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Here’s What’s Probably Causing Your Gallstones

November 17, 2025

Gallstones don’t always cause symptoms – but when they do, the pain can hit fast.

“Most people feel a sudden, sharp pain in the upper right side of the abdomen, often after eating a fatty meal,” says Anant Agarwalla, MD, a gastroenterologist at Hartford HealthCare’s Digestive Health Institute. “It may spread to your back or right shoulder and can be intense enough to cause nausea or even vomiting.”

So why do they form, and what can you do about them? Here’s what you need to know.

What are gallstones, exactly?

Gallstones are small, hard stones that form when substances in your bile – a digestive fluid made by your liver – become too concentrated and solidify.

“They can be as tiny as a grain of sand or as big as a golf ball,” says Dr. Agarwalla. “Some people have just one, while others have many.”

Gallstones usually form in the gallbladder – a small organ under your liver that helps digest fat – and can sometimes travel into the bile ducts, which carry bile to your small intestine.

There are two main types: cholesterol stones (the most common) and pigment stones. Sometimes, instead of stones, a thick sludge forms – but it can cause the same symptoms.

> Related: What Your Stomach Pain Is Trying to Tell You

Here are the top three culprits that cause gallstones.

1. Too much cholesterol in your bile.

That burger-and-fries habit or those late-night pizza oreders might be doing more than you think.

“This is the most common cause of gallstones – and it starts with an imbalance in your digestive fluid,” says Dr. Agarwalla.

Your liver makes bile to help break down fat. “But when there’s too much cholesterol and not enough bile salts to dissolve it, that extra cholesterol can harden into stones,” he adds.

> Related: 5 Foods to Avoid If You Have High Cholesterol

2. Too much bilirubin in your system.

Bilirubin is a yellowish substance your body makes when it breaks down red blood cells.

“Certain medical conditions – like liver disease or blood disorders – can make your liver produce too much bilirubin,” says Dr. Agarwalla. “That can result in pigment gallstones, which are smaller and darker than cholesterol stones.”

3. Your gallbladder isn’t emptying well.

When your gallbladder doesn’t empty completely or often enough, bile can become overly concentrated and form stones.

“This can happen during pregnancy, with obesity or after rapid weight loss – all of which can affect how your gallbladder works,” Dr. Agarwalla explains.

Are you at risk for gallstones?

Some people are more likely to develop them – especially if they:

• Are female (particularly during pregnancy or while taking birth control pills).
• Are over age 40.
• Have obesity.
• Have recently lost weight quickly.
• Have diabetes or liver disease.
• Have a family history of gallstones.
• Eat a high-fat or high-cholesterol diet.

“Gallstones are very common,” says Dr. Agarwalla. “The good news is that we can treat them effectively – especially when we catch them early.”

> Related: These Diet Changes Could Help Your Gallbladder Disease

When to see your doctor.

Gallstone pain usually passes in a few hours. But if it doesn’t – or you notice other symptoms like fever, yellowing of the skin or eyes or vomiting – it could be a sign of something more serious.

“Gallstones can cause inflammation, infection or even pancreatitis,” says Dr. Agarwalla. “If your symptoms aren’t going away, don’t wait – reach out to your provider to get checked out.”