Gallbladder pain is a common occurrence in the right upper abdomen, just below the ribs. It can also be felt in the upper middle section of the abdomen. Although it is sometimes referred to as biliary colic, it is not an intermittent pain. Alternatively, it is generally a steady pain that can be described as gnawing or gripping, which can vary from mild to severe. It can last from a few minutes to several hours, depending on the cause. If it persists for longer, it may be associated with a more serious underlying cause.
Another characteristic of gallbladder pain is that it may radiate to the upper portion of the back; changing your position does not relieve the pain. Painful episodes may be triggered by a fatty meal, though it may not surface for several hours after eating and may awaken you in the middle of the night. It may return at the same time daily, although it could be a less frequent reoccurring condition.
Other symptoms may also be associated with gallbladder pain, such as:
- nausea and vomiting
- fever
- yellowing of the eyes and skin
- severe abdominal pain
- feeling of fullness
- belching
- headaches
- diarrhea or constipation
- fatty stools
- burping with regurgitation of bitter fluid
- sweating
- lightheadedness
- weakness
- shortness of breath
Causes
Gallbladder pain may be caused either by gallstones or inflammation of the gallbladder (cholecystitis).
Gallstones
Although most gallstones do not cause pain, a few people experience gallbladder pain several years after they form. They usually cause a mild to severe pain in the right upper abdomen or middle section behind the breastbone, and this pain rapidly intensifies in a few minutes to hours. The pain radiates to the right shoulder and upper back. It is caused by the obstruction of the bile ducts by the gallstones, which pass from the gallbladder or liver to the small intestine.
The most common cause of gallstone formation is too much cholesterol in the diet that cannot be handled by the bile from the liver. When cholesterol accumulates, it can form cholesterol gallstones and these can block the bile ducts leading to the intestine, causing the associated pain. The pain may disappear when the stone is dislodged.
There are several risk factors linked to gallstone formation, including:
- gender - females are more likely to be affected
- age - older people, 60 years and above are at risk
- race - more common among American Indians and Mexican-Americans
- diabetes
- pregnancy
- high-fat, low fiber diet
- high blood cholesterol
- history of gallstones in the family
- medications - cholesterol lowering drugs, estrogen therapy
- rapid weight loss
Cholecystitis
This condition is characterized by inflammation of the gallbladder. It may be related to the presence of a gallstone (calculous cholecystitis) or may be due to other obstructions not associated with gallstones (acalculous cholecystitis).
About 1-3% of people who have gallstones may experience acute gallbladder inflammation or acute cholecystitis, and the symptoms are more severe and persistent. The pain may be experienced when jumping (jarring motion) or even when inhaling. Patients usually want to lie still and may experience fever, chills, nausea, and vomiting.
People who experience these should seek immediate medical attention as complications including infection may occur. Diabetics are at higher risk of developing this disease.
In some, these symptoms are mild and vague, and are therefore difficult to differentiate from similar symptoms associated with other gastrointestinal disorders. You may experience abdominal discomfort (especially after eating), nausea, gas, and chronic diarrhea. These are caused by chronic cholecystitis, in which the gallbladder becomes stiff due to scarring.
Other Possible Causes
Uncommon causes of gallbladder pain include blockage of the common bile duct (choledocholithiasis), which in addition to severe pain, can cause yellowish skin and eyes, dark colored urine, light colored stools, and rapid heartbeats with a drop in blood pressure.
Other causes of gallbladder pain include bleeding inside the bile ducts, entry of parasites such as worms into these passages, and cancers of the gallbladder, bile ducts or pancreas.
Pain related to heart attacks may be mistaken for gallbladder pain, which may be felt as a upper-mid abdominal pain and may be accompanied by nausea and vomiting. This is of particular concern for those who are at risk of a heart attack.
Imaging examinations (ultrasound, Ct scan, etc ) and blood tests will be used to diagnose a gallbladder disorder.
Treatment
Avoiding the risk factors associated with gallbladder disease, such as high fat, low fiber diet, may help prevent stone formation and gall bladder inflammation. Those who are diagnosed with gallstones but do not experience symptoms may not require treatment beyond diet modification.
However, for those diagnosed with gallstones or cholecystitis who experience symptoms, the most definitive treatment is surgical removal of the stones and the diseased gallbladder.
Although some doctors may prescribe medications to dissolve the gallstones, they may take a long time to treat. Furthermore, gallstones may recur in most patients. Patients with small gallstones that are made up of cholesterol may benefit more from drug treatment rather than obese people with calcified stones.
The use of antibiotics and pain killers alone are not effective in relieving gallbladder pain due to gallstones or cholecystitis. These treatments are therefore inappropriate for treating these disorders since recurrence rates are high and complications may occur. There are no home remedies or alternative treatments for gallbladder disease. If you have these symptoms, consult a doctor for proper treatment.