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Do gallstones cause diarrhea?

The short answer:

Yes, gallstones are commonly associated with unexpected changes in your bowel movements. chronic diarrhea and abdominal discomfort are commonly reported with gallstones. 

Key facts:

  • Gallstones are solid-like masses formed when the bile in your gallbladder becomes hard.
  • Gallstones range in size from the size of a grain of sand to the size of a golf ball. You may have one or more gallstones at the same time.
  • Gallstones are commonly associated with unexpected changes in bowel movements and diarrhea after meals is a common symptom.
  • Symptoms of gallstones include abdominal pain, nausea, vomiting, diarrhea, and jaundice

What are gallstones | Gallstones and diarrhea | Types of gallstones | Causes of gallstones | People with high risk | Symptoms | Complications | FAQs

What are gallstones:

The gallbladder is a pear-shaped sack (4 inches long). It locates beneath your liver.  It receives the bile secreted by the liver and passes it to your interest. The function of the bill is to break the fat in your meal.

When the bile in your gallbladder becomes hard and forms solid-like substances, this is known as gallstones.

The medical term for gallstones varies according to the location of these stones:

When these stones formed within your gallbladder it is called cholelithiasis

If stones are formed in the bile duct it is known as choledocholithiasis

The gallstone’s size ranges from the size of a grain of sand to the size of a golf ball. You may have one or more gallstones at the same time

Unfortunately, you may not know you have gallstones until they block the passage of your bile duct. From this point, you will have severe pain, and urgent treatment is required.

People with gallstones usually need surgical removal of the gallbladder. However, gallstones that don’t cause symptoms and signs usually don’t need treatments.

Why do gallstones cause diarrhea?

When you have Gallstones, you are at a high risk of diarrhea. Gallstones are commonly associated with unexpected changes in bowel movements. Diarrhea, 3- 5 bowel movements per day or more with loose stool, is a main symptom of gallstones.

When the gallstones block the flow of the bile, bile acids are not reabsorbed into your bloodstream and accumulated in your bowel. Bile acids in your bowel increase salt content and induce fluid secretion and increase mucosal permeability in the colon leading to watery diarrhea (Ref).

Types of gallstones:

  • Cholesterol gallstones: They are the most common type, representing 80 % of gallstones. They usually have a yellowish-green color.
  • Pigment gallstones: They are made of bilirubin. They are smaller in size and darker in color.

The main causes of gallstones

The formation of gallstones is related to the bile content.

  • Increased cholesterol level. The bile secretion normally acts to dissolve your cholesterol. However, in case your liver secretes much cholesterol, your bile can not dissolve all the secreted amount. The excess cholesterol accumulates and forms gallstones.
  • Increased bilirubin: This occurs due to pathological conditions including liver cirrhosis, biliary tract infection, and blood disorder. In these cases, there is excessive production of bilirubin by your liver leads to gallstones.
  • Accumulation of bile secretion: accumulation of bile in your gallbladder as a result of insufficient emptying of its content. This leads to concentrated bile secretion and hence, gallstones are formed.
  • Decreased bile salts

People who are at high risk to develop gallstones:

  • Age: Gallstone prevalence also increases with age. Elderly patients (people above 60 years old) are at higher risk to develop gallstones than younger adults. Over one-quarter of females older than the age of 60 will have gallstones (Ref).
  • Family history: a family history of gallstones increases the risk to develop gallstones.
  • Gender: it is found that women are at higher risk (twice) than men of developing gallstones.
  • Genetic factors: it is found that Native American secret much cholesterol due to genetic factors. This put them at a higher risk to form gallstones.
  • Obesity: increased body weight especially for women, increase the risk of gallstone formation.
  • Diabetic patients: diabetic patients have increased blood levels of fatty acids (triglycerides). This increases the risk of having gallstones.
  • Rapid weight loss: in this case, your body depends on fat storage and thus, breakdown fats, and your liver secretes extra cholesterol in your bile, this lead to gallstone formation.
  • Diseases: People with hemolytic anemia, and liver diseases are at higher risk of gallstone formation.
  • Medications such as oral contraceptives, cholesterol-lowering drugs, and hormone replacement therapy.
  • Diet: fat-rich diet and a low-fiber diet increase your risk to have gallstones.
  • Pregnant women: Due to hormonal changes during pregnancy. Progesterone decreases the contractility of the gallbladder leading to stasis and hence, increasing the risk of gallstone formation. About 1-3 % of pregnant women develop gallstones. This percentage markedly decreased after labor (Ref).

Symptoms of gallstones:

Gallstones are common with no symptoms. However, symptoms appear when gallstones block your bile duct.  These symptoms include the following:

Abdominal pain:

Intense pain in the right side of your middle or upper abdomen is the main sign that makes you expect that you have gallstones. Although this pain could be constant or intermitted. his pain suddenly occurring.

Your pain becomes worse after eating especially when you eat a fat-rich diet.

The pain could then spread centrally in your abdomen, your right shoulder, or between your shoulder.

Change in bowel movement:

  • When you have Gallstones, you are at a high risk of diarrhea. Gallstones are commonly associated with unexpected changes in bowel movements.
  • Diarrhea, 3- 5 bowel movements per day or more with loose stool, is a main symptom of gallstones.
  • In case you have a blocked bile duct, you will have dark urine and light-colored stool


  • Jaundice means you have yellow skin and your eyes also become yellow (the white region o your eyes).
  • This occurs when your gallbladder is unable to pass the bile into your intestine.
  • This lead to the accumulation of waste biomaterial in your blood system.
  • Although jaundice is a symptom of many health problems related to the liver and blood, however, it remains a characteristic symptom of gallstones (Ref).
  • When you have developed jaundice from gallstone, this means you have itching and usually feel fatigued.

Complications of gallstones

Complications of gallstones include:

Inflammation of gallbladder:

  • About 30% of patients having symptomatic gallstones develop gallbladder inflammation.
  • Inflammation of your gallbladder is medically known as cholecystitis.
  • Cholecystitis occurs when gallstones block the bile duct leading to inflammation.

Symptoms of cholecystitis include

  • Pain in your upper right abdomen, this pain increases during beath
  • Fever (30% of patients)
  • Nausea
  • Vomiting

You have to consult your doctor in the following situations:

  • Chills
  • Low-grade fever
  • Pain to sweating
  • Develop yellow skin and yellow eyes

Blockage of a bile duct

Stones in your gallbladder could block the bile duct in which bile secretion passes from your gallbladder or liver into your intestine.

This could lead to jaundice and infection of the bile duct, and this is commonly accompanied by severe pain.

Blockage of pancreatic duct:

This duct is a tube go from your pancreas into the duodenum. This duct combines with the bile duct just before entering the duodenum. Gallstones could lead to blockage of this duct leading to inflammation of your pancreas which is known as pancreatitis. Pancreatitis commonly leads to intense, constant abdominal pain and usually requires hospitalization.

Gallbladder cancer:

Having gallstones increase your risk to have gallbladder cancer.

However, it is gallbladder cancer is rare to occur despite the elevated risk.


1. How can I stop diarrhea from gallstones?

For treatment of bile acid diarrhea, you can use the following:

  • A low-fat diet that helps you to reduce the symptoms of diarrhea
  • Bile acid binders that bind to the bile acids in your gut. These medications include colestyramine, colestipol, and colesevelam.

2. What is the color of gallbladder diarrhea?

If you have diarrhea due to gallstones, your stool may be pale, clay, or putty-colored

The change in stool color is due to the change in bilirubin levels in your bowel.

3. How do you know if you have bile acid diarrhea?

When you have bile acid diarrhea which results from gallstones you may suffer from persistent or intermittent, frequency, urgency, flatulence, abdominal pain, nocturnal defecation and stool incontinence