Gallstones are solid deposits that form in the gallbladder , a small organ located beneath the liver that helps in the digestion of fats. They are quite common and often develop without causing noticeable symptoms. While most people with gallstones experience no serious health issues, there is a recognized association between long-standing gallstones and an increased risk of gallbladder problems, including inflammation and, in rare cases, gallbladder cancer . Understanding this connection is important for early detection and prevention. Awareness of gallstone risk factors and monitoring gallbladder health can help manage potential complications effectively.



Understanding gallstones and how to recognise the signs
Gallstones are solid deposits that can form in the gallbladder, a small, pear-shaped organ located beneath the liver on the right side of the abdomen. The gallbladder stores bile, a digestive fluid produced by the liver, which is released into the small intestine (duodenum) to aid in digestion.

Gallstones vary in size, ranging from as tiny as a grain of sand to as large as a golf ball. Some people develop a single stone, while others may have multiple stones simultaneously.


There are different kinds:

Cholesterol gallstones: Mostly made of cholesterol, the most common type in many populations.
Pigment stones: Darker stones, formed from bilirubin, a waste product of red blood cell breakdown.



Symptoms of gallbladder stones
Often, gallstones cause no symptoms. If a gallstone blocks a bile duct, symptoms may include:

• Sudden, intense pain in the upper right portion of the abdomen
• Sudden, intense pain in the center of the abdomen, just below the breastbone
• Back pain between the shoulder blades
• Pain in the right shoulder
• Nausea or vomiting
• Gallstone pain can last from a few minutes to several hours

What is gallbladder cancer and how gallstones might lead to gallbladder cancer


Gallbladder cancer

Gallbladder cancer develops when abnormal (cancerous) cells grow in the gallbladder, a small, pear-shaped organ located beneath the liver in the upper right abdomen. The gallbladder stores and releases bile, a digestive fluid produced by the liver that helps break down fats in food.

This cancer usually starts in the innermost layer of the gallbladder, called the mucosa, and gradually spreads outward. In its early stages, gallbladder cancer often causes no noticeable symptoms, and it is frequently discovered incidentally during or after gallbladder surgery.



Gallstones might lead to gallbladder cancer

Having gallstones does not guarantee cancer, most people with gallstones never develop gallbladder cancer, but several mechanisms and risk associations have been observed in research.

1. Chronic Inflammation and cancer risk

According to CancerResearchUK gallstones can cause repeated irritation and inflammation of the gallbladder lining, leading to chronic cholecystitis. This persistent inflammation can result in cellular changes that increase the risk of developing gallbladder cancer over time.


2. Impact of stone size, number, and duration

Research published in PMC indicates that larger gallstones, particularly those greater than 3 cm in diameter, are associated with a significantly higher risk of gallbladder cancer compared to smaller stones. Additionally, the presence of multiple stones and the duration of gallstone disease can further elevate this risk.

While having gallstones does not guarantee the development of gallbladder cancer, these factors can increase the likelihood. It's important for individuals with gallstones to consult healthcare professionals for appropriate monitoring and management.



Other risk factors alongside gallstones
Besides gallstones themselves, several factors can further increase gallbladder cancer risk:

• Gallbladder polyps, especially large ones (over ~1 cm) can become cancerous.
• Obesity and overweight, which also increase gallstone formation.
• Chronic infection (e.g. Salmonella typhi carriers) has been linked to gallbladder cancer in some populations.
• Porcelain gallbladder
• Abnormal biliary anatomy or congenital anomalies, such as anomalous pancreaticobiliary junctions.
• Other lifestyle factors: Smoking, family history, diabetes, and possibly diet.

Diagnosis of gallbladder cancer
Diagnosis may involve:

Ultrasound scans of the gallbladder
CT or MRI scans to identify suspicious growths, polyps or thickening of gallbladder walls
Blood tests for liver and bile duct function

In some cases, removal of the gallbladder (cholecystectomy), during which tissue can be examined microscopically



Prevention and management
While gallbladder cancer is rare and most gallstones never lead to cancer, there are strategies that may reduce risk:

• Monitoring gallstones and gallbladder polyps – Regular imaging may be advised if gallstones are large, or polyps are present.
• Surgical removal of gallbladder (cholecystectomy) in certain high-risk cases — e.g. very large stones, symptomatic stones together with known risk factors, or for porcelain gallbladder.
• Lifestyle changes – Maintaining a healthy weight, balanced diet, regular exercise, avoiding smoking. These also reduce gallstone formation and inflammation.
• Managing infections – Appropriate treatment of gallbladder infections or bile duct infections to limit chronic inflammation.
• Regular medical follow-up if you have multiple risk factors (gallstones, polyps, obesity etc.)

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making any changes to your health routine or treatment.