Gallstones in children: causes, symptoms and treatment (May 2024)

Gallstones aren’t only an adult problem. In May 2024 we published a clear guide for parents about pediatric gallstones — what causes them, how to spot them early, and what doctors usually do. If your child has belly pain or unexplained jaundice, this page gives the practical steps you can take right away.

What causes them?

Gallstones in kids form when bile in the gallbladder becomes unbalanced. That can happen for a few concrete reasons: rapid weight loss or obesity, certain blood disorders that break down red blood cells faster (like sickle cell), long-term total parenteral nutrition (IV feeding), some medications, or conditions like cystic fibrosis. Newborns and infants can get stones from problems after birth that change bile chemistry. Knowing the likely cause helps doctors decide the best tests and treatment.

One detail parents ask about: biliary sludge. This is thickened bile that can lead to stones over time. It often appears on an ultrasound and can sometimes go away without surgery if the underlying issue is fixed.

Symptoms to watch for

Symptoms in kids can be subtle. The most common sign is sudden, intense pain in the upper right or middle belly that can last from minutes to hours. Other red flags: yellowing skin or eyes (jaundice), dark urine, pale stools, nausea or vomiting, and fever if an infection has started. Toddlers might just be unusually fussy, refuse food, or have a swollen tummy. If pain is severe, constant, or comes with fever and jaundice, get medical help fast.

Doctors usually start with a physical exam and an ultrasound. Blood tests check liver enzymes and signs of infection. Ultrasound is painless and the best first test to confirm stones or sludge in kids.

As for treatment, options range from watchful waiting to surgery. If stones cause no symptoms, doctors may monitor the child and treat contributing issues like obesity or medication changes. When stones cause repeated pain or block bile flow, the usual fix is laparoscopic cholecystectomy (removing the gallbladder), which most kids recover from quickly. In emergencies where a stone blocks the bile duct, procedures like ERCP can remove the blockage before surgery.

There’s also a medicine, ursodeoxycholic acid, that can dissolve certain stones, but it works slowly and isn’t right for all cases. Your child’s doctor will explain risks and benefits clearly.

Practical next steps: keep a symptom diary noting when pain hits and what came before it (meals, illness, meds), get an ultrasound if your doctor recommends one, and ask about referral to a pediatric gastroenterologist or surgeon if tests show stones. For more detailed explanations and tips from our May 2024 post, read the full article on our site to help you prepare for doctor visits and decisions.