Most gallstones never cause trouble. The ones that do have a characteristic pattern.
Assessed and treated by a GMC-registered GP
Prescriptions, sick notes and referral letters included
A written treatment plan after every appointment
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Gallstones form in the gallbladder, a small sac under the liver that stores bile. They are very common — around one adult in ten has them — and the great majority never cause a single symptom.
That last point matters more than it sounds. Silent gallstones found incidentally on a scan need no treatment and no operation. Most people who have them will go their whole lives without knowing. Being told you have gallstones is not, on its own, being told you need surgery.
What changes things is symptoms — and when they come, the pattern is distinctive:
Biliary colic is a severe, constant pain in the upper abdomen, often to the right, typically starting an hour or two after a fatty meal and lasting from thirty minutes to several hours. It frequently radiates to the right shoulder blade, and it comes with nausea and vomiting. Despite the name, it is not colicky — it builds, plateaus, and eases, rather than coming in waves. Being told to expect waves is one reason people misidentify it.
Three things needing urgent attention, because gallstone complications are where the real risk sits:
And one thing we would rather say than have you discover: rapid weight loss increases gallstone formation — including weight loss on GLP-1 weight-management medicines. It is a real and well-documented effect, and we would rather you knew about it in advance.
The majority of gallstones are silent, cause no symptoms and are found incidentally on a scan requested for something else. That is the normal outcome.
Between attacks you feel entirely normal, which is why the diagnosis is often delayed — by the time an appointment comes round, there is nothing to find.
Bloating, wind, indigestion and fatty food intolerance are commonly blamed on gallstones. They are just as common in people without them, and removing the gallbladder frequently does not resolve them — which is worth knowing before an operation is agreed on that basis alone.
Bile contains cholesterol, bile salts and bilirubin. When the balance shifts, or the gallbladder empties sluggishly, crystals form and grow into stones. Most are cholesterol stones; pigment stones occur where red cells are broken down excessively.
Symptoms happen when a stone blocks the outlet, and the gallbladder contracts against the obstruction — which is why an attack follows a fatty meal, the trigger for that contraction.
A note on the old "fair, fat, forty, female, fertile" mnemonic: it is both inaccurate and unkind, and it is not how anyone should be assessed. Age, sex, pregnancy and weight change are genuine factors; the phrasing is a relic.
Losing weight quickly substantially increases the chance of forming gallstones. When fat is broken down rapidly, more cholesterol enters the bile, and a gallbladder emptying less often on a reduced food intake gives stones time to form.
This applies to very low calorie diets, to bariatric surgery, and to GLP-1 weight-management medicines. It is a recognised effect, it appears in the safety information, and it is one of the reasons we discuss the risks properly rather than simply issuing a prescription. Losing weight at a steadier pace, and not skipping meals entirely, reduces it.
Gallstones are diagnosed by ultrasound, and the history is often close to diagnostic on its own — which makes this well suited to a remote consultation, with the scan arranged afterwards.
Stones in the bile duct are easily missed on standard ultrasound. Where liver tests are abnormal or the duct looks dilated, an MRCP — a specialised MRI — is the next step, and we refer for it.
We cannot examine your abdomen. Pain lasting more than a few hours, fever, or jaundice needs assessment in person the same day, and we will say so directly rather than arranging an outpatient scan for someone who needs a hospital.
Gallstones found by accident, causing no symptoms, do not need an operation. The risk of developing symptoms is modest each year, and surgery carries its own risks. Watchful waiting is correct, and being told so clearly saves a lot of unnecessary worry — and sometimes an unnecessary operation.
A lower-fat diet reduces how often attacks happen, because less fat means less gallbladder contraction. It does not dissolve the stones, and it is a holding measure rather than a treatment. Regular meals matter too — long fasting periods allow bile to sit and concentrate.
Laparoscopic cholecystectomy: keyhole removal of the gallbladder, usually a day case, with a return to normal activity in one to two weeks.
Some people develop persistent loose, urgent stools after gallbladder removal — typically first thing in the morning, and often labelled "IBS" afterwards. It is usually bile acid malabsorption, it is diagnosable with a SeHCAT scan, and it responds dramatically to a bile acid binder such as colestyramine. A great many people put up with it for years without knowing it is treatable. If that describes you, come and say so.
Ursodeoxycholic acid can dissolve small cholesterol stones, but takes many months, works in a minority, and stones usually return after stopping. It is reserved for people who cannot have surgery, and we would be honest about its limits rather than offering it as an easy alternative.
Call 999 or go to A&E immediately for:
Seek same-day medical assessment for:
Arrange an urgent appointment for:
Book a routine consultation for:
Worth stating plainly: rapid weight loss on GLP-1 medication increases gallstone risk. It does not mean you should not take it — the benefits of treating obesity are substantial — but it does mean:
The olive oil and lemon juice "liver flush" does not remove gallstones. The soft green-brown objects passed afterwards have been chemically analysed repeatedly: they are soap — the oil saponified by digestive juices in the gut. They contain no cholesterol and no bilirubin, and they form in a bucket if you mix the ingredients outside the body.
Beyond being useless, it is not harmless: a large fat load in someone with gallstones can precipitate a genuine attack, or dislodge a stone into the bile duct. People have needed emergency surgery after doing one.
No supplement dissolves gallstones. Milk thistle, apple cider vinegar and various herbal preparations are widely marketed on that claim with nothing behind it. If the pain is troublesome enough to be looking for remedies, it is troublesome enough to be assessed properly.
Once attacks have started, they usually recur, and a proportion of people go on to develop cholecystitis, jaundice or pancreatitis — which turn a planned day-case operation into an emergency admission. Having it dealt with electively is considerably safer than having it dealt with urgently.
Gallstones that cause no symptoms usually need no treatment at all — they are common, frequently found incidentally on a scan done for something else, and most never cause trouble. Surgery for silent gallstones is not routinely recommended.
NHS care covers everything free — ultrasound, blood tests, and laparoscopic cholecystectomy, which is the definitive treatment where stones are causing symptoms.
What costs nothing and genuinely helps between episodes is dietary fat reduction, since fatty meals trigger gallbladder contraction and therefore pain.
Where money is wasted: gallbladder “flushes” and cleanses sold online, which do not dissolve stones — the objects people report passing are saponified oil, not gallstones. Ursodeoxycholic acid dissolution therapy works poorly for most stones and is rarely used.
Where a private consultation is genuinely worth paying for is a prompt ultrasound and blood tests when pain is recurring, and a referral — because the argument for surgery strengthens with each episode, and complications are what should be avoided rather than endured.
Private cholecystectomy can shorten a long wait, which is a legitimate reason to pay when attacks are frequent.
What needs emergency assessment: pain lasting more than a few hours with fever; jaundice — yellow eyes or skin, dark urine, pale stools, which suggests a stone blocking the bile duct; or severe pain radiating to the back with vomiting, which can indicate pancreatitis.
NICE CG188, Gallstone disease: diagnosis and management, is the governing guideline. It recommends ultrasound as first-line imaging and laparoscopic cholecystectomy for people with symptomatic gallstones.
CG188 recommends against routine surgery for asymptomatic gallbladder stones found incidentally — the basis for the point above.
CG188 covers management of common bile duct stones, including ERCP and bile duct clearance, and recommends cholecystectomy for people with acute cholecystitis, biliary colic or gallstone pancreatitis.
CG188 recommends offering advice on reducing dietary fat for symptom control while awaiting treatment.
NICE CG188 and CKS set out the complications requiring urgent assessment — acute cholecystitis, cholangitis, obstructive jaundice and gallstone pancreatitis — which underpin the emergency features listed.
No. Silent gallstones found incidentally on a scan need no treatment. Only a minority go on to cause symptoms, and surgery carries its own risks, so watchful waiting is the correct approach. Being told you have gallstones is not the same as being told you need them removed.
Severe, constant pain in the upper abdomen — usually on the right — typically starting one to two hours after a fatty meal, lasting from thirty minutes to several hours, often radiating to the right shoulder blade, with nausea and vomiting. Despite being called "biliary colic", it does not come in waves. It builds, plateaus and then eases, and you feel entirely normal in between.
A lower-fat diet genuinely reduces how often attacks happen, and regular meals help. But it does not dissolve the stones, and once attacks have started they usually keep coming. Diet is a holding measure. The risk of waiting is that a planned day-case operation becomes an emergency admission with cholecystitis or pancreatitis.
No. The green-brown objects passed afterwards have been analysed many times: they are soap, formed when the oil reacts with digestive juices in the gut. They contain no cholesterol or bilirubin, and the same objects form in a jar outside the body. Worse, a large fat load in someone with gallstones can trigger a genuine attack or dislodge a stone — people have ended up in emergency surgery after trying one.
Yes, entirely normally. The gallbladder stores and concentrates bile, but the liver keeps producing it and it simply flows continuously into the bowel instead. Most people notice no difference and can eat normally, though it is sensible to reintroduce fatty foods gradually in the first few weeks.
Common, treatable, and frequently mislabelled as IBS. It is usually bile acid malabsorption — bile now flowing continuously into the bowel rather than in controlled amounts — and it responds dramatically to a bile acid binder such as colestyramine. A great many people put up with this for years without being told it has a name and a treatment.
It may have contributed, and we would rather be straightforward about it. Rapid weight loss — from any cause, including GLP-1 medications like tirzepatide and semaglutide — increases gallstone formation, because more cholesterol enters the bile and the gallbladder empties less often. It is a recognised effect. It does not mean stopping treatment is automatically right, but it does mean losing weight steadily, not skipping meals entirely, and telling us about any severe upper abdominal pain.
Not so — liver function tests are usually normal in straightforward biliary colic and do not exclude gallstones. They become abnormal when a stone moves into the bile duct. Ultrasound is the test that finds stones in the gallbladder, and it should be done fasted.
Referred pain. The gallbladder and the skin over the right shoulder blade share nerve supply through the diaphragm, so the brain interprets the signal as coming from the shoulder. It is one of the most characteristic features of biliary pain and is genuinely useful in making the diagnosis.
August 23, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews
