Gallbladder Pain


What Does Gallbladder Pain Feel Like?

Located in the abdomen to the upper right, underneath the liver’s lower edge, is the gallbladder. A little sac that is completely sheltered behind the ribs.

Definitions and Terms Referring to Gallbladder Inflammation

The system of the gallbladder and the ducts responsible for carrying bile to the gallbladder from the liver and to the smaller intestine from the gallbladder is known as the biliary system. Sudden, and unexpected pain in the bile duct or the gallbladder is called biliary colic. Gallbladder inflammation is called cholecystitis.

Gallbladder Pain Related to The Inflammation (Signs and Symptoms)

Pain from inflammation of the gallbladder is felt under the lower ribs in the upper portion of the abdomen. It can also be felt under directly under the breastbone. gallbladder Pain can also travel to the lower portions of the chest and can be felt in the right shoulder area or even near the right portion of the neck.

Typically, gallbladder pain is not felt on the left side of the abdomen or associated area like those on the right. However, rare cases do persist in this area and pain in the left side can be felt.

Pain related to gallbladder inflammation is sudden and unexpected and is relatively mild. However, it builds over several days as a dull and consistent pain that stays on for 15 minutes to an hour and can last for several days. The pain doesn’t come in waves, it is fairly steady. It makes breathing difficult if breathing is heavy. It is most commonly aggravated in the early hours after large meals. It cannot be relieved by any medicinal drug or passing of gas or stool or by vomiting. It occurs every few months, years or days. It is a recurring pain.

Vomiting occurs concurrently with the pain. Other symptoms also include high fever, itching, jaundice, dark urine and soft, pale stools, lump or tender skin in the abdominal area. In some case, it can cause migraines although the two may not be related.

Duration of Inflammation Related Pain

Pain differs in duration depending on the severity of the condition. Biliary dyskinesia, more commonly known as the gallbladder, the pain lasts for roughly 30 minutes, more or less. In case of cholecystitis, pain last for about half a dozen hours or a few days. Inflammation last for a few hours. Only in the case of cancer does the pain last daily as a dull pain.

Symptoms of Gallbladder Pain & Causes

The pain and related symptoms are:

  • Chronic gallbladder inflammation – Usually there are no visible symptoms
  • Gallbladder polyps – Usually there are no visible symptoms
  • Gallbladder sludge – Usually there are no visible symptoms
  • Cholangitis or inflammation of the bile duct – pain in the upper portion of the abdomen, fever, jaundice, dark urine, greyish coloured stools
  • Gallbladder cancer – Constant dull, pain and unexpected weight loss
  • Acute gallbladder inflammation – Recurrent pain in the upper portion of the abdomen for up to, often with fever and vomiting.

Gallbladder Pain With Inflammation Due to Gallstones

  1. Sudden, dull pain, or tenderness in the upper portion of the abdomen.
  2. Vomiting between episodes of pain.
  3. No fever.
  4. No symptoms in between two attacks.
  5. Diagnosis is done through ultrasonography. Painkillers are usually used for treatment but in chronic attack cases, the gallbladder can be removed.
  6. During pregnancies, the gallbladder is slow to empty and so much more prone to developing gallstones, especially if the disease has persisted before the pregnancy. Surgery, if necessary, should be done prior to entering the third trimester of the pregnancy.
  7. In children, the inflammation is rare but risks are associated with diseases like sickle cell disease, or obesity of Crohn’s disease. Prolonged fasting or artificial feeding are also risks in children.

Complications Arising Due to Gallbladder Inflammation and Due to Bile Duct Disease

  1. Acute pancreatitis: and inflammation of the pancreas due to gallstones in the pancreatic duct causing obstruction. Symptoms are severe pain in the abdominal area and vomiting
  2. Gallbladder disease and their life-threating problems: a rupture to the gallbladder, or peritonitis inflammation, or pus accumulating in the liver, are causes that invoke symptoms that mean that the disease is life-threatening. High-fever, dizziness and impaired visions are also a cause. Sepsis can also set in once bacteria enters the blood stream.

Diagnosis

  1. An abdominal ultrasound could potentially be the first way to detect the gallstones which can be as small as 2 mm.
  2. Stones in the bile duct can be revealed via an endoscopic ultrasound.
  3. Biliary sludge, or polyps or cancers can be seen via a Magnetic Resonance Imaging (MRI).
  4. In the matter of detail, a Magnetic resonance cholangiopancreatography (MRCP) is useful for looking at the gallbladder as well as the bile ducts. A contrast substance is injected into the vein which lights up the affected areas on the MRCP. It can detect tumours too.
  5. To take a direct look an Endoscopic retrograde cholangiopancreatography (ERCP) is done in which a camera at the end of a tube is inserted through the mouth giving a direct picture.
  6. X-rays are not a very full-proof method as they detect gallstones in barely 20% cases. A CT scan also only detects about 80% cases.
  7. Blood tests are the first methods recommended by a doctor before an ultrasound. It is useful in detecting the current condition of the gallbladder before more tests for detection are required.

Gallbladder Pain Relief & Treatment

  1. Analgesics for Severe Pain
  • Antispasmodics: dicyclomine can be used.
  • Non-steroidal anti-inflammatory drugs (NSAIDs): a diclofenac injection directly into muscle to help relieve pain. The drugs indomethacin and ketorolac can also be taken as a suppository.
  • Narcotic analgesics: and injection of morphine taken directly into the muscle. Pethidine can also be used.
  1. Analgesics for Mild to Moderate Pain
  • Non-steroidal anti-inflammatory drugs (NSAIDs): ibuprofen tablets can be taken directly.
  • Antispasmodics: butylscopolamine (hyoscine butylbromide) tablets
  • Paracetamol
  • Opiates: codeine
  1. Fasting: Patients are advised not to eat during an attack of the gallbladder and to drink simple water. Water prevents painful contractions in the gallbladder.
  2. Antiemetics: metoclopramide, ondansetron and prochlorperazine are antiemetics a doctor can prescribe for vomiting and/or nausea.
  3. Antibiotics: intravenous antibiotics can be used in case of inflammation.
  4. Surgical removal of the gallbladder: cholecystectomy is the use of surgery to remove the gallbladder via the abdomen. A small cut in the abdominal wall allows the doctor to use and endoscope to go in and remove the gallbladder. Open surgery is only used when cholecystectomy isn’t an option.

Other Options for Treatment

Where surgery is risky, doctors suggest acids to dissolve the gallstones. This is only possible when the stones are small. The chances of the reappearance of the stones is about 50%.

Stones are also broken up into smaller pieces of 2mm or less. The chance of the reappearance of the stones is about 30%.

There isn’t much scientific evidence related to this but it is said that flushing the gallbladder helps. Certain herbs are also recommended for alleviating pain and preventing gallstones.

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