Debilitating pain that strikes the upper right part of the abdomen, radiates to the back or below the right shoulder blade accompanied by other symptoms like bloating, nausea, and cramping may be signs of a gallbladder attack. A gallbladder attack is a potentially dangerous medical condition that needs timely treatment to avoid further complications. If you suspect you are having gallstone attacks, schedule your appointment at the Manhattan Gastroenterology to get the best possible advice and care regarding your condition. The experienced and board-certified gastroenterologists use the latest technological advancements and research to make an accurate diagnosis and recommend the best treatment options to alleviate your pain. Our doctors work hard to deliver exceptional and top-quality individual care to prevent future attacks and dangerous consequences.

The gallbladder is a small, pear-shaped organ just under the liver, in the upper-right section of your abdomen. It stores bile, the digestive fluid produced by the liver. This bile helps to break down fats. When you eat, the gallbladder sends bile through ducts to the small intestine to digest the food. Sometimes the bile becomes solid and forms stones that can lead to pain and other symptoms.

What Are Gallbladder Attacks?

Gallbladder attacks are the most painful gastrointestinal problem that occurs when bile and minerals in the gallbladder form hard deposits, also known as gallstones. These stones can be as small as a grain of sand, or as large as the size of a golf ball. These gallstones get stuck while traveling through the duct to the stomach and block the outflow of bile which causes the gallbladder to spasm, resulting in mild to debilitating pain.

Many people with gallstones can pass them without feeling intense pain, but most people end up with an aggressive attack that requires medical treatment. Recognizing the symptoms, causes, and treatment of gallbladder attacks can help deal with them and reduce the risk of further attacks.

What Does a Gallbladder Attack Feel Like?

Gallbladder Attack
Gallbladder Attack

A gallbladder attack causes sharp pain in the upper right or upper-middle section of the abdomen. Most people experience gallstone attacks during or after a meal high in fats or cholesterol. The gallbladder releases bile into the digestive tract to break down the fats, but the bile duct is blocked by a gallstone. When the bile cannot move in or out of the duct, it causes symptoms that lead to an attack.

Too much bile in the gallbladder can irritate it and causes inflammation and pain. The attack stops when the gallstones move and are no longer lodged in the duct.

There are two subtypes of gallbladder disease that lead to attack-like symptoms. They are:

  • Cholecystitis
  • Choledocholithiasis

Cholecystitis

It is the acute or chronic redness, swelling, or inflammation of the gallbladder due to blockage of the bile duct due to excess bile production or gallstones. Normally the bile drains out of the gallbladder into the small intestine. If the bile is blocked, it builds up in the gallbladder, which results in inflammation and infection.

Symptoms of a gallbladder attack include:

  • Severe pain that starts suddenly in the upper right of the abdomen
  • Pain that radiates to the back or below the right shoulder blade
  • Bloating
  • Nausea
  • Vomiting
  • Chills
  • Fever
  • Sweating
  • Abdominal cramping
  • Jaundice or yellowing of the skin

In some people, cholecystitis can also cause a yellowing of the whites of the eyes. It is essential to consult a doctor if you continue to experience these problems. The doctor will analyze your symptoms to make an accurate diagnosis regarding your condition.

Acute Cholecystitis

Acute cholecystitis is recognized by the sudden onset of intense pain near the upper right part of the abdomen or under the right shoulder blade. The pain radiates outward and worsens with deep breathing as the diaphragm puts pressure on the liver, which, in turn, further irritates the gallbladder.

Other symptoms of cholecystitis are:

  • Pain that worsens with deep breathing
  • Fever
  • Sweating
  • Loss of appetite
  • Jaundice
  • An abdominal bulge
  • Sudden onset of pain that may last for several hours

Choledocholithiasis

As compared to cholecystitis, choledocholithiasis is a type of ductal disease that occurs when a gallstone gets stuck in the bile duct. In most cases, people with gallstones do not notice the passing of the gallstone into the bile duct. They will only feel abdominal pain that is associated with gallbladder disease.

Other symptoms include:

  • Pain in the upper right abdomen
  • Fever
  • Yellowing eyes
  • Yellowing skin
  • Appetite loss
  • Nausea and vomiting
  • Light, grey, or clay-colored stools
  • Dark-colored or tea-colored urine

If your symptoms of gallbladder attack syndrome last for more than two hours or you develop a fever, you should seek emergency medical care to prevent complications.

How to Recognize Symptoms of Gallbladder Attacks

The gallbladder is an essential organ that stores the bile produced by the liver. This bile helps to digest fat from the liver. Everything in the body is connected, and when one organ fails to work right, it will affect other organs and their functions, resulting in varying levels of ache.

The following are the most commonly recognized symptoms of gallbladder attacks:

Fever

Sudden onset of fever with or after intense pain in the upper right or upper middle section of your abdomen is a sign of a gallstone attack. Fever indicates inflammation of the gallbladder or infection, and it should not be taken lightly. You should seek immediate medical help as a gallstone infection can spread to other parts of the body, and result in life-threatening complications if left untreated.

Jaundice

When the gallbladder is full of stones, it cannot store and process the bile, and the excess bile can make its way into the bloodstream. It can make patches of your skin turn yellow, and even the whites of your eyes will begin to yellow.

Loss of Appetite

The bile produced by the gallbladder breaks down fats during the digestive process. However, when the gallbladder is blocked, the body fails to function normally or break down the fats. Due to this, you may feel full or experience a loss of appetite.

Nausea and Vomiting

When the body cannot break down fats with a blocked gallbladder, you will feel nauseous or have the urge to throw up and vomit. The pain from the gallbladder attack or blockage of bile can also add to these symptoms.

Diarrhea and discolored stools or urine

Frequent or watery bowel movements, light-colored stools, and dark-colored urine are signs of gallbladder problems. Pale stools indicate that gallstones are blocking the bile ducts.

If you notice any of these symptoms, contact your doctor immediately to prevent serious complications or medical emergency.

Causes of gallbladder attacks and gallstones

Many factors can lead to the formation of gallstones. In some people, high levels of cholesterol in the bile can lead to gallstones, while for others, high levels of bile salts, salts, bilirubin, and calcium also contribute to the build-up of gallstones.

Other risk factors include:

  • Obesity
  • Diabetes
  • Being over the age of 60
  • A family history of gallbladder disease
  • Crohn’s Disease
  • Cirrhosis
  • Use of certain medications that include estrogen
  • A disease that affects the way your body absorbs nutrients

If you are at a high-risk factor for gallbladder attack or gallstone pain, talk to your doctor about it to learn what can be done to manage these risk factors and prevent the formation of gallstones.

How Long Does a Gallbladder Attack Last?

Usually, a gallbladder attack can last anywhere from 15 minutes to a few hours, depending on the size of the gallstones.

Diagnosing and Treating Gallbladder Disease

Treatments for gallbladder disease depend on the severity of the symptoms and diagnosis. Several treatments can help, but your doctor will recommend the best option depending on your condition.

The doctor will use the following diagnostic methods to assess the extent of your symptoms:

  • Ultrasound
  • CT scan
  • Endoscopic ultrasound
  • Blood tests
  • Urine test
  • Imaging tests including ERCP (Endoscopic Retrograde Cholangiopancreatography) and MRCP (Magnetic Resonance Cholangiopancreatography)

Non-surgical treatment for gallbladder attacks includes:

  • Pain relief medications to deal with a periodic gallbladder attack
  • Medications to dissolve cholesterol-based gallstone
  • Anti-nausea medicines
  • Lithotripsy or shock wave dissolution to break the gallstones

You can avoid a gallbladder attack with self-care and medications, but larger gallstones or severe symptoms require surgery. It is necessary to discuss your treatment options with a specialist to learn which option will work out best for you.

Gallbladder Removal Surgery

If your gallbladder issues are turning severe or causing frequent attacks, your doctor may recommend gallbladder removal surgery. Gallstones tend to recur in people who have an attack, and in such cases, removing the gallbladder is the most effective way of preventing future attacks. You can enjoy a normal life without a gallbladder as the bile can reach the small intestine through other paths.

Surgical procedures to treat gallstones include:

Open cholecystectomy – It is the traditional surgical method for removing the gallbladder. During this procedure, an incision is made in the abdomen, and the gallbladder is taken out. You may have to stay in the hospital for about one week. You can turn to normal work and life activities and recover from the effects of surgery in 4 to 6 weeks.

Laparoscopic cholecystectomy – It is also known as the keyhole surgery due to the small incisions and use of a tiny video camera during the procedure. Multiple incisions are made in the abdomen, the gallbladder is separated, and sutures are applied. It is a minimally invasive procedure, and you can leave the hospital within 24 hours. The average recovery time to return to normal work and activities is approximately two weeks.

During laparoscopic cholecystectomy, if your surgeon suspects any risks in removing the gallbladder, he may switch to open cholecystectomy. The only difference between an open and laparoscopic gallbladder removal is the intensity of the procedure. Both the procedures are performed under general anesthesia to keep you pain-free and comfortable. Open surgeries are more invasive, while laparoscopic procedure uses minimally invasive devices to remove the gallbladder, which also reduces the recovery time.

The doctor will provide instructions regarding rest and recovery. Staying away from high levels of activity and avoiding lifting heavy objects is vital for speedy healing.

Can Gallbladder Attacks Be Prevented or Stopped While It Is Happening?

Gallbladder attacks are so painful that you can end up in the emergency room. Nothing can be done to stop a gallbladder attack while it is happening, but there are ways to relieve the pain. The pain subsides once the gallstone has passed.

Some ways to lessen the intensity of gallbladder pain include:

  • Apply a heated compress to the affected area for 10-15 minutes
  • Try sipping menthol tea which has pain relief properties
  • Sip apple cider vinegar to stop inflammation and ease the pain
  • Take a magnesium supplement to alleviate gallbladder spasms

Not all gallstones attacks can be controlled, but there are ways to reduce your risk of gallstone formation. Healthcare experts believe that people with a healthy diet have a lower risk of gallstone disease. Changing the foods you eat and maintaining a healthy weight can also prevent the formation of gallstones. Discuss your gallbladder health with your doctor to learn more about managing your cholesterol levels and making the right lifestyle changes to stay healthy.

Is It Possible to Pass a Gallstone?

Even though it is rare, it is possible to pass a gallstone. It only happens when the gallstones are small. The stones may exit the gallbladder through the bile ducts and move into your intestines.

Gallstones are excreted in the stool, unlike kidney stones, which go out through the urinary tract. You may notice tiny gallstones in the toilet after a bowel movement. They are usually diamond-shaped and yellowish but can come in any shape, size, or color.

Gallstone Attacks vs. Gallbladder Cancer Symptoms

The symptoms of gallbladder attacks may also indicate underlying medical issues. Some signs of gallbladder diseases are similar to those of gastroesophageal reflux disease (GERD) and are often confused with a heart attack.

The symptoms of gallstones and gallbladder cancer are also similar in some aspects but should not be confused with one another. Gallbladder cancer can be hard to detect and is often caught in later stages or during treatment for another health issue.

Signs of gallbladder cancer include:

  • Fever
  • Nausea and vomiting
  • Bloating
  • Lumps in the abdomen
  • Pain above the stomach
  • Jaundice

Some people may have gallstones and not even know it until they experience an attack, and they may live the rest of their lives without any problems. Asymptomatic gallstones are often called silent gallstones. Talk to your healthcare provider if you think you are experiencing the symptoms of gallstones or gallbladder cancer. The sooner you seek medical attention, the better chances you stand of getting the problem diagnosed before it aggravates any more.

The gastroenterology experts at Manhattan Gastroenterology are highly trained and skilled in preventing, diagnosing, and treating all types of digestive disorders related to the GI tract, gallbladder, and liver. They help you understand what may be causing your gallbladder attacks and test you for other gallbladder health issues too find the best solutions for your condition. The top-rated gastro doctors use their unmatched experience and skills to recommend the best advice to manage your annoying symptoms and control further attacks.

Updated on Sep 1, 2023 by Dr. Shawn Khodadadian (Gastroenterologist) of Manhattan Gastroenterology