A gallbladder attack is also called a gallstone attack, acute cholecystitis, or biliary colic. If you have pain in the upper right side of your abdomen, it might be related to your gallbladder. Keep in mind that there are other causes of pain in this area as well. These include:
- heartburn (GERD)
- hepatitis (liver inflammation)
- peptic (stomach) ulcer
- hiatal hernia
- kidney infection
- kidney stones
- liver abscess
- pancreatitis (pancreas inflammation)
- shingles infection
- severe constipation
What is the gallbladder?
The gallbladder is a small sack in the upper right abdomen, below your liver. It looks like a sideways pear. Its main job is to store about 50 percent of bile (gall) that is made by the liver.
Your body needs bile to help break up fats. This liquid also helps you absorb some vitamins from foods. When you eat fatty foods, bile is released from the gallbladder and liver into the intestines. Food is mostly digested in the intestines.
Gallstones are tiny, hard “pebbles” made from fats, proteins, and minerals in your body. A gallbladder attack typically happens when gallstones block the bile duct or tube. When this happens, bile builds up in the gallbladder.
The blockage and swelling trigger pain. The attack normally stops when the gallstones move and bile can flow out.
There are two main types of gallstones:
- Cholesterol gallstones. These make up the most common type of gallstones. They look white or yellow because they’re made out of cholesterol or fat.
- Pigment gallstones. These gallstones are made when your bile has too much bilirubin. They’re dark brown or black in color. Bilirubin is the pigment or color that makes red blood cells red.
You can have gallstones without having a gallbladder attack. In the United States, about 9 percent of women and 6 percent of men have gallstones without any symptoms. Gallstones that don’t block the bile duct usually won’t cause symptoms.
Other types of gallbladder problems that may cause pain are:
- cholangitis (bile duct inflammation)
- gallbladder sludge blockage
- gallbladder rupture
- acalculous gallbladder disease or gallbladder dyskinesia
- gallbladder polyps
- gallbladder cancer
A gallbladder attack usually happens after you eat a large meal. This occurs because your body makes more bile when you eat fatty foods. You’re more likely to have an attack in the evening.
If you’ve had a gallbladder attack, you’re at higher risk of having another one. Pain from a gallbladder attack typically differs from other kinds of stomach pain. You may have:
- sudden and sharp pain that lasts for minutes to hours
- dull or cramping pain that worsens quickly in the upper right part of your abdomen
- sharp pain in the middle of your abdomen, just below the breastbone
- intense pain that makes it difficult to sit still
- pain that doesn’t worsen or change when you move
- abdominal tenderness
Pain from a gallbladder attack may spread from the abdomen to the:
- back between your shoulder blades
- right shoulder
You may also have other symptoms of a gallbladder attack, like:
- skin and eye yellowing
- dark or tea-colored urine
- light or clay-colored bowel movements
A gallbladder attack can lead to other complications, which would cause other symptoms. For example, it can trigger liver problems. This happens because a blockage in the duct can back up bile in the liver. This may set off jaundice — yellowing of your skin and the whites of your eyes.
Sometimes gallstones can block the way to the pancreas. The pancreas also makes digestive juices that help you break down food. A blockage can lead to a complication called gallstone pancreatitis. Symptoms are similar to a gallbladder attack. You may also have pain in the upper left abdomen.
Only about one-third of people with gallstones will have a gallstone attack or serious symptoms. A gallbladder attack is a medical emergency that requires immediate care. You may need treatment to prevent complications.
Don’t ignore the pain, and don’t try to self-medicate with over-the-counter painkillers. Seek help from a doctor right away if you have any of these signs of a gallbladder attack:
- intense pain
- high fever
- skin yellowing
- yellowing of the whites of your eyes
Initially, a doctor will give you pain medication to help ease the pain. You may also be given anti-nausea drugs to help relieve symptoms. If the doctor determines that you can go home without further treatment, you may want to try natural pain relief methods as well.
Your gallbladder attack may go away on its own. This can happen if the gallstones safely pass and don’t cause complications. You’ll still need a follow-up visit with your doctor.
You may need scans and tests to confirm that the pain is from a gallbladder attack. These include:
- abdominal X-ray
- CT scan
- liver function blood test
- HIDA scan
An abdominal ultrasound is the most common and quickest way for a doctor to see if you have gallstones.
An oral drug called ursodeoxycholic acid, also called ursodiol (Actigall, Urso), helps to dissolve cholesterol gallstones. It may be right for you if your pain goes away on its own or you don’t have symptoms. It works on a small number of gallstones that are 2 to 3 millimeters in size only.
This medication can take months to work, and you may need to take it for up to two years. Gallstones can return once you stop taking the medication.
You may need surgery if the pain doesn’t ease up or if you have repeat attacks. Surgical treatments for a gallbladder attack are:
Cholecystectomy. This surgery removes the entire gallbladder. It prevents you from having gallstones or a gallbladder attack again. You’ll be asleep for the procedure. You’ll need a few days to a few weeks to recover from the surgery.
Gallbladder surgery may be done with keyhole (laparoscope) surgery or open surgery.
Endoscopic retrograde cholangiopancreatography (ERCP). In ERCP, you’ll be asleep under anesthesia. Your doctor will pass a very thin, flexible scope with a camera on it through your mouth all the way to the opening of the bile duct.
This procedure can be used to find and remove gallstones in the duct. It can’t remove stones in the gallbladder. You’ll need very little recovery time because there is typically no cutting in ERCP.
Percutaneous cholecystostomy tube. This is a drainage surgery procedure for the gallbladder. While you’re under general anesthesia, a tube is placed into your gallbladder through a tiny cut in your stomach. Ultrasound or X-ray images help to guide the surgeon. The tube is connected to a bag. Gallstones and extra bile drain into the bag.
Gallstones can be genetic. However, you can make some lifestyle changes to lower your risks of getting gallstones and having a gallbladder attack.
- Lose weight. Being obese or overweight increases your risk. This is because it can make your bile richer in cholesterol.
- Exercise and get moving. An inactive lifestyle or spending too much time sitting raises your risk.
- Achieve a more balanced lifestyle slowly. Losing weight too quickly increases your risk of gallstones. This happens because fast weight loss causes your liver to make more cholesterol. Avoid trying fad diets, skipping meals, and taking weight loss supplements.
Stick to a healthy daily diet and regular exercise to lose weight safely. A diet to help prevent gallstones includes avoiding unhealthy fats and sugary or starchy foods. Eat more foods that help lower cholesterol. This includes high-fiber foods, such as:
- fresh and frozen vegetables
- fresh, frozen, and dried fruit
- whole-grain breads and pasta
- brown rice
If you have a gallbladder attack, talk to your doctor about ways to prevent having another one. You may need gallbladder removal surgery. You can have normal, healthy digestion without a gallbladder.
Be aware that you can get gallstones even if you eat a healthy, balanced diet and get plenty of exercise. You can’t control causes like:
- genetics (gallstones run in the family)
- being female (estrogen boosts cholesterol in bile)
- being over 40 years (cholesterol increases with age)
- having Native American or Mexican heritage (some races and ethnicities are more prone to gallstones)
Conditions that can raise your risk of a gallbladder attack are:
- type 1 diabetes
- type 2 diabetes
- Crohn’s disease
Talk to your doctor if you have a family history of gallstones or if you have one or more risk factors. An ultrasound may help find out if you have gallstones. If you’ve had a gallbladder attack, see your doctor for all follow-up appointments, even if you didn’t need treatment.