Symptoms of gallstones

What are the symptoms of gallstone disease?

As mentioned earlier, 75% of the cause Gallstones no symptoms.
Usually they are too small or remain inconspicuous in the Gallbladder. The remaining 25% of gallstones either cannot pass through the gallbladder, i.e. they are of a size that makes passage into the biliary tract impossible.

Any movement of the gallbladder causes the stones to hit the gallbladder wall and cause Pain. In some cases, these gallstones are located exactly in the opening of the gallbladder and block the exit, which can not only lead to pain, but also to a build-up of the bile in the gallbladder. In this case it can also become a Jaundice (Jaundice) come.

If the gallstones are small enough to be carried by the gallbladder into the bile duct system, there is a risk that the stones could get caught in the ducts, rub against the walls of the bile ducts, or block them. This can also lead to build-up and jaundice symptoms.

In almost every case, however, this process of stone hiking is accompanied by symptoms such as severe pain (so-called Colic) connected. Colic (Gallstone disease) are typical of pain. They are described as very strong to extremely severe pain that occurs in waves but disappears just as quickly.
Most of the time the patient is bathed in sweat and restless and often cannot pinpoint the exact location of the pain. The right and middle upper abdomen, radiating to the back and right, are common shoulder called. Some patients report nausea and Vomit during colic.
Similar symptoms can also occur with the so-called Kidney stones occur. If the gallstones remain in the gallbladder, they often lead to gallstone disease after eating high-fat food (the gallbladder performs particularly strong kneading movements afterwards) or when lying down at night (here gallstones can be pushed against the gallbladder wall) (Biliary colic). Patients localize this pain mainly in the upper abdomen (a few cm above the belly button).


Even if the fatigue not one of the main symptoms of one Gallstones (Cholelithiasis) heard, it can occur at the same time. When the gallstones come into contact with the walls of the gallbladder and bile ducts or due to a possible blockage of the bile ducts, a inflammatory reaction occur through the a general feeling of illness, fatigue and a lower load capacity occurs. These symptoms come from the release of messenger substances (Inflammation mediators) in the event of an inflammatory reaction. These symptoms occur especially with chronic inflammation.

Also increased bilirubin levels in the blood can cause tiredness. Bilirubin is a substance that Breakdown of red blood cells (Erythrocytes) arises and usually via the Bile enters the intestine and is excreted from there in the stool. If you have gallstone disease, the Relocation of the biliary tract This path of excretion can be blocked, as a result of which the bilirubin accumulates and the bilirubin content of the blood increases.
If the value rises so much that the bilirubin can no longer be prepared by the liver for the bile (here the bilirubin goes from the original one fat soluble in a water soluble Condition over) so it can cause neurological symptoms. The fat-soluble bilirubin is able to penetrate to a certain extent into the brain. In light forms this can be done initially fatigue trigger, if the bilirubin level in the blood is very high, one speaks of a Kernicterus, or from one Bilirubin encephalopathy. At this point the bilirubin levels are so high that one has been for a long time Jaundice (Jaundice) consists of a Yellowing of the whites of the eyes (Medical: Scleric terus) and the skin (Skin icterus) noticeable. To fatigue and apathy come here additionally confusion. Usually this only occurs in infants and only rarely in adults.


The bile contains important substances for the complete digestion of food. In the case of gallstone disease with blockage of the bile ducts, the bile can no longer reach the intestine and digest the food there. Due to incomplete digestion, constipation can quickly develop. Constipation goes hand in hand with an excessive feeling of fullness and an increased formation of gas in the intestine (Meteorism), by bacteria that use the incompletely digested food. Since the bile is mainly required for the digestion of fats, these symptoms occur especially when eating foods that contain very fat. Paradoxically, however, fatty foods can also lead to diarrhea.

Learn more about Diarrhea after eating.


A generalized itching gallstone disease occurs when the bile passes through the Obstruction of the bile ducts can no longer flow properly due to stones. The human needs the bile on the one hand by bile acids Digest fats to be able to and on the other hand to get rid of harmful substances. In the first place is the bilirubin, a substance that is involved in Breakdown of red blood cells arises. If the bilirubin can no longer flow out via the bile, it accumulates in the body, just like the bile acid. Based on current research, it is believed that a itching (Pruritus) is caused by the backlog of these substances. The bile acids irritate nerve endings in the skin, creating the sensation of itching. This effect is intensified by bilirubin, which, if it cannot flow away, can deposit in the skin after a while, causing a Jaundice (Jaundice), so the skin turns yellow. This is due to the yellow color of the bilirubin.

stomach pain

stomach pain are a very common symptom of gallstone disease. The pain is mostly in the upper right part of the abdomen, located directly under the costal arch, since this is where the gallbladder is located under the skin and part of the liver.

Mild abdominal pain occurs mainly after meals. Especially if the meals are many, fatty Food contained, because at this time the gallbladder is working at full speed. Humans need bile to digest fatty food, which is why the gallbladder wants to move the bile into the intestine after consuming fatty food by contracting and thus pressing the bile into the intestine. Are located Gallstones in the gallbladder, the movement of the gallbladder rubs them against the wall, which is painful. It is also possible that small gallstones may come off, i.e. enter the intestine through the bile duct. Here too irritate the gallstones the walls of the bile duct and may expand it a little. This process can painful be.

The gallstone disease leads to a Inflammation of the gallbladder (Cholecystitis) or the bile ducts (Cholangitis) so this too can be painful.

If the bile duct is acutely blocked by an entrapment of gallstones, the gallbladder can usually become blocked no longer empty at all. This can be too severe, acute painn, the so-called Biliary colic (see below).


diarrhea with gallstone disease comes mainly after fatty food in front. Humans need bile to digest fats, if the drainage of the bile is blocked by a stone, they can Fat is no longer digested properly become. This leads to the fact that the fats are deposited in the stool and so-called Fatty stools can arise. Fatty stools can vary in consistency from soft to runny, have a greasy shine and have a terrible smell.

Back pain

Pain in one Gallstone disease, especially with biliary colic (see below) are mostly in the right upper part of the abdomen. If you have a painful gallstone disease, there is one Radiation of pain not uncommon, however. Especially in the case of sudden, very severe pain, a Radiance in the back or in the shoulder. Even with mild, chronic pain, it is often difficult to determine the exact location of the pain. In addition to the classic, right upper abdominal pain Side or back pain can also occur, usually on the right side of the body. The cause of the radiation can be a gall bladder located further back or a cluster of different nerve fibers that are responsible for the perception of pain. In the latter case it can happen that the brain is no longer able to clearly determine the origin of the pain stimulus and therefore sometimes does not determine it correctly.


nausea applies to diseases of the digestive tract, which also includes the gallbladder and bile ducts very unspecific symptom. At almost every inflammatory disease and it can occur in diseases associated with incomplete digestion of food and affecting the digestive tract. Pain can also cause nausea due to the release of stress hormones or the cramping of the muscles of the gallbladder and intestines.

Humans need bile to digest fats. If the drainage of the bile is blocked by gallstones, this can no longer take place properly. The Undigested fats can cause nausea, especially if they get into later intestinal sections.


With gallstone disease, two different types of pain can usually occur. On the one hand mild, often chronic pain, mostly after eating, especially if it was high in fat. On the other hand you can severe, cramping pain, the so-called Biliary colic occur.

As a rule, it is abdominal pain, especially in the right, upper area of ​​the abdomen under the costal arch. The pain often radiates to the right shoulder or back.

If the gallbladder or bile ducts become inflamed due to the action of the stones on the walls of the gallbladder and bile ducts, this can cause severe pain, which, however, differs in quality and course from biliary colic. As a rule, they begin less acutely, but rather creeping and are there permanently without swelling and decreasing.


Flatulence (Meteorism) are a common symptom of bile duct obstruction by gallstones. The bile is needed to digest fats. If gallstones get into the bile ducts, the bile can no longer flow into the intestine and there it helps with digestion. After a while, the undigested fats reach the later intestinal sections, especially the large intestine, which is naturally heavily populated with bacteria. This Bacteria utilize the undigested fats, this is done primarily through fermentation (anaerobic metabolism, where no oxygen is required). During fermentation, gases are produced which are noticeable as flatulence. The richer the food, the worse the gas.

Light chair

If gallstones cause a Drainage disorder the bile, because a stone obstructs the bile ducts, it usually occurs light, discolored, almost white stool. Through the bile, the body separates the so-called Bilirubin from, a waste material created when old red blood cells break down. This substance is converted into dark coloring matter in the large intestine by intestinal bacteria Stercobilin and Urobilinthat give the chair the brown color. If bilirubin no longer reaches the intestine, these pigments can no longer be produced and the stool is bright and discolored.


Also about heartburn reported in gallstone disease. When the bile ducts are obstructed, the bile juice, which is important for the digestion of fats, can no longer drain away Digestive disorders. These digestive disorders can affect the stomach, which can lead to acid regurgitation and heartburn. However, heartburn alone is rarely related to gallstones. If one assumes that the heartburn is caused by gallstones, then there are usually other symptomsthat more clearly indicate gallstone disease.

Shoulder pain

With gallstone disease, the pain is mostly in the right upper part of the abdomen, which corresponds to the anatomical location of the gallbladder.

Often, however, one Radiation in the right shoulder reported. These symptoms are based on the phenomenon of transferred pain through convergence (a convergence) of various nerve fibers. The nerve fibers that report the pain of the gallbladder to the brain converge with pain fibers from the right shoulder, so that the brain reports stimuli from both regions, especially when there is severe pain. With such clearly assigned regions in medicine, one speaks of Head's zones. The Head's zone for the gallbladder is the right shoulder.

Symptoms of biliary colic

Biliary colic in gallstone diseasen are usually acute onset, severe pain. The pain has one wavelike Character, meaning that they swell up and down. The pain is usually concentrated in the upper right part of the abdomen below the ribs, but it can spread to the right shoulder and back. Especially with severe biliary colic, the stomach is often hard (defensive tension).

The pain occurs because a gallstone has entered the biliary tract. Here he clogs the drain the bile. So on the one hand it comes to one Backwaterstretching the gallbladder, which can be painful. The main pain comes from the attempt by the gallbladder and bile duct muscles, which try to push the stone further forward and push it out of the bile duct. Here, the muscles become so exhausted that there is an oxygen deficit in the muscle, which causes the muscle to feel the pain of suffocation (Medical: ischemic pain).