Definition

What is gallbladder pain?

Gallbladder pain is an all-inclusive term used to describe any pain due to disease related to the gallbladder. The major gallbladder problems that produce gallbladder pain are biliary colic, cholecystitis, gallstones, pancreatitis, and ascending cholangitis.

How common is gallbladder pain?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of gallbladder pain?

Symptoms vary and may be triggered by eating certain foods. The pain may be described as intermittent, constant, abdominal, radiating to the back, mild to severe depending on the underlying cause.

Gallbladder pain may vary or feel different depending on the cause. Many people with gallstones never experience pain. However, there are some variations in gallbladder pain that help the doctor to make a diagnosis.

  • Biliary colic (intermittent duct blockage): Sudden and rapidly increasing pain (ache or pressure) in the right upper abdomen or epigastric area; some people will have pain radiating to the right shoulder (or back pain in the tip of the scapula) and/or also develop nausea and vomiting. The pain usually subsides in about 1 to 5 hours although a mild ache may persist for about a day.
  • Cholecystitis (inflammation of gallbladder tissue secondary to duct blockage): severe steady pain in the right upper abdomen that may radiate to the right shoulder or back, abdominal tenderness when touched or pressed, sweating, nausea, vomiting, fever, chills, and bloating; discomfort lasts longer than with biliary colic.
  • Acalculous cholecystitis (no gallstones) has similar symptoms to cholecystitis but occurs as a complication of other problems like trauma or burns; patients have severe symptoms and appear very ill.
  • Pancreatitis: Gallstones from the gallbladder can block the pancreatic duct and cause pancreatitis (inflammation of the pancreas) with upper abdominal pain that may radiate to the back, tender abdomen, more pain after eating, with nausea and vomiting.
  • Ascending cholangitis (or simply cholangitis or infection of the biliary system) causes fever, abdominal pain, jaundice and even hypotension (low blood pressure), and confusion; it is a medical emergency.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes gallbladder pain?

As stated previously, the major gallbladder problems that produce gallbladder pain are biliary colic, cholecystitis, gallstones, pancreatitis, and ascending cholangitis. There are two major causes of pain that either originate from the gallbladder or involve the gallbladder directly. They are due to:

  • Intermittent or complete blockage of any of the ducts by gallstones; or
  • Gallstone sludge and/or inflammation that may accompany irritation or infection of the surrounding tissues, when partial or complete obstruction of ducts causes pressure and ischemia (inadequate blood supply due to a blockage of blood vessels in the area) to develop in the adjacent tissues.

Gallstones usually form in the gallbladder, but may form in any of the ducts. When the gallbladder is compressed (squeezed by musculature), bile usually goes out through the ducts into the GI tract; however, if gallstones or gallstone sludge is present, there can be partial or complete blockage of the ducts with pressure on the surrounding tissue, sometimes enough to cause local ischemia. Other processes such as trauma can cause gallbladder pain. Infection of the biliary ducts and the gallbladder, usually occurring after gallstone obstruction also can cause pain.

Risk factors

What increases my risk for gallbladder pain?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is gallbladder pain diagnosed?

The history and physical exam helps to establish a presumptive diagnosis. Murphy’s sign (pain or temporary respiratory arrest on deep right subcostal palpation) has been estimated to be over 95% specific for acute cholecystitis. A few laboratory tests such as liver function tests, lipase, amylase, complete blood count (CBC), and an abdominal X-ray are done to determine the exact problem is causing the pain. Ultrasound can detect gallstones, and CT scan may delineate organ structural changes. A HIDA scan (uses radioactive material) can measure gallbladder emptying while an ERCP test uses an endoscope to place dye in the ducts of the pancreas, gallbladder, and liver. Magnetic resonance imaging (MRI) is sometimes used to detail the organ structures (liver, gallbladder, and pancreas); other tests also may be considered. The results of these tests help pinpoint the problem and establish the diagnosis.

How is gallbladder pain treated?

If you have no gallbladder pain (even if you have gallstones but never had pain), you need no treatment. Some patients who have had one or two attacks may elect to avoid treatment. Pain during an acute attack is often treated with morphine. Medical treatments include:

  • Oral bile salt therapy (<50% effective),
  • Ursodiol (Actigall, for example)
  • Dissolution, and
  • Lithotripsy (shock waves).

The definitive treatment is to remove the gallbladder (and/or the obstructing gallstones) by surgery. Currently, the surgical method of choice is laparoscopic surgery, where the gallbladder is removed by instruments using only small incisions in the abdomen. However, some patients may require more extensive surgery. Usually, people do well once the gallbladder is removed unless there is an underlying cause that mimics gallbladder pain (for example, biliary dyskinesia, a motility disorder of sphincter of Oddi).

Women who are pregnant are treated like women who are not pregnant, although pregnant women more commonly have cholesterol gallstone development than non-pregnant women. Although supportive care is tried in women who are pregnant, acute cholecystitis is the second most common surgical emergency in pregnancy (appendicitis is the first).

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage gallbladder pain?

The following lifestyles and home remedies might help you cope with gallbladder pain:

  • Maintaining a healthy weight and engaging in physical activity can reduce gallbladder pain and decrease the amount of gallbladder pain attacks. Consult with your doctor before performing any strenuous activity. While exercise is helpful, some activities cause strain on your abdomen and may worsen your symptoms.
  • Increasing nutrient-rich foods in your diet such as vegetables and fruits can improve gallbladder function and prevent complications.
  • Applying heat can be soothing and relieve pain. For gallbladder health, a heated compress can calm spasms and relieve pressure from bile build up.
  • Peppermint contains menthol, a soothing compound that promotes pain relief. To ease gallbladder pain and improve gallbladder health, drink peppermint tea until your pain goes away. Drink this tea regularly to reduce the amount of gallbladder pain attacks you may experience.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: August 24, 2018 | Last Modified: August 24, 2018

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