Gallbladder Attacks: Symptoms, Triggers, and When to See a Surgeon
The gallbladder isn’t an organ we think about very often. Yet many people could benefit from knowing more about it, given that gallbladder disease rates are rising (particularly among younger people).
The gallbladder is a small organ located under the liver that stores bile, which is a digestive fluid produced by the liver. When you eat, the gallbladder releases bile into the small intestine through the bile ducts to help digest fats. The gallbladder becomes more active when you consume processed or fatty foods.
One of the most common diseases of the gallbladder is gallstones (known medically as cholelithiasis). While these are often asymptomatic, sometimes they will cause a gallbladder attack, which can be a medical emergency. If you are a frequent gallstone attack sufferer, you may need to undergo a gallbladder removal or cholecystectomy.
In this article, we’ll combine medical expertise with authentic patient experiences to provide a well-rounded view of how to recognize and respond to a gallbladder attack.
What Is a Gallbladder Attack?
Also known as gallstone attack, acute cholecystitis, or biliary colic, a gallbladder attack occurs when one of your bile ducts gets blocked, causing a sudden, severe abdominal pain. The culprit of the blockage is almost always a gallstone, although gallbladder inflammation without gallstones (acalculous cholecystitis) is a rare cause.
When bile ducts get blocked, bile gets backed up inside the liver and can even seep out into the bloodstream. Yellowing of the skin, known as jaundice, can occur when bilirubin (a byproduct of red blood cell breakdown that becomes part of bile) seeps into the tissues. Nausea, vomiting, high fever, and chills are additional gallbladder attack symptoms.
Recognizing the Signs and Symptoms of a Gallbladder Attack
Many gallbladder attack patients speak of a sudden, severe, and “knife-like” pain in the upper right or center of the abdomen. Descriptions like “grabbing pain,” “burning pain,” and “lightning strike in the abdomen” are typical.
The pain may radiate to the back, shoulder blades, or even the chest. This depends on which bile duct gets blocked. Usually it’s the cystic duct, but occasionally it can be the common bile duct or the pancreatic duct (the latter scenario may cause pancreatitis, or inflammation of the pancreas).
The intensity of the pain can vary from a 4/10 to as high as a 10/10 (“worst pain imaginable”), with some patients comparing it to childbirth or a heart attack. One recurring description is that the pain stays the same even when a person repositions their body. You’ll likely also experience nausea, vomiting, fever, chills, and/or jaundice.
It’s possible for a gallbladder attack to subside on its own (indicating that the gallstone is no longer blocking a bile duct). However, if the pain is unrelenting and you experience other symptoms like fever and shortness of breath, seek medical attention immediately. Even if the attack goes away, check in with a gastroenterologist as soon as you can.
Risk Factors and Underlying Causes of Gallbladder Problems
The rise in gallbladder disease, and the fact that it’s trending younger, indicates that lifestyle and/or environmental factors may be at play. In particular, rising obesity levels seem to be exacerbating the issue due to increasing LDL (“bad”) cholesterol in the bloodstream and making the bile more saturated. Losing weight extremely rapidly can also make gallstones more likely to form due to a disruption in the usual balance of cholesterol and bile acids.
Here’s a quick list of medical and lifestyle risk factors for gallstones:
- Having a family history of gallstones
- Being obese
- Eating a high-fat and/or low-fiber diet
- Losing weight extremely quickly
- Taking certain medications, such as birth control or hormone therapy
- Having diabetes
- Being pregnant
- Being female
Many patients report upper right quadrant pain after overindulgence in heavy, greasy foods. If you’re experiencing this, it may be time to switch to a Mediterranean diet that’s rich in fruits, vegetables, healthy fats, and whole grains. (And also, see your doctor.)
Diagnosis and Medical Treatments for Recurring Gallstone Attacks
The diagnostic process for gallstone attacks typically begins with a review of the patient’s medical history and symptoms. Blood tests (including liver function tests) can help identify signs of infection, inflammation, or liver issues. Imaging tests like an ultrasound, a CT scan, or a HIDA scan may be used if the diagnosis is uncertain or if complications are suspected.
Your doctor will likely prescribe pain relievers, anti-nausea drugs, and agents like ursodeoxycholic acid (Ursodiol) to help dissolve gallstones. You may undergo endoscopic retrograde cholangiopancreatography (ERCP), a procedure in which tools are inserted through a flexible tube and used to identify and either remove or break up the stones inside bile ducts.
Because gallstones are likely to recur (even if successfully dissolved), doctors frequently recommend surgical options like laparoscopic cholecystectomy. Laparoscopic gallbladder removal is much less invasive than traditional gallbladder surgery, and most patients recover within a week. Open surgery may still be necessary if there’s significant scarring or other complications present.
Failure to diagnose and treat gallstones in a timely manner can result in life-threatening complications such as acute cholecystitis or pancreatitis. The inflammation of your gallbladder can even trigger the development of gallbladder cancer, although this is rare.
Preventive Measures and Long-Term Management
If you’re concerned about gallstones (perhaps due to mild yet noticeable pain after high-fat meals) but they haven’t yet led to a severe gallbladder attack, there are some lifestyle modifications you can make to help things stay under control. Regular meals and healthy dietary choices are key, and if you’re trying to lose weight, do so gradually. Be sure to monitor the early signs and discuss any post-meal abdominal pain with your gastroenterologist.
If you’ve had your gallbladder removed, your body will no longer be able to store bile once it’s produced. Instead, bile will be released into the duodenum at a constant rate. This means that you may need to cut out fatty foods from your diet and eat smaller, more frequent meals for several months. You can gradually reintroduce foods as your body adjusts.
Don’t Ignore Gallbladder Attack Symptoms
If you’re having recurring upper-right-quadrant abdominal pain after meals, this is a reason to see your gastroenterologist as soon as you can. Prompt medical attention, including perhaps seeing a surgeon, can prevent this common health complaint from turning into something more serious.
Your doctor can give you more details on lifestyle adjustments and possible medical treatments that can offer relief. By monitoring your symptoms and combining expert advice with accounts of real patient experiences, you can set yourself up for better health going forward.
