Short answer: it depends on where the stone is and whether it causes symptoms. Stones in the gallbladder that cause no symptoms usually need no treatment. Stones that have slipped into the bile duct can be removed through the mouth by ERCP, with no cut on the skin. Gallbladder stones that cause pain or infection are treated by removing the gallbladder, a keyhole operation done by a surgeon. Medicines and "flushes" do not reliably dissolve gallstones.
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Go to an emergency department now if you have gallstones and:
- Fever or shivering with pain in the upper right or middle of the tummy
- Yellow eyes or dark urine — what jaundice means
- Severe pain in the upper tummy going through to the back, with vomiting — this can be pancreatitis
- Pain that has not eased after five or six hours
In Guwahati: Hayat Hospital Emergency, Kahilipara, or the nearest hospital.
A stone on ultrasound, but no pain
This is the most common situation. Gallstones are often found by chance on an ultrasound done for another reason. Most people with silent stones never have trouble from them: only about 1 to 4 in every 100 develop symptoms in a given year.
For silent stones, guidelines advise no surgery and no medicine, only awareness of the warning signs above. Gas, bloating and acidity are usually not caused by gallstones, and removing the gallbladder does not cure them.
A few situations are different, and removal may be advised even without pain: a calcified ("porcelain") gallbladder, a gallbladder polyp of 10 mm or more, or very large stones. This matters more here than elsewhere, because the Guwahati (Kamrup) region records some of the highest rates of gallbladder cancer in India. The risk for any one person is still small, but it is a reason to have the ultrasound report read properly rather than ignored.
Stones that cause pain
Typical gallstone pain is a steady pain in the upper right or upper middle of the tummy, often after a heavy or oily meal, lasting from 30 minutes to a few hours. It may spread to the right shoulder or back.
Once stones have caused this pain, or an infection of the gallbladder, the attacks tend to return. The standard treatment is laparoscopic cholecystectomy: removal of the gallbladder through small keyhole cuts, done by a surgeon. Most people go home in a day or two and digest food normally without a gallbladder. Dr. Agarwal is a gastroenterologist and does not perform this operation; he confirms that the stones are the cause, checks that the bile duct is clear, and refers you to a surgeon.
Stones in the bile duct: removed without a cut
Sometimes a stone leaves the gallbladder and lodges in the bile duct, the tube that carries bile to the intestine. This can cause jaundice, infection of the bile duct (cholangitis) or pancreatitis, and it needs treatment even if the pain has settled.
Bile duct stones are removed by ERCP. A flexible endoscope is passed through the mouth under sedation, the opening of the bile duct is widened, and the stones are pulled out. There is no cut on the skin, and it is usually a day-care procedure. ERCP is done at Hayat Hospital; the procedure charge is about ₹50,000, with a stent and accessories extra if needed (full cost guide).
When it is unclear whether a stone is in the duct, an MRCP scan or endoscopic ultrasound (EUS) settles the question before ERCP is planned. After the duct is cleared, removing the gallbladder is usually advised so that more stones do not follow.
What about medicines, diet and home remedies?
| Approach | Does it work? |
|---|---|
| Tablets to dissolve stones (ursodeoxycholic acid) | Only for some small cholesterol stones, over many months, and stones often come back after stopping. Guidelines do not recommend it as routine treatment. |
| "Gallbladder flush" with oil and juice | No. The soft lumps passed afterwards are formed from the oil, not gallstones. It can trigger an attack. |
| Shock-wave treatment (lithotripsy) | Used for kidney stones. It is not a standard treatment for gallbladder stones. |
| Diet | No diet dissolves stones. Smaller, less oily meals can reduce attacks while you wait for treatment. Avoid crash dieting, which itself causes stones. |
What to bring to the consultation
- The ultrasound report and films, and any CT or MRCP
- Recent liver function tests (LFT)
- A note of when the pain comes, how long it lasts, and any episode of fever or jaundice
- Your list of medicines
Have an ultrasound report showing stones?
Send it on WhatsApp. You will be told whether it needs a consultation, further tests or nothing at all.
Common questions
Can gallbladder stones be removed without surgery?
I have a gallstone but no pain. Do I need an operation?
Can a gallstone cause jaundice?
Is ERCP the same as gallbladder surgery?
Do gallstones cause gas and acidity?
Related
Written and medically reviewed by Dr. Mayank Agarwal, MBBS, MD (Medicine), DM (Gastroenterology) · Assam Medical Council Reg. No. 19633 · Last reviewed:
This page gives general information about gallstones. It does not replace a consultation — the right tests and treatment depend on your own reports and health. Please do not start or stop any medicine without advice.
Based on:
- European Association for the Study of the Liver. EASL Clinical Practice Guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol 2016;65:146–181.
- Buxbaum JL, et al. ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis. Gastrointest Endosc 2019;89:1075–1105.
- ICMR–National Centre for Disease Informatics and Research. Report of National Cancer Registry Programme 2012–2016. Bengaluru, 2020.