puts you at risk. About 20-30% of people with untreated symptomatic gallstones end up in the hospital with complications within five years. Thatâs not a gamble worth taking.
Whatâs New in Gallstone Treatment?
Thereâs one promising new option for people who canât have surgery. In 2023, the FDA approved a technique called endoscopic ultrasound-guided gallbladder drainage. Itâs not a cure-itâs a bridge. A tiny tube is placed through the stomach into the gallbladder to drain infected bile. Itâs life-saving for high-risk patients who need time to stabilize before surgery. But itâs not a replacement for removal.Another trend is single-incision laparoscopic surgery (SILS), where everything goes through one cut near the belly button. It leaves no visible scars. But itâs harder for surgeons, takes longer, and has a 20% higher complication rate than standard laparoscopy. Most experts donât recommend it unless itâs for cosmetic reasons.
The future is in faster recovery. Hospitals using Enhanced Recovery After Surgery (ERAS) protocols are seeing 30% shorter hospital stays and 25% fewer readmissions. That means less time in bed, less pain, and quicker return to normal life.
Final Thoughts
Gallstones arenât just a nuisance. Theyâre a ticking clock. If youâve had biliary colic, youâre not just waiting for the next attack-youâre waiting for something worse. Surgery isnât scary anymore. Itâs routine. Safe. Effective. And for most people, itâs the only way to truly be free of the pain.Donât wait for an emergency. If youâve had one episode of gallstone pain, talk to your doctor about cholecystectomy. The sooner you act, the easier the surgery, the faster you recover, and the less likely you are to end up in the ER again.
Can gallstones go away on their own?
Gallstones rarely disappear without treatment. While very small cholesterol stones might dissolve with medication like ursodeoxycholic acid, this only works in about half the cases-and even then, the stones usually return within five years. Most stones stay put and can cause repeated pain or serious complications like cholecystitis or pancreatitis. Waiting for them to vanish is not a safe strategy.
Is gallbladder surgery risky?
Laparoscopic cholecystectomy is one of the safest major surgeries performed today. In experienced hands, the complication rate is under 2%. Risks include infection, bleeding, or injury to the bile duct, but these are rare. The bigger risk is not having surgery if you have symptoms. Untreated gallstones lead to emergency surgery, which carries a much higher risk of complications and longer recovery.
Will I need to change my diet after gallbladder removal?
You donât need a special diet, but your body may need time to adjust. Without a gallbladder, bile flows directly from the liver into the intestine instead of being stored. Some people get diarrhea after fatty meals-this usually improves over weeks or months. Eating smaller, low-fat meals for the first few weeks helps. Most people return to their normal diet without issues.
Can I get gallstones again after surgery?
No. Once your gallbladder is removed, you canât form new gallstones. The stones form inside the gallbladder. Without it, thereâs no place for them to develop. Any lingering symptoms after surgery-like pain or bloating-are usually due to other causes, such as bile reflux, sphincter of Oddi dysfunction, or unrelated digestive issues. Theyâre not gallstones.
How do I know if my pain is from gallstones?
Gallstone pain is typically sudden, steady, and located in the upper right abdomen or center of the belly. It often radiates to the right shoulder or back, lasts 1-5 hours, and doesnât improve with gas, vomiting, or bowel movements. Itâs often triggered by fatty meals. The best way to confirm itâs gallstones is with an ultrasound-simple, painless, and over 95% accurate. If youâre unsure, donât guess. Get checked.
Why do women get gallstones more often than men?
Hormones play a big role. Estrogen increases cholesterol levels in bile and slows gallbladder emptying. Women, especially those whoâve been pregnant, on birth control, or using hormone therapy, are 2-3 times more likely to develop gallstones. Obesity and rapid weight loss also raise risk, which explains why rates are higher in women over 40 and in Hispanic populations.
Is there a way to prevent gallstones?
You can lower your risk. Avoid rapid weight loss-aim for no more than 1-2 pounds per week. Eat regular meals-skipping meals slows gallbladder emptying. Choose healthy fats like olive oil and fish over fried foods and processed snacks. Maintain a healthy weight. Stay active. These steps wonât guarantee youâll never get stones, but they significantly reduce your chances.
Sona Chandra
OMG I had 17 attacks in 18 months and thought I was dying every time I ate pizza 𤎠I thought it was just 'bad digestion' until I passed out in a Taco Bell parking lot. Surgery saved my life. No more midnight ER runs. No more crying in the shower from pain. Iâm running marathons now. If youâre reading this and still waiting? STOP. Just go. Your future self will thank you.
Jennifer Phelps
I got diagnosed after my third episode and my doctor said wait and see so I did and then I got cholecystitis and ended up in ICU for 3 days and now Iâm wondering why no one told me how fast this can turn deadly like I just lost 3 weeks of work and my dog was so scared of me crying all the time
beth cordell
After surgery I went back to eating tacos every Friday đŽđ and no pain. Zero. Nada. My liver is happy. My gallbladder? RIP in peace. 10/10 would remove again. Also my cat now sits on my scar like itâs a throne đš
Lauren Warner
People romanticize gallbladder removal like itâs a spa day. The truth? Youâre left with bile reflux, chronic diarrhea, and a body that canât process fat without screaming. The 95% satisfaction rate? Thatâs from people who didnât have preexisting IBS. If youâre middle-aged and overweight, this isnât a fix-itâs a trade-off you didnât know you were making.
Craig Wright
It is a matter of national health policy that so many individuals delay surgical intervention until emergency conditions arise. In the United Kingdom, the National Health Service mandates prompt referral following first symptomatic episode. The American system, by contrast, encourages reactive rather than proactive care. This is not merely a medical failure-it is a systemic one.
Lelia Battle
Itâs interesting how we treat the gallbladder like a disposable organ, when in reality itâs a sophisticated reservoir that evolved over millions of years. Removing it solves the symptom but doesnât address why the stones formed in the first place-diet, hormones, genetics. Maybe weâre too quick to cut instead of asking deeper questions about what our bodies are trying to tell us.
Rinky Tandon
Let me be clear: if you're a South Asian woman over 35 with a sedentary job and you've had one episode of right upper quadrant pain, you have gallstones. End of story. No ultrasound needed. You're statistically guaranteed. Waiting is not patience-it's negligence. Your liver doesn't care about your fear of surgery. It's already screaming. Get it out before you end up septic in a Mumbai hospital with no insurance.
Ben Kono
I had the surgery and now I canât eat anything without diarrhea. My wife says I smell like bile. I miss my gallbladder. I didnât know Iâd miss it until it was gone
Cassie Widders
My mum had hers out last year. She says the hardest part wasnât the pain-it was the weirdness of not having that little organ anymore. Like a ghost limb but for digestion. She still checks her belly in the mirror sometimes. Weird but kinda sweet.
Konika Choudhury
Indian women get gallstones because we eat too much ghee and sit on the floor too long and our doctors donât take us seriously until we collapse. My cousin died waiting for surgery because they thought it was just indigestion. Donât be her
Darryl Perry
Stop delaying. Get it removed. The data is clear. The risk of complications rises with every day you wait. Youâre not being brave. Youâre being reckless.
Windie Wilson
So let me get this straight. You remove an organ thatâs been with you since birth⌠just so you can eat a cheeseburger without screaming? I mean⌠I guess thatâs progress? đ¤ˇââď¸ At least your colon gets a vacation now. đ