What causes cholelithiasis (gallstones)?

Bile is a digestive fluid made by the liver and stored in the gallbladder. It contains cholesterol, bile salts and other substances. When the mixture contains too much cholesterol or bilirubin, or does not empty normally, crystals may form and gradually become gallstones.

A stone can be made mainly of cholesterol or of pigment formed from bilirubin. Having stones does not always cause symptoms; trouble usually begins when a stone blocks the flow of bile from the gallbladder or nearby ducts. This can lead to upper abdominal pain, indigestion, nausea or vomiting. Gallstones can also irritate the gallbladder or contribute to pancreatitis.

Factors associated with gallstone formation include obesity, rapid weight loss, pregnancy, a diet pattern that promotes cholesterol imbalance, and some conditions affecting the liver or blood. Family tendency and increasing age may also influence risk. These factors do not prove that a person has stones, and some people develop them without an obvious trigger.

If symptoms are recurring, arrange a GP Consultation for an assessment. A clinician may ask where the pain occurs, whether meals trigger it, and whether you have fever, jaundice, dark urine or pale stools. Examination and tests can help distinguish gallstones from other causes of abdominal pain.

Until you are assessed, note the timing of symptoms and any food or drink that seems to bring them on. Avoid self-prescribing treatments intended to dissolve stones, because the right approach depends on the stone location, symptoms and overall health. A clinician can explain whether monitoring, further testing or treatment is appropriate.

Seek urgent medical help for severe or persistent abdominal pain, especially with fever, repeated vomiting, yellowing of the skin or eyes, confusion, faintness or marked weakness. These features can indicate infection, blockage or inflammation and should not be managed at home.

Sudden pain that spreads to the back, or pain with difficulty keeping fluids down, also warrants prompt assessment because gallstone-related inflammation can involve the pancreas. If symptoms are mild but keep returning, book a routine clinical review rather than waiting for a more severe episode.

Ask what might be causing your symptoms, whether imaging or blood tests are needed, and how the results would change your care. You can also ask which warning signs should prompt urgent help and whether any current medicines, weight changes or medical conditions could affect gallstone risk.