The gallbladder is a pear-shaped organ beneath the liver. It stores bile produced by the liver and, through the common bile duct, releases it into the small intestine to digest fats. Problems with this organ most often begin when something blocks the outflow of bile through the ducts, and in most cases this is a stone.
How the gallbladder hurts: character and location of pain
A stone that has blocked the duct causes an attack called biliary colic. This pain has consistent features: it is severe, constant, lasts longer than 30 minutes and can continue for several hours; it is felt in the middle of the abdomen or just under the ribs on the right; it is accompanied by nausea or vomiting.
Does the gallbladder always hurt — no. In many people stones exist and cause no sensations, so they are discovered by chance. Pain appears precisely at the moment the duct is blocked, so calm periods between attacks do not disprove anything.
What causes gallbladder pain
Bile is formed in the liver, accumulates in the gallbladder and is concentrated there. Stones form when substances in bile harden. The initial stage is sludge-like bile, biliary sludge: in 80–85% of cases it disappears, but most often it returns. Blockage of the duct by a stone causes the pain.
Factors that increase the likelihood of stones:
- age over 40 years;
- female sex;
- obesity;
- a diet high in fat and low in fiber;
- rapid weight loss, diabetes mellitus or Crohn's disease.
Women suffer from cholelithiasis 3–5 times more often than men, and according to some data — 8–15 times. After age 70, stones are found in 30% or more of the population. Excess body weight occurs in approximately two thirds of patients.
Other symptoms of gallbladder diseases
In addition to pain, an attack causes nausea and vomiting. When bile outflow is impaired, jaundice appears: the skin or whites of the eyes turn yellow, the skin itches, urine becomes darker, and stool becomes lighter. In people with dark skin, yellowness is harder to notice. Very high temperature, a feeling of heat or cold, and chills are signs that require emergency help.
Which gallbladder diseases cause pain
The most common cause is stones in the gallbladder or ducts, that is, gallstone disease (cholelithiasis). Stones can cause inflammation of the gallbladder (cholecystitis) and of the pancreas (pancreatitis), as well as jaundice due to blockage of the duct. Cancer is rarely found in the gallbladder.
How gallbladder disease is detected
Asymptomatic stones are often discovered during a scan or X-ray done for another reason. When there are complaints, ultrasound examination and a blood test are used. If a stone is found in the common bile duct, the doctor may refer for ERCP — an endoscopic procedure used to free the duct from stones. For stones that cause symptoms, removal of the gallbladder is discussed; a person can live without this organ because bile finds other routes to the small intestine.
When gallbladder pain requires emergency help
Abdominal pain that lasts longer than 30 minutes is a reason to seek medical help urgently. The doctor assesses temperature, skin and eye color, and the nature of vomiting together with examination results, so independent conclusions about the causes of pain are inappropriate here.
Pain in the right side by itself is not a reason to call an ambulance. You should call 103 or 112 if the pain is sudden and very severe; if it spreads from the abdomen to the back and is accompanied by vomiting; if the temperature is very high or the person alternates between feeling hot and cold; if the skin or whites of the eyes have turned yellow.
This material is for reference: it describes signs and examinations but does not replace a doctor's consultation — the diagnosis and further approach are determined by the doctor after examination.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer