Stages of Gallstones

Gallstone disease does not follow a fixed set of medical stages, but it usually moves through recognisable phases. Describing them helps explain when treatment is needed.

Phase 1: Stone formation (no symptoms)

Bile becomes unbalanced and crystals or sludge form over months or years. There is no pain, and the stones are often found only on an ultrasound done for another reason.

Phase 2: Silent stones

Stones are present but do not block anything. Most people stay in this phase for life. Doctors usually advise watching and healthy habits rather than surgery.

Phase 3: Biliary colic

A stone briefly blocks the gallbladder outlet and causes pain, usually after fatty food. Pain settles when the stone moves. Attacks tend to repeat, and surgery is usually recommended at this point.

Phase 4: Complications

• Cholecystitis: gallbladder inflammation, with fever and constant pain
• Bile duct stones: jaundice, dark urine, pale stools, infection of the duct
• Gallstone pancreatitis: severe pain with vomiting, a medical emergency

Why this matters

Once pain attacks begin, the chance of further attacks and complications rises. Waiting without advice can lead to an emergency. See a doctor after a first attack of typical pain, and call 112 or 102 for severe pain, fever or jaundice.

Not everyone moves through every phase

Many people stay in the silent phase for life. A few go straight to a complication without earlier warning. This is why any new, severe or lasting upper belly pain deserves a prompt medical review.