Gallstones: Risk Factors and Typical Age of Onset

Gallstones (cholelithiasis) are hardened deposits of digestive fluid that form in the gallbladder. While they can develop at any age, incidence rises significantly after age 40.

Age and Gender Patterns

• Peak incidence: 40–60 years old.
• Gender: Women are 2–3 times more likely than men to develop gallstones, especially during reproductive years (estrogen effect).
• After 60: Prevalence reaches 10–15% in men and 20–25% in women.

Key Risk Factors

• Obesity / rapid weight loss
• Pregnancy / hormone therapy / oral contraceptives
• Family history
• Certain ethnicities: Native American, Hispanic, Northern European descent have higher rates.
• Medical conditions: Diabetes, metabolic syndrome, Crohn’s disease, cirrhosis.
• Diet: High-fat, high-cholesterol, low-fiber diets.
• Medications: Fibrates, somatostatin analogs, ceftriaxone.

Clinical Note

Most gallstones are asymptomatic (“silent”). Symptomatic stones cause biliary colic (episodic RUQ pain) and can lead to cholecystitis, choledocholithiasis, or pancreatitis. Asymptomatic stones in low-risk individuals generally do not require treatment.