That pain after a heavy meal — the one that sits just under your right ribs and makes you want to lie completely still — is something a lot of Nigerians chalk up to ulcer, stress, or something they ate. Most times, they wait it out. Take some antacids. Move on.
But in many cases, that pain is not ulcer at all. It is gallstones. And the longer it goes unrecognised, the more dangerous it becomes.
Gallstones are surprisingly common in Nigeria, and they are also surprisingly under-diagnosed — largely because the symptoms can be easy to confuse with other, more familiar complaints. In this article, we walk through the signs of gallstones that most people miss, and explain when it is time to stop guessing and see a specialist.
First, What Are Gallstones?
Your gallbladder is a small, pear-shaped organ that sits beneath your liver, on the right side of your abdomen. Its job is to store bile — a digestive fluid produced by the liver that helps break down fatty foods. When substances in the bile (usually cholesterol or bilirubin) become too concentrated, they can harden into small stones. These are gallstones.
Gallstones can range from the size of a grain of sand to the size of a golf ball, and you can have one or many at once. Some people carry them for years without knowing. Others develop symptoms that become impossible to ignore.
The real danger arises when a stone migrates out of the gallbladder and blocks one of the bile ducts — the tubes that carry bile from the liver into the small intestine. This can cause severe pain, infection, jaundice, and even life-threatening complications if not treated.
The Signs Most People Miss
1. Pain Under the Right Ribs After Eating
The most classic sign of gallstones is a sudden, intense pain in the upper right side of the abdomen — often described as a gripping, squeezing, or stabbing sensation. It typically comes on 30 minutes to two hours after eating, particularly after a fatty or heavy meal. The pain can last anywhere from a few minutes to several hours.
Here is what makes it easy to miss: the pain often goes away on its own. So people assume it was just gas, indigestion, or something they ate. They take an antacid, feel better, and forget about it — until the next episode. If this pattern sounds familiar, it is worth taking seriously.
2. Pain That Travels to Your Shoulder or Back
Many people are surprised to learn that gallstone pain can radiate to other areas of the body. Pain felt at the tip of the right shoulder, between the shoulder blades, or in the middle of the back is actually a common feature of gallstone attacks. This referred pain happens because the nerves around the gallbladder and diaphragm share pathways with those in the shoulder region.
If you have been treating what you think is a muscle problem in your shoulder or back — and it seems to coincide with meals — it is worth mentioning to a doctor.
3. Nausea and Vomiting
Nausea is a very common companion to gallstone pain, and it can sometimes be so prominent that the pain itself gets overlooked. Many patients describe feeling persistently nauseous after eating, sometimes with actual vomiting. Because nausea is associated with so many conditions — from food poisoning to ulcer to morning sickness — it rarely immediately raises suspicion of gallstones.
4. Yellowing of the Skin or Eyes (Jaundice)
If a gallstone moves out of the gallbladder and lodges in the common bile duct, it can block the flow of bile entirely. Bile then backs up into the bloodstream, causing a yellow tint to appear in the skin and the whites of the eyes. This is jaundice, and it is a medical emergency.
In Nigeria, jaundice is sometimes attributed to malaria or hepatitis — both common conditions. But gallstone-related jaundice has a distinct pattern: it often comes alongside right-sided abdominal pain and may appear and disappear depending on whether the stone shifts. If you notice any yellowing, do not wait.
5. Dark Urine and Pale Stools
These two symptoms go together and are closely related to jaundice. When bile is blocked from reaching the intestines, it cannot do its normal job of giving stool its brown colour. The result is stools that are pale, clay-coloured, or almost white. At the same time, the bile that backs up into the bloodstream is excreted by the kidneys, turning the urine a dark brown or tea colour.
Many Nigerians attribute dark urine to dehydration, which is understandable in our climate. But if dark urine is accompanied by pale stools and any upper abdominal discomfort, gallstone disease should be ruled out.
6. Fever and Chills
Fever alongside abdominal pain is a warning sign that a gallstone may have caused an infection — either of the gallbladder (acute cholecystitis) or of the bile ducts (cholangitis). Cholangitis in particular is a serious, potentially life-threatening condition that requires emergency treatment. If you have fever, chills, and abdominal pain together, do not manage this at home. Seek medical attention immediately.
7. Recurrent Indigestion That Does Not Respond to Antacids
Many people with gallstones describe a long history of what feels like chronic indigestion — bloating, a feeling of fullness, discomfort after meals — that has never fully responded to antacids or ulcer medications. If your stomach complaints keep coming back despite treatment, gallstone disease is a possibility worth investigating.
Who Is at Higher Risk?
While gallstones can affect anyone, certain factors increase your risk:
- Being female — oestrogen increases cholesterol levels in bile
- Being over 40
- Having a diet high in fat and refined carbohydrates (a familiar pattern in many Nigerian diets)
- Being overweight or having rapid weight loss
- Having a family history of gallstones
- Having sickle cell disease — a common cause of pigment gallstones in Nigeria
- Being pregnant or having had multiple pregnancies
When Should You See a Doctor?
You should see a gastroenterologist if:
- You have recurring upper right abdominal pain, especially after meals
- You notice any yellowing of the skin or eyes
- Your urine has turned dark and your stools are pale
- You have fever and chills alongside abdominal pain
- You have a long history of indigestion that has not responded to treatment
The investigation typically starts with an abdominal ultrasound scan, which can detect gallstones in the gallbladder with high accuracy. If a stone is suspected to have moved into the bile duct, additional investigations — including an ERCP (Endoscopic Retrograde Cholangiopancreatography) — may be recommended.
What Is ERCP and Why Does It Matter for Gallstones?
ERCP is a specialist procedure that combines endoscopy and X-ray imaging to examine and treat problems in the bile ducts. When a gallstone has moved out of the gallbladder and is causing a blockage in the common bile duct, ERCP allows the specialist to locate the stone and remove it — all without open surgery.
At Redus Center for Digestive Health in Lekki, Lagos, our team performs ERCP using advanced equipment. If you have been diagnosed with gallstones or suspect you may have them, our specialists can assess your situation and advise on the best course of treatment.
Frequently Asked Questions
Can gallstones go away on their own?
Small gallstones can occasionally pass through the bile duct without treatment, but this is not something to count on. Stones that cause symptoms are unlikely to resolve without medical intervention, and waiting can increase the risk of serious complications like cholangitis or pancreatitis.
Are gallstones the same as an ulcer?
No. Gallstones and peptic ulcers are entirely different conditions. Ulcer pain is typically in the centre of the upper abdomen and may improve with food or antacids. Gallstone pain tends to be on the right side, often comes on after eating, and does not respond to antacids. A doctor can distinguish between the two with appropriate investigations.
Can I eat normally if I have gallstones?
Many people with gallstones manage symptoms partly through diet — reducing fatty and fried foods, eating smaller and more frequent meals, and avoiding foods that consistently trigger discomfort. However, diet alone does not treat gallstones. If you have symptomatic gallstone disease, you should seek medical advice rather than relying solely on dietary changes.
Where can I get checked for gallstones in Lagos?
Redus Center for Digestive Health in Lekki Phase 1 offers specialist gastroenterology consultations and investigations including abdominal ultrasound and ERCP. Contact our team to arrange an appointment.