Gallbladder Pain
What Is Gallbladder Disease?
Gallbladder disease is fairly common in the United States. In fact, it’s estimated that approximately 6% of men and 9% of women have gallstones. Several diseases related to the gallbladder can cause pain, including biliary colic, cholecystitis, pancreatitis, and ascending cholangitis. Most individuals with gallstones are asymptomatic, and their gallstones are detected accidently on abdominal imaging. But symptomatic patients may experience gallbladder pain, which you can learn about in this article.
Where Is Gallbladder Pain Felt?
Gallbladder pain usually first presents through biliary colic, described as an intense, dull discomfort. This gallbladder pain location is usually in the right upper or middle upper portion of the abdomen (1 to 2 inches below the chest bone).
Another common complication related to gallstones is acute cholecystitis. This refers to gallbladder inflammation that presents with right upper quadrant abdominal pain, fever, and increased white blood cell count. Additionally, if the gallstone gets lodged in the common bile duct, patients may experience fever and abdominal pain.
Jaundice may also develop because of bilirubin buildup. This is referred to as acute cholangitis. This pain is constant and severe, to the point most check themselves into the hospital for.
What Are Gallbladder Pain Symptoms?
Gallbladder pain is often associated with sweating, nausea, and vomiting. Once symptoms develop, they are likely to recur and may cause complications.
Symptoms other than pain can also be related to gallstones disease. Some of these symptoms include belching, fullness after meals or bloating, regurgitation, nausea or vomiting, and burning feelings in the chest.
What Causes Gallbladder Pain?
Eating a fatty meal is a common trigger for gallbladder contraction, which causes the gallstone (or possibly sludge) to push against the gallbladder outlet or cystic duct opening, leading to pain within 30-45 mins after eating. The pain is not exacerbated by movement and is not relieved by bowel movements or passage of flatus. The pain usually subsides within an hour and the entire attack usually lasts less than 6 hours.
Dr. Kingsley’s Bedside Physical Exam Pearl
Murphy’s sign is a well-known physical exam finding first described by Dr. John Murphy in 1903 in acute cholecystitis patients. We can guide patients to perform this exam on themselves over telemedicine, which helps with diagnosing a gallbladder issue.
We demonstrate Murphy’s sign by asking the patient to take and hold a deep breath while pressing on the right upper quadrant of the abdomen where the gallbladder is located. If the pain worsens when the inflamed gallbladder comes into contact with the examiner’s hand, that is a positive Murphy’s sign — and an indication of cholecystitis.
What to Do if You Think You Have Gallbladder Pain
If you suspect you have gallbladder pain, the first thing to do is to characterize it, which helps with diagnosis. Try keeping a pain diary, documenting if your pain is related to certain types of foods, how long it lasts, and what it feels like. If you can identify the foods that worsen your pain, try avoiding them to see if your pain improves. If the pain continues or worsens, see a doctor who can order an ultrasound to look for gallstones.
If you have gallstone symptoms or complications such as fever or jaundice, see a doctor as soon as possible. Early intervention with antibiotics can prevent these complications from becoming life threatening emergencies.
Gallbladder Pain Treatment
If you’re experiencing gallbladder pain, you may ask your physician, “what is the fastest way to relieve gallbladder pain?” The treatment path for gallbladder conditions depends on the severity, frequency, and complexity of symptoms.
Elective surgery is one option to remove the gallbladder and gallstones. However, surgery always has its risks and not everyone is a surgical candidate.
Many patients prefer nonsurgical treatment, which can include bile acid dissolution therapy with a medicine called ursodiol. This medication is ideal for patients who have uncomplicated gallstone disease (biliary colic), have small, non-calcified stones measuring <1 cm, and have a patent cystic duct. We recommend following up with an abdominal ultrasound to assess the body’s response. The overall success rate of this therapy ranges from 30-50%.
Acute cholecystitis is treated with antibiotics to prevent a secondary infection of the gallbladder due to cystic duct obstruction and bile stasis. If antibiotics are not started early in this case, life-threatening sepsis (bloodstream infection) can develop as well as complications of abscess formation. The antibiotics used in treatment must cover a broad range of bacteria. A combination of the antibiotics ciprofloxacin and metronidazole is common in outpatient settings.
Pain control is also crucial during an acute attack of biliary colic and for acute cholecystitis. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, ketorolac, and diclofenac are recommended as the first outpatient pain treatments. Opioid pain medications are reserved for patients who cannot tolerate NSAIDs or have inadequate relief with NSAIDs.
Ultimately, if a patient waits too long to be seen by a doctor and doesn’t start treatment early enough, hospitalization may be required to start IV antibiotics and possible surgical intervention. Therefore, if you’re concerned about your gallbladder pain, don’t hesitate to see a Kingsley Clinic doctor today.