What to Know About Gallstones When You Have Crohn’s Disease
Digestive HealthCrohn's Disease

Crohn’s Complications: What to Know About Gallstones

Crohn’s Complications: What to Know About Gallstones
Dorling Kindersley/Getty Images
By
Updated on June 17, 2026
by
Add us on Google
Digestive pain is an unfortunate fact of life for those with Crohn’s disease. In addition to the discomfort of diarrhea, abdominal cramps, and potential complications, you’re also at increased risk for gallstones, which can be painful.

 Indeed, research has found that gallstones are more than twice as common among people with Crohn’s disease than in the general population — 14.7 percent versus 6.1 percent.

The gallbladder is a small, pear-shaped organ located right below the liver. Gallstones form in the gallbladder when sediment from bile, a liquid made in the liver and stored in the gallbladder to help the body digest fats, collects and hardens. These stones can be as small as a grain of sand, or as large as a golf ball. The liver and gallbladder are closely interconnected with the intestines, which are often inflamed from Crohn’s.

Gallstones aren’t necessarily a problem, and many people are unaware they even have them, but if they migrate and create a blockage in your gallbladder, they can cause symptoms like pain and complications like inflammation or infection. If this happens, you’ll need surgery to remove your gallbladder.

Here’s why people with Crohn’s are more likely to develop gallstones, what to look for if you suspect you may have them, how to prevent them if you don’t, and what to expect if you need surgery.

Next up video playing in 10 seconds

7 Crohn’s-Friendly Alternatives to Sugar

Find 7 Crohn's-friendly alternatives to refined sugar.

Why Crohn’s Disease Increases Your Risk for Gallstones

“Classically, Crohn’s will target the last portion of the small intestine known as the terminal ileum,” says Nour A. Parsa, MD, a gastroenterologist at Loma Linda University Health in California. “This is where bile acids, which are made in the liver, are primarily absorbed.”

During normal metabolism (breakdown) of food, bile salts and bile acids break up fat, and bilirubin (a waste product made from the breakdown of red blood cells) gives bile and stool their yellowish brown color. If your bile contains too much bilirubin or cholesterol, the excess becomes sediment that can harden into gallstones. If your Crohn’s affects the terminal ileum, the inflamed, diseased ileum fails to absorb bile salts, which are expelled with your bowel movements, leaving you without enough raw material to make adequate bile to digest food well.

“When bile salts and bile acids are not effectively reabsorbed, binding of cholesterol can be affected and lead to cholesterol gallstone formation,” says Suneeta Krishnareddy, MD, a gastroenterologist at Columbia University Irving Medical Center in New York City.

Other risk factors for gallstone formation in people with Crohn’s disease include a history of small bowel surgical resection, which increases the risk of malabsorption, receiving total parenteral (intravenous) nutrition (TPN), and altered gallbladder motility, Dr. Parsa says.

Symptoms of Gallstones

The majority of gallstones are asymptomatic, says Seifeldin Hakim, MD, a gastroenterologist with Memorial Hermann Medical Group in Houston. “Many patients will have gallstones, and they do not even know it,” he says.

But gallstones cause discomfort when they block bile from entering the bile ducts. Symptoms of blocked bile ducts, also called a “gallbladder attack,” include:

  • Pain in the back between the shoulder blades
  • Steady pain in the upper right quadrant of the abdomen that comes on suddenly and lasts from minutes to several hours
  • Pain in the right shoulder
  • Nausea or vomiting

If you experience any of these symptoms, be sure to notify your doctor.

If you develop more severe symptoms, such as prolonged pain that lasts a few hours, a fever, light-colored stools, dark urine, nausea and vomiting, or yellowing of your skin or the whites of your eyes, seek medical attention right away.

Asymptomatic gallstone disease usually does not require any treatment, Parsa says, but when symptoms appear, intervention is usually necessary. The first treatment option for symptomatic gallstones may be gallbladder surgery; other, less-frequently used options may include dissolution therapy, such as using shock waves to break up the stones, or a prescription treatment that dissolves cholesterol stones.

Preventing Gallstones When You Have Crohn’s

“Gallstone disease is often a result of uncontrolled Crohn’s disease,” Parsa says. “Appropriate treatment, often with biologic therapy, and lifestyle measures, such as maintaining a healthy weight and keeping physically active, are the best ways to prevent gallstone formation.”

Managing your Crohn’s effectively may also reduce the likelihood of surgical intestinal resection, which increases the risk of gallstones.

Beyond controlling Crohn’s and trying to avoid surgery, preventing gallstones when you have Crohn’s disease involves the same measures as anyone would take to prevent gallstones.

These include:

  • Maintain a healthy weight.
  • Exercise regularly.
  • Eat healthy monounsaturated and polyunsaturated fats instead of saturated fats.

  • Limit added sugars in your diet, as well as other refined carbohydrates.
  • Limit caffeine and alcohol consumption.

  • Be aware that certain medications can increase risk for asymptomatic gallstones, such as estrogen and progestin (synthetic progesterone) used as hormone replacement therapy by some women during perimenopause and menopause.

When Gallbladder Surgery Is Necessary With Crohn’s

The mere presence of gallstones doesn’t mean surgery to remove the gallbladder is necessary, says Martin Luchtefeld, MD, a colorectal surgeon with Corewell Health in Grand Rapids, Michigan. “Reasons for removing the gallbladder include repeated episodes of cholecystitis [inflammation of the gallbladder] or complications from gallstones, such as pancreatitis or bile duct stones,” he says.

Although you can expect gallbladder surgery to ease the pain of gallstones, Dr. Luchtefeld says, it may bring on an unpleasant and familiar symptom: diarrhea.

“The gallbladder normally stores bile produced by the liver until the time of a meal,” he says. Eating food, especially fatty food, stimulates the gallbladder to release bile into the gastrointestinal (GI) tract via the duodenum (the very first part of the small bowel, just below the stomach). “Once the gallbladder and its storage mechanism are removed, the bile is released continuously into the GI tract," he says. "So if bile is in the GI tract without food, it can be very irritating to the bowel and cause diarrhea."

Chronic diarrhea can be treated, however: You might be advised to take over-the-counter antidiarrheal medications, or a drug that removes bile acids from the body, such as cholestyramine (Prevalite).

If you need gallbladder surgery, Luchtefeld recommends finding a surgeon who works with people with Crohn’s on a regular basis.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Crohn’s Disease. Cleveland Clinic. April 23, 2026.
  2. Gong Y et al. Risk Factors for Gallstones in Crohn’s Disease: A Systematic Review and Meta-Analysis. Digestive Diseases and Sciences. September 25, 2024.
  3. Wang X et al. Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis. Clinical Gastroenterology and Hepatology. August 2024.
  4. Jones MW et al. Anatomy, Abdomen and Pelvis: Gallbladder. StatPearls. October 31, 2022.
  5. Gallstones. Cleveland Clinic. January 15, 2024.
  6. Bilirubin Test. Cleveland Clinic. January 9, 2023.
  7. Bile. Cleveland Clinic. May 13, 2024.
  8. What to Do About Gallstones. Harvard Health Publishing. April 6, 2026.
  9. Gallbladder and Gallstones. GI Society and Canadian Society of Intestinal Research.
  10. Wang M et al. Dietary Fatty Acids and Gallstone Risk: Insights From NHANES and Mendelian Randomization Analysis. Frontiers in Nutrition. August 14, 2024.
  11. Foods to Avoid If You Have Gallbladder Issues. University of Pittsburgh Medical Center. February 21, 2025.
  12. Yuk JS et al. Menopausal Hormone Therapy Increases the Risk of Gallstones: Health Insurance Database in South Korea (HISK)-Based Cohort Study. PLoS One. December 4, 2023.
  13. Chronic Diarrhea: A Concern After Gallbladder Removal? Mayo Clinic. December 27, 2025.
Meet Our Experts
See Our Editorial PolicyMeet Our Health Expert Network

Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care ...

See full bio

Elizabeth Shimer Bowers

Author

Elizabeth Shimer Bowers has more than 20 years of experience in the editorial field and has written for numerous companies and websites, including WebMD, HealthDay, Reader's Digest...

See full bio
See Our Editorial PolicyMeet Our Health Expert Network