The most reliable way to get rid of gallstones is surgical removal of the gallbladder, which eliminates both the stones and the organ that forms them. But not every gallstone needs treatment. Most people with gallstones never develop symptoms, and those who do have a range of options depending on stone type, size, and severity.
Most Gallstones Don’t Need Treatment
About 80% of people with gallstones never know they have them. A long-term study tracking 298 patients with silent or minimally symptomatic gallstones found that only 1% to 2% per year developed noticeable symptoms. Over 25 years, serious complications were rare (about 4%), and they were almost always preceded by earlier warning pain. So if gallstones showed up incidentally on an imaging scan and you’ve never had symptoms, the standard approach is simply to leave them alone and monitor.
The exception: stones found in the common bile duct carry a much higher complication risk (up to 50%), even without symptoms. These are typically treated proactively.
Surgery: The Most Common Solution
Gallbladder removal is the go-to treatment when gallstones cause repeated pain, interfere with your daily life, or pose a risk of complications like infection or duct blockage. It’s the most common reason people have their gallbladder taken out.
The vast majority of these surgeries are done laparoscopically, through a few small incisions. Recovery takes about two weeks. In cases where the laparoscopic approach isn’t possible, an open surgery through a larger incision is used instead, with recovery stretching to six to eight weeks.
Losing your gallbladder doesn’t mean you can’t digest food. Your liver still produces bile, which flows directly into the small intestine. Some people notice digestive changes afterward, though. Anywhere from 5% to 47% of patients experience what’s called postcholecystectomy syndrome, which can include bloating, indigestion, or loose stools. Diarrhea happens because excess bile acids reach the colon without being stored and concentrated first. For most people these issues are mild and improve over time, sometimes with dietary adjustments.
Dissolving Stones Without Surgery
If your gallstones are small, made of cholesterol, and your gallbladder still functions properly, oral dissolution therapy is an option. A prescription bile acid medication works by gradually breaking down cholesterol stones from the inside. The catch: it only works on pure cholesterol stones. Any calcium or pigment in the stone makes it resistant to dissolving. Treatment typically takes months to over a year, and stones can recur after you stop taking the medication.
Shock wave therapy (lithotripsy) is another non-surgical route, though it’s far less common today. It uses focused sound waves to shatter stones into fragments small enough to pass or dissolve. Candidates generally need a functioning gallbladder, no more than three stones, and stones smaller than 30 mm. Patients with larger, calcified, or numerous stones have lower success rates, making other treatments more practical. This approach is usually combined with the oral dissolution medication to help clear the remaining fragments.
For people who are too sick for surgery, a drainage procedure can be performed instead. A thin tube is placed through the skin directly into the gallbladder to drain infected bile. This can serve as a temporary bridge until the patient is healthy enough for surgery, or it can remain in place long-term as a permanent solution.
Why Gallbladder “Flushes” Don’t Work
You’ll find plenty of recipes online for gallbladder cleanses, typically involving large amounts of olive oil, lemon juice, or apple juice consumed over a day or two. Proponents claim the globs that appear in the stool afterward are expelled gallstones. They’re not. According to the Mayo Clinic, those lumps are actually solidified mixtures of oil, juice, and digestive fluids.
These flushes carry real risks. Nausea, vomiting, diarrhea, and abdominal pain are common during the process. More concerning, if you do have actual gallstones, flooding your system with fat triggers a rush of bile that could push a stone into a duct and cause a painful blockage.
Diet Changes That Protect Your Gallbladder
Diet won’t dissolve existing gallstones, but it plays a significant role in preventing new ones and reducing the frequency of painful attacks. The core principle is straightforward: eat less saturated fat and more fiber.
Saturated fat forces your gallbladder to release more bile to handle digestion, which increases the chance of triggering an attack. Cutting back on red meat, butter, fried foods, and full-fat dairy reduces that demand. On the other hand, omega-3 fatty acids found in fish like salmon, mackerel, and sardines may actually be protective against gallstone formation.
Fiber helps clear excess fat and cholesterol from your digestive system before it can concentrate in bile. Most people don’t get enough. Fruits, vegetables, whole grains, and legumes are the best sources. Increasing your fiber intake gradually helps you avoid bloating.
Rapid Weight Loss Increases Risk
If you’re losing weight to improve your health, the pace matters. Losing weight very quickly, whether through extreme dieting or bariatric surgery, significantly raises your chances of forming new gallstones. When the body breaks down fat rapidly, the liver secretes extra cholesterol into bile, creating the perfect conditions for stones to crystallize.
People on very low-calorie diets or those who’ve had weight-loss surgery can take a preventive bile acid medication during the rapid loss phase to reduce this risk. If you’re planning significant weight loss, a steady pace of one to two pounds per week is far safer for your gallbladder than dramatic drops.
Symptoms That Need Immediate Attention
Gallstone pain typically hits in the upper right abdomen or between the shoulder blades and can last anywhere from a few minutes to several hours. Three specific warning signs mean you should get to an emergency room: abdominal pain so severe you can’t sit still or find a comfortable position, yellowing of your skin or the whites of your eyes, and high fever with chills. These suggest a stone has blocked a duct or caused an infection, both of which can escalate quickly without treatment.