Gallstones are a frequent cause of pain on the right side of the abdomen, particularly among women. These small, hardened deposits develop in the gallbladder, a small organ located beneath the liver that stores bile—a digestive fluid that helps break down fats.

Gallstones can vary widely in size and number. Some are as tiny as a grain of sand, while others may grow as large as a golf ball. Certain individuals may have only one stone, whereas others develop multiple stones at the same time.

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Different Types of Gallstones

There are two primary types of gallstones: cholesterol gallstones and pigment gallstones. In some cases, stones may contain a mixture of both components.

Cholesterol Gallstones

Cholesterol gallstones are the most common type. They are mainly composed of cholesterol, a fatty substance naturally found in bile. When bile contains too much cholesterol and not enough bile salts, crystals can form and gradually harden into stones.

Pigment Gallstones

Pigment gallstones are less common and are formed from bilirubin, a yellow pigment produced when red blood cells break down.

These stones are typically smaller and are more likely to occur in individuals with conditions such as liver cirrhosis, hemolytic anemia, or chronic infections. Excess bilirubin in the bile increases the likelihood of pigment stone formation.

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Is Right-Side Abdominal Pain in Women a Symptom?

Not everyone with gallstones experiences symptoms. When gallstones do not cause pain or other noticeable problems, they are referred to as “silent gallstones” and are often discovered incidentally during imaging tests for unrelated conditions.

However, when gallstones block the bile ducts, they can trigger intense abdominal pain, jaundice, and inflammation of the gallbladder. This pain often occurs in the upper right abdomen and may radiate to the back or right shoulder.

Other possible symptoms of gallstones include:

• Bloating and indigestion, especially after eating fatty foods
• Changes in bowel habits, including diarrhea or pale, clay-colored stools
• Chest discomfort that may be mistaken for heart pain
• Fever and chills
• Nausea and vomiting
• Right shoulder blade or upper back pain
• Sharp, stabbing, or cramp-like abdominal pain

Symptoms may appear suddenly and often worsen after meals that are high in fat.

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What Causes Gallstones?

Gallstones form when substances in bile—such as cholesterol or bilirubin—become imbalanced. Although the exact cause of this imbalance is not fully understood, several contributing factors have been identified.

Common theories explaining gallstone formation include:

• Impaired gallbladder emptying: If the gallbladder does not contract effectively, bile may become overly concentrated, increasing the chance of stone formation.
• Obesity: Higher body fat levels can increase cholesterol production and reduce gallbladder motility.
• Rapid weight loss: Losing weight too quickly alters the chemical composition of bile and can trigger gallstone development.

These mechanisms often work together, rather than in isolation.

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What Increases Your Risk?

Certain factors increase the likelihood of developing gallstones. You may be at higher risk if you:

• Are female
• Are over the age of 40
• Have a family history of gallstones
• Have underlying medical conditions such as liver cirrhosis, hemolytic anemia, obesity, or diabetes

Hormonal factors, including estrogen levels during pregnancy or hormone therapy, can also contribute to increased cholesterol in bile and reduced gallbladder movement.

While these risk factors raise the chances of gallstone formation, not everyone with risk factors develops stones, and some individuals without any clear risk factors may still be affected.

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Getting a Diagnosis

If you suspect gallstones, it is important to seek medical evaluation.

During your appointment, a healthcare provider will ask about your symptoms and medical history and assess potential risk factors. A physical exam may be performed to check for tenderness or swelling in the abdomen.

Gallstones can be confirmed using the following tests:

• Abdominal ultrasound: Uses sound waves to create images of the gallbladder and is the most common diagnostic tool.
• Blood tests: Evaluate liver function and detect signs of inflammation or infection. Elevated bilirubin or liver enzymes may suggest bile duct blockage.
• Computed tomography (CT) scan: Produces detailed cross-sectional images of the gallbladder and surrounding organs.
• Endoscopic retrograde cholangiopancreatography (ERCP): A flexible tube with a camera is passed through the mouth into the intestine, allowing contrast dye to highlight bile ducts.
• Hepatobiliary iminodiacetic acid (HIDA) scan: Uses a radioactive tracer to track bile flow from the liver to the gallbladder and intestine.
• Magnetic resonance cholangiopancreatography (MRCP): A noninvasive MRI-based method for viewing bile ducts.

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What Treatment Looks Like

Treatment depends on the type of gallstones, the severity of symptoms, and whether complications are present.

Surgery

Cholecystectomy, the surgical removal of the gallbladder, is the most common and effective treatment for gallstones.

Surgery is usually recommended for individuals who experience recurrent pain, develop complications, or are at high risk of future stone formation. Most people can live normally without a gallbladder, as bile can flow directly from the liver into the intestine.

Medications

If surgery is not suitable, medications may be used to dissolve gallstones.

Common drugs include ursodiol and chenodiol, which work best for cholesterol-based stones rather than pigment stones. These medications are most effective for small stones and require long-term use—sometimes months or years—to achieve results.

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Tips for Preventing Right-Side Abdominal Pain

Although gallstones cannot always be prevented, certain lifestyle choices may lower your risk:

• Avoid extreme or rapid weight loss
• Drink sufficient water daily
• Eat smaller, more frequent meals
• Limit foods high in fat and cholesterol
• Maintain a healthy body weight
• Include fiber-rich foods such as fruits, vegetables, and whole grains

These habits help keep bile balanced and promote proper gallbladder function.

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Complications to Watch For

Gallstones can cause serious complications if they block bile ducts or trigger inflammation:

• Cholangitis: Infection of the bile ducts, causing fever, chills, jaundice, and severe pain
• Cholecystitis: Inflammation of the gallbladder, leading to intense abdominal pain, fever, nausea, and possible infection or perforation
• Choledocholithiasis: Stones in the common bile duct, resulting in jaundice, dark urine, pale stools, and abdominal pain
• Pancreatitis: Blockage of the pancreatic duct by gallstones, causing severe abdominal pain, vomiting, and requiring urgent medical care

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Living With Gallstones

Living with gallstones often involves making dietary and lifestyle adjustments to reduce symptoms and prevent complications. With proper medical care and healthy habits, most people with gallstones can lead normal, active lives without major limitations.

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Disclaimer: This article is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment of gallstone disease.