Gallstones are hard lumps that form in the gallbladder, and they get more common with age. They affect 10 to 15% of people in the US, about 25 million, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Most gallstones are “silent” and need no treatment. But when they block a duct, they can cause pain, infection or pancreatitis. In older adults, these warning signs can be milder, so problems are often found late.
This guide explains the signs to watch for, why age changes the risk, when to go to the ER and how gallstones are treated.
What gallstones are
Your gallbladder is a small, pear-shaped pouch under the liver. It stores bile, a fluid that helps digest fat. When you eat, it squeezes bile into your gut.
Gallstones form when bile has too much cholesterol or bilirubin, or when the gallbladder does not empty well. There are two main types:
- Cholesterol stones, yellow-green, the most common type in the US
- Pigment stones, dark, made of bilirubin
They can be as small as a grain of sand or as big as a golf ball.
Why risk goes up with age
NIDDK lists older age as a risk factor. As we age, bile carries more cholesterol and the gallbladder empties more slowly. Other risks include:
- Being a woman, or taking estrogen therapy
- Obesity, or losing weight very fast
- Diabetes
- Some medicines, like certain cholesterol drugs (fibrates)
- Family history
- Liver disease (cirrhosis)
Warning signs
A gallbladder attack (biliary colic) usually causes:
- Pain in the upper right or middle belly, often lasting from 30 minutes to several hours
- Pain that may spread to the right shoulder or back
- Pain after a heavy or fatty meal, often in the evening or at night
- Nausea or vomiting
In older adults, signs can be milder or unusual. Some people have little pain, no fever or only confusion or loss of appetite. That is why gallbladder problems in seniors are easy to miss.
When to get help right away
NIDDK says to see a doctor right away if, during or after an attack, you have:
| Sign | What it may mean |
|---|---|
| Belly pain lasting several hours | Inflamed gallbladder (cholecystitis) |
| Fever, even low, or chills | Infection |
| Yellow skin or eyes (jaundice) | Blocked bile duct |
| Tea-colored urine or pale stools | Blocked bile duct |
| Severe pain spreading to the back | Pancreatitis |
Call 911 if you have severe pain with fever and confusion, or if you feel faint. A blocked, infected bile duct (cholangitis) can become life-threatening quickly.
Why complications are more serious after 70
Older adults are more likely to:
- Have a gallbladder infection without classic signs
- Develop gangrene or a tear in the gallbladder
- Get pancreatitis from a stone in the duct
- Need emergency surgery instead of a planned one
Emergency surgery has more risk than planned surgery. So if you have had one attack, talk with your doctor about next steps. NIDDK notes that after one attack, more are likely.
How gallstones are diagnosed
- Ultrasound of the belly. Quick, painless and the main test.
- Blood tests for infection, liver and pancreas problems.
- CT or MRI (MRCP) if doctors suspect a stone in the bile duct.
- HIDA scan to see how well the gallbladder empties.
Treatment options
| Treatment | Who it is for | Recovery |
|---|---|---|
| Watchful waiting | Silent stones with no symptoms | None |
| Laparoscopic gallbladder removal | Most people with symptoms | Often home the same day; normal activity in about a week |
| Open surgery | Severe inflammation, scarring or problems during keyhole surgery | Hospital stay up to a week; about a month to recover |
| ERCP | Stones stuck in the bile duct | A scope removes the stone; often before surgery |
| Ursodiol pills | Small cholesterol stones in people who cannot have surgery | Months to years; stones often return |
| Drainage tube | Very ill people too frail for surgery | Bridge until surgery or long-term |
Removing the gallbladder (cholecystectomy) is one of the most common operations in the US. You can live normally without a gallbladder. Bile flows straight from the liver to the gut.
Age alone is not a reason to avoid surgery. Many healthy people in their 70s and 80s do well with keyhole surgery. Your surgeon will weigh your heart, lung and kidney health.
Questions to ask your surgeon
- Is my surgery planned or urgent?
- Will it be keyhole (laparoscopic)? What is the chance it becomes open surgery?
- Will I go home the same day?
- Who will help me at home the first few days?
- What signs mean I should call you after surgery?
Life after gallbladder surgery
- Most people eat normally within weeks.
- Some have looser stools for a while. Smaller, lower-fat meals help.
- Walk daily to help healing and prevent clots.
- Call your surgeon for fever, yellow skin or worsening pain.
Diet and prevention
You cannot fully prevent gallstones, but you can lower risk:
- Keep a steady, healthy weight. Avoid crash diets. Losing weight too fast raises risk.
- Eat fiber: vegetables, fruit, beans and whole grains.
- Choose healthy fats like olive oil and nuts over fried foods.
- Do not skip meals for long stretches.
- Stay active most days.
During an attack-prone period, smaller, lower-fat meals can reduce pain.
What Medicare pays in 2026
- Doctor visits, ultrasound and outpatient surgery: Part B, after the $283 deductible, usually 20% coinsurance.
- Hospital stay: Part A, with the $1,736 deductible per benefit period (CMS).
- Ursodiol and pain pills: Part D, with a $2,100 yearly out-of-pocket cap.
Ask if you are an inpatient or under observation. It changes what you pay.
Common questions
What are the first signs of gallstones in older adults?
Upper right belly pain after meals, nausea, or pain into the right shoulder. Some older adults only have mild pain, poor appetite or confusion.
Do gallstones always need surgery?
No. Silent gallstones usually need no treatment. Surgery is for stones that cause symptoms or complications.
Is gallbladder surgery safe for people over 75?
Many healthy older adults do well with laparoscopic surgery. Planned surgery is safer than emergency surgery.
Can gallstones go away on their own?
Rarely. Pills can dissolve small cholesterol stones, but it is slow and stones often return.
What foods trigger gallbladder attacks?
Large, fatty or fried meals are common triggers.
Does Medicare cover gallbladder removal?
Yes, when medically needed. Part B covers outpatient surgery and Part A covers inpatient stays.
Written by Khasim Basha Shaik. I research senior health for readers and summarize official sources. I’m not a doctor or licensed health professional. Talk with your doctor about any symptoms or treatment. Last reviewed October 14, 2026.
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