Gallbladder Pain: Symptoms, Causes, and Treatments

Gallbladder pain is often felt in the right upper belly, under the ribs. It can also spread (radiate) to the lower chest or your right shoulder blade and may be confused with a heart attack.

The gallbladder is a pear-shaped organ located in your right upper abdomen, just under your ribcage. It stores and releases bile used in digestion.

Gallbladder pain can come and go. It can be triggered by eating a fatty meal, rapid weight loss, fasting, or going too long between meals. Unlike gas pain, gallbladder pain is not relieved by changing position, burping, or passing gas.

This article discusses the causes of gallbladder pain, including gallstone and gallbladder diseases. It also explains treatments for gallbladder pain relief and how to prevent a recurring gallbladder attack.

Symptoms

Gallbladder pain typically occurs in the upper right or mid abdomen and may be accompanied by other symptoms such as:

• Fever
• Chills
• Nausea or vomiting
• Light-colored stool
• Dark or brown-colored urine
• Yellow skin

Causes of Gallbladder Pain

These are potential sources of gallbladder pain.

Gallstones

The most common cause of gallbladder pain is gallstones (also called "cholelithiasis"). These are hard particles that form due to either an imbalance of the substances that make up bile (the fluid that the gallbladder secretes to aid in the digestion of food) or the gallbladder not emptying as it should. These particles can be quite small or grow to the size of a golf ball.

Pain can occur when a gallstone blocks one of the ducts in the biliary tract—the part of your body that contains your gallbladder and your bile ducts. The pain may ease when the gallstone moves and the bile duct is no longer blocked.

Inflammation

Gallbladder inflammation (called "cholecystitis") most commonly develops as a result of gallstones.

Acute Cholecystitis

When a gallstone becomes stuck within the gallbladder, inflammation ensues This causes sudden and sometimes severe abdominal pain (called "biliary colic") along with nausea, vomiting, fever, and a loss of appetite. Biliary colic describes a dull, cramping pain in the upper-right part of the abdomen.

Acalculous Cholecystitis

Acalculous cholecystitis causes the same symptoms as acute cholecystitis, although a gallstone is not the culprit. While the precise cause is not clear, experts suspect poor bile and blood flow within the gallbladder may cause this condition to develop. Acalculous cholecystitis is mostly seen in people who are severely ill, like those on mechanical ventilation or those with a major infection or severe burn injury.

Bile Duct Obstruction

Choledocholithiasis occurs when gallstones block the common bile duct, restricting the flow of bile from the liver to the intestine. The resulting rise in pressure can cause an increase in liver enzymes and jaundice.

Motility Disorder of the Gallbladder

Functional gallbladder disease (FGBD), sometimes referred to as "biliary dyskinesia," is the technical name for gallbladder disease without the presence of any gallstones. It includes dysfunction of the sphincter of Oddi, the muscular sphincter that helps to control gallbladder emptying.

Biliary dyskinesia is a gallbladder syndrome that occurs when your gallbladder is not emptying properly. Due to improper drainage of bile, gallbladder pain and other symptoms, such as nausea and vomiting, may result.

Gallbladder Cancer

Gallbladder cancer is rare and is often not diagnosed until it is fairly advanced. Besides gallbladder pain, a person with gallbladder cancer may be jaundiced and experience nausea, vomiting, and weight loss.

Because of its vague symptoms, gallbladder cancer is often found late. Gallbladder cancer that is diagnosed late can have a poor prognosis.

Polyps

Gallbladder polyps are abnormal growths on the inside lining of the gallbladder. They are usually benign and don't cause any symptoms. However, some people may experience pain and other symptoms similar to those cause by gallstones.

Bile Duct Infection

Acute cholangitis occurs from a bacterial infection in the common bile duct. This is often the result of an obstructing gallstone, or sometimes a bile duct stricture or cancer of the gallbladder, bile duct, pancreas, or duodenum (first part of the small intestine).

Symptoms of acute cholangitis may include upper-right-sided abdominal pain, fever, and jaundice. In more severe cases, a person may also develop low blood pressure and confusion, which can be signs of life-threatening sepsis.

Treatments

The treatment of gallbladder pain depends on the precise cause and may include medication or surgery.

Medication

Medications are rarely used to treat gallstones, but your healthcare provider may recommend a medication like a nonsteroidal anti-inflammatory (NSAID) for gallbladder pain relief.

Antibiotics may be given if a person develops a gallbladder or biliary tract infection, which is a complication of gallstone disease.

Bile acid pills are sometimes given to people with minimal symptoms and a well-functioning gallbladder. The medications ursodeoxycholic acid and ursodiol help to dissolve the cholesterol type of gallstones in two-thirds of patients within two to three months, but the stones may not disappear entirely.

Surgery

There are two surgical ways to remove the gallbladder:

• Open cholecystectomy: The gallbladder is removed through a large cut in the abdomen. This is sometimes the only option for ruptured gallbladders or surgery where extensive exploration may be needed, as in cancer.
• Laparoscopic cholecystectomy: The surgeon uses long, thin instruments to remove the gallbladder through a much smaller cut in the abdomen. This is the most common gallbladder surgery.

An endoscopic retrograde cholangiopancreatography (ERCP) is a procedure performed by a gastroenterologist. It can be used to both visualize and remove the problem, and it is most commonly used to relieve an obstructed bile duct.

Prevention

Focusing on a healthy lifestyle is your best chance to prevent gallstones and, thus, gallbladder pain.

Bear in mind that these strategies do more than keep your gallbladder healthy—they also keep your heart healthy:

• Visit your primary care healthcare provider for periodic checkups.
• Exercise for at least 30 minutes, five days per week.
• Eat a healthy diet rich in vegetables, fruits, low-fat dairy products, whole grains, legumes, and spices.
• Stay at a healthy body weight and try to avoid rapid weight loss.
• Avoid foods high in saturated fat and cholesterol.
• If you are on a cholesterol medication or hormone replacement therapy, speak with your healthcare provider to find out if these medications have increased your risk for the development of gallstones.
  

When to See a Healthcare Provider

If you think you are experiencing gallbladder pain, inform your healthcare provider as soon as possible, even if your symptoms have gone away. Your healthcare provider will want to make sure that you are not experiencing a problem that will put you at risk for more severe disease in the future.

Get immediate medical attention if you experience any of the following symptoms:

• Severe, intense pain that prevents you from getting comfortable
• Pain that increases when you take a breath
• Pain that lasts for more than five hours
• Yellow skin or yellow around the whites of your eyes (called jaundice)
• Fever and chills
• Rapid heartbeat
• Persistent vomiting
• Persistent lack of appetite or unexplained weight loss
• Cola or tea-colored urine
• Clay-colored stools

Summary

Gallbladder pain may be caused by gallstones, inflammation, or other types of gallbladder disease. Treatment for gallbladder pain depends on the cause. In some cases, surgical removal of the organ may be required.

Be sure to get checked out by a healthcare provider. A thorough assessment and prompt treatment of your pain is the best way to prevent complications and get back to feeling your best.