Gallstones • Katy & Sugar Land
Gallstones: Symptoms, Diagnosis & Treatment
When Gallstones Need Treatment — and When They Can Be Left Alone
Gallstones are hardened deposits that form inside the gallbladder, the small pouch under the liver that stores bile. They are extremely common; many adults have them without ever knowing. Trouble starts when a stone blocks the outlet of the gallbladder or slips into the bile duct, causing pain, inflammation, or infection.
Not every gallstone needs treatment. Silent stones found by chance are usually left alone. Stones that cause attacks, inflammation, or bile duct problems are usually treated by removing the gallbladder, because the stones will keep forming as long as the gallbladder is there. Dr. Murtaza Shakir, board certified in General Surgery and Complex General Surgical Oncology, evaluates and treats symptomatic gallstones for patients in Katy, Sugar Land, and Greater Houston.
This page explains how gallstones form, what symptoms they cause, how they are diagnosed, which complications matter, and how the decision between observation and surgery is made. For the surgery itself, see the main gallbladder surgery page.
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Understanding the Condition
What Are Gallstones?
Crystals that grow in stored bile
Bile is a digestive fluid made by the liver and concentrated in the gallbladder between meals. When the balance of cholesterol, bile salts, and bilirubin in that fluid tips too far, the excess crystallizes and slowly grows into stones. They range from a grain of sand to a golf ball, and a gallbladder may hold one stone or hundreds.
Cholesterol stones are the most common type in the United States and form when bile carries more cholesterol than it can keep dissolved. Pigment stones are darker and form from excess bilirubin, more often in people with certain blood disorders or liver conditions.
Risk rises with age, female sex, pregnancy, obesity, rapid weight loss, diabetes, a family history of stones, and certain medications. Diet plays a role, but stones can form in people who eat carefully. Learn more about what the gallbladder does.
Silent stones vs. symptomatic stones
Silent (asymptomatic) gallstones are found 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. Surgery is generally not recommended for silent stones.
Symptomatic gallstones have caused at least one episode of biliary pain, or have led to inflammation, infection, or a blocked duct. Once a stone has caused an attack, further attacks are likely, and complications become more probable with each one. This is the group for whom gallbladder removal is usually advised.
The question Dr. Shakir answers at a consultation is which group you are in, and whether your symptoms are actually coming from the stones. Our article on whether gallstones always need surgery expands on this.
Recognizing the Signs
Gallstone Symptoms
A gallstone attack, or biliary colic, is the classic symptom. It is steady rather than crampy, usually starts within an hour or two of a meal, and lasts from thirty minutes to several hours before fading.
Steady pain in the upper right abdomen, under the ribs
Pain in the upper middle abdomen (below the breastbone)
Pain that spreads to the back or right shoulder blade
Pain that begins after eating, especially fatty or large meals
Nausea, with or without vomiting
Bloating, fullness, or indigestion after meals
Attacks that last 30 minutes to several hours
Attacks that wake you at night
Between attacks most people feel completely normal, which is why gallstones are often mistaken for indigestion or reflux for months. Our articles on gallbladder pain after eating and back and shoulder pain from gallstones describe the pattern in more detail. For a fuller guide to what an attack feels like, see gallbladder attack symptoms.
When Gallstone Symptoms Need Urgent Care
These signs suggest a complication rather than a simple attack:
- Pain lasting more than a few hours or steadily worsening
- Fever or chills
- Yellowing of the skin or eyes (jaundice)
- Dark urine or pale, clay-colored stools
- Persistent vomiting
- Pain in the upper abdomen that bores through to the back, with vomiting (possible pancreatitis)
Call 911 or go to the nearest emergency department if these occur.
Diagnosis
How Gallstones Are Diagnosed
The diagnosis is usually simple. The harder and more important job is confirming that the stones are the cause of the symptoms and checking for complications.
01
History and Examination
The timing, location, and character of the pain, its relationship to meals, and any fever or jaundice are the most useful clues. Tenderness under the right ribs when pressing while you breathe in (Murphy’s sign) suggests inflammation.
02
Abdominal Ultrasound
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.
03
Blood Tests
Liver enzymes and bilirubin rise when a stone is blocking the bile duct. White blood cell count rises with infection. Lipase rises with pancreatitis. Normal blood tests with a typical history still point to uncomplicated gallstones.
04
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 assesses how well the gallbladder empties when symptoms are typical but no stones are seen.
Complications
Problems Gallstones Can Cause
Most gallstone attacks resolve on their own. The reason symptomatic stones are usually treated is to prevent the complications below, each of which requires more urgent and more complex care.
Acute Cholecystitis
A stone lodges in the gallbladder outlet and the gallbladder becomes inflamed and often infected. Pain becomes constant, fever develops, and hospital admission is usually needed. Surgery is typically performed within a few days. See symptoms of acute cholecystitis.
Choledocholithiasis
A stone escapes into the common bile duct and blocks the flow of bile from the liver, causing jaundice, dark urine, and pale stools, and risking a serious infection of the duct (cholangitis). The stone is usually removed by endoscopy (ERCP) before or after gallbladder surgery.
Gallstone Pancreatitis
A small stone blocks the shared outlet of the bile and pancreatic ducts, inflaming the pancreas. This causes severe upper abdominal pain radiating to the back, with vomiting, and requires hospital care. Gallbladder removal is recommended once the pancreatitis settles, usually during the same admission.
Chronic Cholecystitis
Repeated attacks scar and thicken the gallbladder wall so that it no longer works well. Symptoms become more frequent and food intolerance more pronounced. The gallbladder is removed electively.
Diagnosed With Gallstones?
Whether your stones can be watched or should be treated depends on your symptoms and test results. A consultation with Dr. Shakir gives you a clear answer.
Treatment Decision
Observation or Surgery?
When observation is appropriate
Gallstones that have never caused symptoms are usually left alone, regardless of their size or number. The risk of a first attack is low, and the risk of surgery in a person who feels well is not justified for most people.
Exceptions exist. Very large stones, a calcified (“porcelain”) gallbladder, gallbladder polyps larger than about 1 cm, and stones in patients who will be far from medical care for long periods may warrant removal even without symptoms. These are individual decisions.
Why the gallbladder is removed rather than the stones
Stones can occasionally be dissolved with medication or fragmented, but they come back in most people within a few years because the gallbladder that formed them is still there. Removing the gallbladder (cholecystectomy) treats the cause and is the standard treatment for symptomatic stones. The liver continues to make bile, which flows directly into the intestine, and most people digest food normally afterward.
When surgery is usually recommended
- 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 no longer empties properly on HIDA scan, with typical symptoms
Surgery is almost always laparoscopic or robotic, takes about an hour, and is usually a same-day procedure. Details of the operation are on the main gallbladder surgery page.
Your Surgeon
Meet Your Gallbladder Surgeon
Murtaza Shakir, MD
Dr. Shakir is a board-certified General Surgeon and Surgical Oncologist serving Katy, Sugar Land, and Greater Houston. He earned his medical degree at Aga Khan University, completed General Surgery residency at Riverside Methodist Hospital in Columbus, Ohio, and a two-year Surgical Oncology fellowship at the University of Pittsburgh Medical Center.
His training in liver, bile duct, and pancreatic surgery gives him a broad view of gallstone disease, from a simple attack to bile duct stones and pancreatitis.
Board certified by the American Board of Surgery in:
- General Surgery
- Complex General Surgical Oncology
Surgical focus:
- Gallstone and gallbladder disease evaluation
- Laparoscopic and robotic gallbladder removal
- Bile duct stone management with gastroenterology
- Liver, bile duct, and pancreatic surgery
Recognized by Houstonia Magazine among Houston’s top general surgeons. Learn more about gallbladder surgery.
Why Patients Choose Us
Why Choose Surgical Associates of Southern Texas for Gallstone Treatment?
Board-Certified Surgical Expertise
Board certified in both General Surgery and Complex General Surgical Oncology.
Honest Treatment Decisions
Silent stones are watched; symptomatic stones are treated. You get a clear reason either way.
Minimally Invasive Surgery
Laparoscopic and robotic gallbladder removal, usually same-day.
Complex Biliary Experience
Bile duct stones, pancreatitis, and difficult gallbladders are within his training.
Clear Communication
Test results, options, and what to expect are explained in plain language.
Katy & Sugar Land Offices
Consultations and follow-up at two Fort Bend County locations.
Locations
Two Convenient Fort Bend County Offices
Gallstone consultations, ultrasound and lab review, and surgical scheduling are available at both offices. View all locations.
Katy Office
Convenient for patients from Katy, Cinco Ranch, Fulshear, Richmond, and West Houston.
Surgical Associates of Southern Texas
410 W Grand Pkwy S
Suite 4D
Katy, TX 77494
Gallstone and gallbladder disease evaluation, imaging review, and laparoscopic or robotic surgery planning.
Sugar Land Office
Convenient for patients from Sugar Land, Richmond, Stafford, Missouri City, and Fort Bend County.
Surgical Associates of Southern Texas
17510 W Grand Pkwy S
Suite 320
Sugar Land, TX 77479
Gallstone and gallbladder disease evaluation, imaging review, and laparoscopic or robotic surgery planning.
Patient Reviews
What Patients Say About Gallbladder Surgery
⭐⭐⭐⭐⭐ Rated 5 Stars by Patients on Google. Real experiences from patients treated in Katy and Sugar Land.
Lydia Dennis
Sugar Land · Robotic Gallbladder Removal
My gastroenterologist referred me to Dr Shakir as an option for my gallbladder removal, and I’m so glad he did. From the initial consultation to today’s post-op appointment with Dr Shakir and his staff, everything went very smoothly. He did the robotic laparoscopic removal and the incisions look amazing. Dr Shakir is knowledgeable, efficient, and professional. I hope I don’t need a general surgeon in the future, but if I do, I’d 100% book another surgery with him.
Rick Rogers
Google Review · Gallbladder Surgery
I had severe pain and was in the ER 5 times in 2 months with no definitive diagnosis. Dr. Shakir looked at my various test results and realized my gall bladder needed to come out. Once he removed it I felt so much better. He listens to you and discusses the options. Great Dr. and surgeon. I HIGHLY RECOMMEND.
See what more patients are saying about their experience with Dr. Shakir.
FAQ
Gallstone Questions
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 usually 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, typically beginning after a meal and lasting thirty minutes to a few hours, often with nausea.
When should gallstones be removed?
After a typical attack, or when they have caused cholecystitis, pancreatitis, or bile duct stones. Removal is planned electively unless a complication makes it urgent.
Can I just have the stones removed and keep my gallbladder?
That is not standard treatment. Stones re-form in a gallbladder that has already made them, so the gallbladder 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.
How are gallstones diagnosed?
Usually with an abdominal ultrasound and blood tests for liver enzymes, bilirubin, white cell count, and lipase. MRCP, endoscopic ultrasound, or a HIDA scan are used when the picture is unclear.
What is the difference between gallstones and cholecystitis?
Gallstones are the stones themselves. Cholecystitis is inflammation of the gallbladder, usually caused by a stone blocking its outlet; it causes constant pain, fever, and typically requires hospital care.
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 a serious condition, and the gallbladder is 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.
Do I need to see a surgeon or a gastroenterologist?
Both may be involved. A gastroenterologist manages bile duct stones with ERCP and evaluates unclear abdominal pain. A surgeon evaluates whether the gallbladder should be removed and performs the operation. Many patients are referred from one to the other.
Who treats symptomatic gallstones near Katy or Sugar Land?
Dr. Murtaza Shakir evaluates and treats gallstones at 410 W Grand Pkwy S, Suite 4D, Katy, TX 77494 and 17510 W Grand Pkwy S, Suite 320, Sugar Land, TX 77479. Call 713-955-9191.
Schedule a Gallstone Consultation
If you have been told you have gallstones, or have pain after meals that you suspect is your gallbladder, schedule an evaluation with Dr. Murtaza Shakir.
A consultation can help determine:
- Whether your symptoms are coming from your gallstones
- Whether observation is safe or treatment is advisable
- Whether any complication needs attention first
- What laparoscopic or robotic gallbladder removal involves
- What recovery and life without a gallbladder look like
Serving patients throughout: Katy • Sugar Land • Richmond • Fulshear • West Houston • Greater Houston