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Gallstone Care
Gallstones: Symptoms, Diagnosis & Treatment
When Gallstones Need Treatment, and When They Can Be Left Alone
Gallstones are hardened deposits of bile that form inside the gallbladder. Many adults carry them for years without a single symptom. Trouble starts when a stone blocks the gallbladder outlet or slips into the bile duct, causing pain after meals, inflammation, infection, jaundice, or pancreatitis.
Not every gallstone needs treatment. Dr. Murtaza Shakir, board certified in General Surgery and Complex General Surgical Oncology, helps patients sort out whether their stones can be safely watched or should be treated. He sees patients at Surgical Associates of Southern Texas in Katy and Sugar Land, serving Richmond, Fulshear, West Houston, and Greater Houston. For the operation itself, see the main gallbladder surgery page.
Meet the Surgeon
Dr. Murtaza Shakir, MD, general surgeon treating gallstones and gallbladder disease in Katy and Sugar Land, TX
- Dual board certified in General Surgery and Complex General Surgical Oncology
- Named a Houstonia Top Doctor in General Surgery, 2026 (see listing)
- Highly reviewed: rated 4.9 stars on Google
- Specialized in laparoscopic and robotic gallbladder removal, bile duct stone care with gastroenterology, hernia repair, and complex abdominal surgery
Patient Reviews
Patient Experiences With Dr. Shakir
Rated 4.9 stars on Google. Real experiences from patients treated in Katy and Sugar Land.
Jump to a section
- At a glance
- What are gallstones?
- Who gets gallstones
- Silent vs. symptomatic stones
- Symptoms and when to see a surgeon
- Complications
- Diagnosis
- Watch or treat?
- Meet your surgeon
- Medication and diet
- Gallbladder removal options
- ERCP for bile duct stones
- Recovery
- Risks
- Patient reviews
- Why choose us
- Insurance
- Locations
- FAQs
- Schedule a consultation
At a Glance
Gallstones at a Glance
- What they are
- Hard deposits that form in the gallbladder when bile holds too much cholesterol or bilirubin. The medical term is cholelithiasis.
- Main types
- Cholesterol stones, the most common type in the United States, and darker pigment stones made from bilirubin.
- Typical symptoms
- Steady upper right or upper middle abdominal pain, often after a meal, sometimes spreading to the back or right shoulder blade, with nausea.
- Who needs treatment
- Silent stones found by chance usually do not. Stones that have caused pain or a complication usually do.
- Usual treatment
- Laparoscopic or robotic gallbladder removal (cholecystectomy), with ERCP to clear any stone trapped in the bile duct.
- Who treats it
- A general surgeon, working with a gastroenterologist when bile duct stones are present. Dr. Shakir is board certified in General Surgery and Complex General Surgical Oncology.
- Urgent warning signs
- Pain lasting more than a few hours, fever or chills, yellow skin or eyes, dark urine, pale stools, or persistent vomiting. Call 911 or go to the nearest emergency department.
- Where
- Offices in Katy and Sugar Land, TX. Call 713-955-9191.
Gallstone Basics
What Are Gallstones?
Gallstones are small, hard deposits that form inside the gallbladder when the chemistry of bile falls out of balance. Bile is a digestive fluid made by the liver. The gallbladder, a small pouch under the liver, stores and concentrates it between meals, then squeezes it into the intestine when you eat.
When bile carries more cholesterol or bilirubin than it can keep dissolved, or too few bile salts, the excess forms crystals. Over months to years those crystals grow into stones. A stone may be as small as a grain of sand or as large as a golf ball, and one gallbladder can hold a single stone or hundreds. Stones also form more easily when the gallbladder does not empty fully or often enough. Learn more about what the gallbladder does.
Cholesterol Gallstones
Cholesterol stones are the most common type in the United States. They are usually yellow-green and form when bile holds more cholesterol than its bile salts can dissolve. Weight, diet, hormones, and genetics all influence this balance.
Pigment Gallstones
Pigment stones are dark brown or black and are made mostly of bilirubin, a breakdown product of red blood cells. They are more likely in people with blood disorders that destroy red cells, such as sickle cell anemia, and in people with cirrhosis or bile duct infections.
The type of stone matters less than what it does. Both types cause the same symptoms and complications, and both are treated the same way once they cause trouble.
Risk Factors
Who Is More Likely to Develop Gallstones?
Gallstones are common, and the risk rises with age, female sex, and excess weight. Some risk factors can be changed; many cannot. Stones also form in people who eat carefully and stay active, so a gallstone diagnosis is not a sign that you did something wrong.
Factors You Cannot Change
- Being female
- Older age
- A family history of gallstones
- Native American or Mexican American heritage
Hormones and Pregnancy
- Pregnancy
- Estrogen from hormone therapy or birth control pills
- Certain other medications
Weight and Diet
- Obesity
- Rapid weight loss, including after bariatric surgery or very low-calorie diets
- A diet high in calories and refined carbohydrates and low in fiber
Medical Conditions
- Diabetes or insulin resistance
- High triglycerides and metabolic syndrome
- Cirrhosis of the liver
- Blood disorders such as sickle cell anemia
- Some intestinal diseases, such as Crohn’s disease
Two Groups
Silent vs. Symptomatic Gallstones
The most important question about any gallstone is whether it has caused symptoms. That single fact shapes almost every treatment decision.
Silent (Asymptomatic) Gallstones
Silent gallstones show up on an ultrasound or CT scan done for another reason and have never caused pain. Most never will. Roughly one to two percent of people with silent stones develop symptoms each year, and surgery is generally not recommended for this group.
Symptomatic Gallstones
Symptomatic gallstones have caused at least one episode of gallbladder pain, or have led to inflammation, infection, or a blocked duct. Once a stone has caused an attack, more attacks are likely, and the chance of a complication grows. This is the group for whom gallbladder removal is usually advised.
Part of a consultation is confirming that your symptoms are really coming from the stones, since reflux, ulcers, and other conditions can cause similar pain. Our article on whether gallstones always need surgery covers this in more depth.
Recognizing the Signs
Gallstone Symptoms and When to See a Surgeon
The classic symptom of gallstones is a gallbladder attack, also called biliary colic: steady pain in the upper right or upper middle abdomen that often begins within an hour or two of a meal. It usually lasts from thirty minutes to several hours, then fades. Between attacks most people feel completely normal, which is why gallstones are often mistaken for indigestion or reflux for months.
- Steady pain under the right ribs or below the breastbone
- Pain that spreads to the back or right shoulder blade
- Pain after eating, especially large or fatty meals
- Nausea, with or without vomiting
- Bloating, fullness, or indigestion after meals
- Attacks that wake you at night
For a detailed look at what an attack feels like and how long it lasts, read our guide to gallbladder attack symptoms. You can also learn why gallbladder pain often follows meals and how gallstones can cause back or shoulder pain.
When to See a Surgeon About Gallstones
Schedule a surgical evaluation if you have:
- Gallstones on ultrasound and pain that fits the gallbladder pattern
- Had one or more gallbladder attacks
- Been seen in the ER for gallbladder pain and sent home
- Recovered from cholecystitis or gallstone pancreatitis
- Had a bile duct stone removed by ERCP
- Been referred by your primary care doctor or gastroenterologist
If the ER found your stones, see what to do after the ER finds gallstones.
When Gallstone Symptoms Need Urgent Care
Seek urgent care for pain lasting more than a few hours or steadily worsening, fever or chills, yellow skin or eyes, dark urine or pale stools, persistent vomiting, or severe upper abdominal pain boring through to the back. These suggest a complication, not a simple attack. For a medical emergency, call 911 or go to the nearest emergency department.
Complications
Complications Gallstones Can Cause
Most gallstone attacks settle on their own. The main reason symptomatic stones are treated is to prevent the complications below, each of which needs more urgent and more involved care than a planned operation.
Acute Cholecystitis
A stone lodges in the gallbladder outlet, and the gallbladder becomes inflamed and often infected. Pain becomes constant, fever often develops, and hospital admission is usually needed. Surgery is typically performed within a few days. See the symptoms of acute cholecystitis.
Chronic Cholecystitis
Repeated attacks scar and thicken the gallbladder wall so it no longer works well. Attacks tend to become more frequent and food intolerance more noticeable. The gallbladder is removed as a planned operation.
Choledocholithiasis (Bile Duct Stones)
A stone escapes into the common bile duct and blocks bile flowing from the liver. This causes jaundice, dark urine, and pale stools. The stone is usually removed by ERCP before, during, or after gallbladder surgery.
Cholangitis
When a stone blocks the bile duct, the trapped bile can become infected. Cholangitis typically causes fever and chills, jaundice, and upper right abdominal pain. It is a medical emergency that needs antibiotics and prompt drainage of the duct, usually by ERCP.
Gallstone Pancreatitis
A small stone blocks the shared opening of the bile duct and pancreatic duct, inflaming the pancreas. It causes severe upper abdominal pain radiating to the back, with vomiting, and requires hospital care. Gallbladder removal is recommended once the pancreatitis settles, often during the same hospital stay.
Diagnosis
How Are Gallstones Diagnosed?
Gallstones are usually diagnosed with an abdominal ultrasound and blood tests. Finding stones is the easy part. The harder and more important step is confirming that the stones are causing your symptoms and checking for complications.
History and Examination
The timing, location, and character of the pain, its link to meals, and any fever or jaundice are the most useful clues. Tenderness under the right ribs when you breathe in during the exam (Murphy’s sign) suggests inflammation.
Abdominal Ultrasound
Ultrasound is the first and best test. It shows stones, thickening of the gallbladder wall, fluid around the gallbladder, and widening of the bile duct. It is painless and takes about twenty minutes.
Blood Tests
Liver enzymes and bilirubin rise when a stone blocks the bile duct. The white blood cell count rises with infection, and lipase rises with pancreatitis. Normal blood tests with a typical history still point to uncomplicated gallstones.
Further Imaging When Needed
An MRCP (a type of MRI) or endoscopic ultrasound looks for stones in the common bile duct when blood tests or ultrasound raise concern. A HIDA scan checks how well the gallbladder empties when symptoms are typical but no stones are seen, which can point to biliary dyskinesia.
Please bring any ultrasound or CT reports, lab results, and ER records to your consultation.
Treatment Decision
Do Gallstones Always Need Surgery?
No. Gallstones that have never caused symptoms are usually left alone, whatever their size or number. Stones that have caused attacks or complications are usually treated by removing the gallbladder, because stones keep forming as long as the gallbladder is there.
When Watchful Waiting Is Reasonable
Observation is usually the right choice when stones were found by chance and you have never had gallbladder-type pain. The yearly risk of a first attack is low, and for most people that risk does not justify an operation. You simply learn the warning signs and seek care if symptoms appear.
There are exceptions. Very large stones, a calcified (“porcelain”) gallbladder, gallbladder polyps larger than about 1 cm, and stones in people who will be far from medical care for long periods may warrant removal even without symptoms. These are individual decisions.
When Surgery Is Usually Advised
- One or more typical gallstone attacks (symptomatic cholelithiasis)
- Acute cholecystitis, once diagnosed
- Gallstone pancreatitis, once recovered
- Stones in the common bile duct, after or alongside their removal
- Chronic cholecystitis with recurring symptoms
- A gallbladder that does not empty properly on a HIDA scan, with typical symptoms
What Happens If Symptomatic Stones Are Left Alone?
Attacks often return and may become more frequent. Each attack carries a chance of cholecystitis, a bile duct stone, cholangitis, or pancreatitis, any of which can turn a planned outpatient operation into an emergency admission.
Your Surgeon
Meet Your Gallbladder Surgeon
Murtaza Shakir, MD
Board-Certified General Surgeon & Surgical Oncologist
Gallstone care at Surgical Associates of Southern Texas is led by Dr. Murtaza Shakir, who is board certified in General Surgery and Complex General Surgical Oncology.
Board certification
American Board of Surgery: General Surgery and Complex General Surgical Oncology
Medical degree
Aga Khan University
Residency
General Surgery, Riverside Methodist Hospital, Columbus, Ohio
Fellowship
Two-year Surgical Oncology fellowship, University of Pittsburgh Medical Center
Surgical practice includes
Named a Houstonia Top Doctor in General Surgery (2026). Learn more about our general surgery services.
Nonsurgical Options
Can Gallstones Be Dissolved or Treated With Diet?
Rarely, and not reliably. Mainstream sources, including the National Institutes of Health, describe gallbladder removal as the usual treatment for symptomatic gallstones and reserve nonsurgical methods for special cases.
Dissolving Medication
Bile acid pills such as ursodiol can slowly dissolve small cholesterol stones in a gallbladder that still works well. They do not dissolve pigment stones, and treatment can take months to years. Because the gallbladder that formed the stones is still there, stones often return after treatment ends. This option is mainly considered for people who cannot safely have surgery.
Breaking Up Stones
Shock wave lithotripsy, which uses sound waves to fragment stones, is rarely used for gallbladder stones today. Like medication, it leaves the gallbladder in place, so stones can form again.
Diet and Lifestyle
Avoiding large, fatty, or fried meals may reduce how often attacks happen, because these meals make the gallbladder contract hard. A diet change does not remove existing stones or the risk of complications. A healthy weight, regular activity, more fiber, and avoiding crash diets may lower the chance of forming new stones.
Why the Gallbladder Is Removed Rather Than the Stones
Taking out only the stones is not standard treatment, because a gallbladder that has made stones tends to make more. Removing the gallbladder treats the source. The liver keeps making bile, which then flows directly into the intestine, and most people digest food normally afterward.
Surgical Treatment
Gallbladder Removal for Gallstones
The standard treatment for symptomatic gallstones is cholecystectomy, the removal of the gallbladder along with the stones inside it. Most operations are minimally invasive, take about an hour, and are often same-day procedures. Dr. Shakir recommends the approach that is safest for your gallbladder, your anatomy, and your health.
| Feature | Laparoscopic | Robotic | Open |
|---|---|---|---|
| Incisions | A few small incisions | Small incisions | A larger incision under the right ribs |
| View and instruments | Camera and slender instruments | Console control and a magnified 3D image | Direct access through the incision |
| Typical use | The most common approach | Selected cases | Severe inflammation, scarring or unsafe minimally invasive surgery |
| Key point | Most patients go home the same day | Dr. Shakir controls every instrument | Converting to open is a safety decision |
Typical patterns only. Dr. Shakir recommends an approach after your exam.
Wondering how the two minimally invasive approaches compare? Read robotic vs. laparoscopic gallbladder surgery or how long gallbladder surgery takes. Full details of the operation are on the main gallbladder surgery page.
Bile Duct Stones
The Role of ERCP for Bile Duct Stones
When a gallstone is trapped in the common bile duct, it is usually removed with ERCP (endoscopic retrograde cholangiopancreatography). ERCP is performed by a gastroenterologist, who passes a flexible scope through the mouth and stomach to the opening of the bile duct. The opening is widened and the stone is pulled out, with no abdominal incision.
- Before surgery: the most common sequence when jaundice, cholangitis, or blood tests point to a duct stone
- After surgery: when a duct stone is found during or after gallbladder removal
- On its own: sometimes used for people who are too ill for surgery, though the gallbladder can still form new stones
ERCP clears the duct but does not remove the gallbladder. For most patients, gallbladder removal follows to prevent the next stone. Dr. Shakir coordinates timing with the gastroenterologist so the two procedures fit together.
After Treatment
Recovery After Gallbladder Removal
Most people go home the same day after laparoscopic or robotic gallbladder removal and return to normal activity within one to two weeks. Walking is encouraged right away. Heavy lifting and strenuous work take longer, and recovery after open surgery or a severely inflamed gallbladder takes more time.
Most people eat normally after recovery. Some notice looser or more frequent stools or sensitivity to very fatty meals at first, which usually improves. Persistent digestive symptoms should be discussed with your doctor.
For a week-by-week timeline, see our gallbladder removal recovery guide. You can also read about foods to eat after gallbladder removal and the long-term effects of gallbladder removal.
Risks
Risks of Gallstone Treatment
Gallbladder removal is one of the most common operations in the United States and is generally safe, but every operation carries some risk. Dr. Shakir reviews the risks that apply to you before surgery. Possible complications include:
- Bleeding or wound infection
- Bile leakage
- Injury to the common bile duct, which is rare but serious
- Injury to the intestine or nearby blood vessels, which is uncommon
- A stone left in the bile duct, sometimes needing ERCP
- A hernia at an incision site
- Blood clots
- Reactions to anesthesia
ERCP has its own risks, including pancreatitis, bleeding, and infection, which the gastroenterologist will review. Leaving symptomatic stones untreated also carries risk: repeat attacks and complications such as cholecystitis, cholangitis, and pancreatitis. For most people with symptomatic gallstones, the balance favors a planned operation.
Why Choose Us
Why Choose Surgical Associates of Southern Texas for Gallstone Treatment?
Dr. Murtaza Shakir is board certified in General Surgery and Complex General Surgical Oncology and treats gallstones and their complications at offices in Katy and Sugar Land.
- Silent stones watched, symptomatic stones treated
- Laparoscopic and robotic removal, usually same-day
- Training in liver, bile duct and pancreatic surgery
- Clear explanations of ultrasound, labs, options and recovery
- Consultations and follow-up in Katy and Sugar Land
Insurance Coverage
Insurance for Gallstone Treatment
Surgical Associates of Southern Texas accepts many major insurance plans for gallstone evaluation and gallbladder surgery, including participating Aetna, Cigna, UnitedHealthcare, and Blue Cross Blue Shield plans. Our office can confirm whether your specific plan participates and whether a referral or prior authorization is needed before your visit.
Coverage, network participation, authorization requirements, and your share of the cost vary by plan. You can also review the insurance accepted for surgical care at our practice.
Aetna, Cigna, UnitedHealthcare, and Blue Cross Blue Shield are only some of the plans we accept. Plan-specific details are on our Aetna, Cigna, UnitedHealthcare, and Blue Cross Blue Shield pages. If your plan is not listed, contact our office and our team will help verify it.
Insurance participation and benefits vary by individual plan. Verification does not guarantee coverage, authorization or payment. Please contact our office and your insurer to verify benefits before treatment.
Our Locations
Two Convenient Fort Bend County Offices
Learn more about our Katy and Sugar Land practices, or view all locations.
Katy Office
410 W Grand Pkwy S, Suite 4D
Katy, TX 77494
Serves: Katy, Fulshear, Richmond, Cinco Ranch and West Houston
Sugar Land Office
17510 W Grand Pkwy S, Suite 320
Sugar Land, TX 77479
Serves: Sugar Land, Richmond, Stafford, Missouri City, Fort Bend County and Southwest Houston
Approximate Drive Times
From West Houston (Energy Corridor): about 15 minutes to Katy, or 25 to 30 minutes to Sugar Land.
From North Houston: about 40 to 50 minutes to either office, depending on traffic.
Common Questions
Frequently Asked Questions About Gallstones
Who is most likely to get gallstones?
Gallstones are more common in women, older adults, people with obesity, people who lose weight quickly, and people with a family history of stones. Pregnancy, estrogen therapy, diabetes, and some blood and liver conditions also raise the risk.
Do gallstones always need surgery?
No. Stones that have never caused symptoms are usually left alone. Surgery is recommended once stones cause attacks, inflammation, bile duct blockage, or pancreatitis, because further episodes are then likely.
Can gallstones go away without surgery?
Rarely on their own. Medication can slowly dissolve small cholesterol stones in selected patients, but it takes months to years and stones often return. For symptomatic stones, gallbladder removal is the reliable treatment.
What does gallstone pain feel like?
A steady, often intense ache in the upper right or upper middle abdomen, sometimes spreading to the back or right shoulder. It typically begins after a meal, lasts thirty minutes to a few hours, and often comes with nausea. See gallbladder attack symptoms.
Can I just have the stones removed and keep my gallbladder?
That is not standard treatment. Stones tend to re-form in a gallbladder that has already made them, so the gallbladder itself is removed. Most people live and eat normally without it.
What foods trigger gallstone attacks?
Fatty, fried, and large meals most often, because they make the gallbladder contract hard. Avoiding them can reduce attacks but does not remove the stones or the risk of complications.
Can gallstones cause pancreatitis?
Yes. A small stone can block the shared opening of the bile and pancreatic ducts, inflaming the pancreas. Gallstone pancreatitis is serious, and the gallbladder is usually removed once it settles.
Is gallbladder removal a big operation?
For most patients it is a same-day laparoscopic or robotic procedure lasting about an hour, with return to normal activity in one to two weeks. See our gallbladder removal recovery guide.
Can gallstones come back after my gallbladder is removed?
Stones cannot re-form in a gallbladder that has been removed. Uncommonly, a stone is found in the bile duct afterward, and it is usually treated with ERCP.
Will insurance cover gallstone treatment?
Coverage depends on your plan, network, deductible, and any authorization requirements. Contact the office to verify your benefits before your visit, or review our insurance information.
Sources and references
- Definition & Facts for Gallstones, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Symptoms & Causes of Gallstones, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Treatment for Gallstones, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Gallstones (Cholelithiasis), MedlinePlus, U.S. National Library of Medicine
Reviewed by the Review Team at Surgical Associates of Southern Texas.
Medical Disclaimer: This page provides general information and is not a substitute for medical advice. For severe or prolonged abdominal pain, fever, yellowing of the skin or eyes, or other emergencies, call 911 or go to the nearest emergency room. Last updated October 16, 2026.
Schedule a Gallstone Consultation
Told you have gallstones, or have pain after meals you suspect is your gallbladder? Schedule an evaluation with Dr. Murtaza Shakir to learn whether observation is safe or treatment is advisable, and what laparoscopic or robotic removal involves. Offices in Katy and Sugar Land serve Richmond, Fulshear, Stafford, Missouri City and Greater Houston.
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