How Symptoms Compare

Irritable bowel syndrome and gallstones both cause abdominal pain, but the precise location of the pain may differ. Some people with IBS or gallstones may also have diarrhea.

IBS

IBS is a common condition affecting the lower digestive system. The key symptom is pain relieved by a bowel movement.

Symptoms of IBS can include:

• Abdominal pain or cramps that improve after a bowel movement
• Bloating or distention
• Constipation
• Diarrhea
• Feeling the need to move the bowels, but nothing comes out

Gallstones

Gallstones are hard deposits that form in the gallbladder. Gallstones can be numerous or solitary, small like a grain of sand or large like a golf ball.

Gallstones that block the bile ducts may cause symptoms but not always. Symptoms, called a gallbladder attack or biliary colic, often start after eating a big meal or during the night or evening.

The most common symptom of a gallbladder attack is pain, which: 

• Is located in the upper right or central abdomen, shoulder blades, or in the right shoulder.
• Lasts from 15 minutes to several hours
• May come and go
• May be accompanied by diarrhea
• May be severe

Causes and Risk Factors Differ for IBS and Gallstones

IBS

IBS is a disorder of gut-brain interaction, meaning there is a disruption in the communication between the digestive system and the brain. The causes of IBS are not well understood.

There’s no single cause of IBS, but risk factors include:

• A history of trauma (especially childhood and/or sexual trauma)
• Being diagnosed with anxiety, depression, or post-traumatic stress disorder (PTSD, a mental health condition causing a triggering of past traumatic events)
• Changes in the gut microbiome (the community of microbes in the gut), such as after an infection)
• Female sex
• Genetics (the tendency to develop IBS may be inherited)

Gallstones

It is not fully understood why gallstones form. They are thought to result from the digestive fluid bile being imbalanced, containing too much cholesterol or bilirubin or not enough bile salts. Certain health conditions or risk factors can increase the risk of gallstones.

Risk factors for gallstones include:

• Being female
• Being over the age of 40 years 
• Having a family history of gallstones
• Being of Native American or Mexican American heritage
• Eating a high-calorie/low-fiber diet
• Having certain medical conditions
• Having obesity
• Rapid weight loss (such as from weight-loss surgery)

Medical conditions that increase risk of gallstones include:

How Are These Conditions Diagnosed?

IBS

IBS is diagnosed with a set of guidelines called The Rome Criteria. Invasive testing is not used to diagnose IBS. A healthcare provider will ask about symptoms, particularly about bowel movements and pain.

The Rome criteria are met when abdominal pain occurs at least one day a week for three months, along with diarrhea, constipation, or alternating between the two.

Gallstones

For gallstones, a healthcare provider will take a detailed health history and ask about symptoms, as well as whether any family members have a history of gallstones.

Tests used to look for gallstones or to see inside the gallbladder include:

How Are IBS and Gallstones Treated?

IBS

Lifestyle changes are used to manage IBS. Including:

• Adding fiber to the diet
• Addressing mental health and practicing stress reduction
• Avoiding triggering foods (spicy foods, alcohol, caffeine)
• Eating small, frequent meals
• Getting physical activity
• Trying a short-term low-FODMAP diet (an eating plan low in certain short-chain carbohydrates called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols)
• Using peppermint oil supplements

Medications used to treat IBS include:

Gallstones

Some gallstones are “silent,” cause no symptoms, and need no treatment.

When gallstones cause symptoms or complications, treatment is surgery to remove the gallbladder. This is called a cholecystectomy. People can live without a gallbladder.

Some people may not want surgery, are not healthy enough for it, or have retained gallstones after cholecystectomy. Other treatments include:

• Oral dissolution therapy: Taking oral medications to dissolve stones
• Contact dissolution therapy: Injecting a solvent into the gallbladder to dissolve stones
• ERCP: Using a scope and X-ray imaging to break up stones
• Extracorporeal shockwave lithotripsy (ESWL): Using high-energy sound waves to break up stones
• Percutaneous cholecystostomy: Inserting a catheter to drain the gallbladder

Key Takeaways

• Gallstones are common and may or may not cause symptoms.
• People may have both IBS and gallstones, but the two conditions are not considered related.
• IBS treatment involves lifestyle changes and medication, while gallstone treatment frequently means surgery.