Gall Bladder Symptoms

Gallbladder symptoms infographic
Gallbladder symptoms infographic

Gallbladder Symptoms: An overview

Symptoms of gallbladder attack may include the following 10 symptoms

  1. Gallbladder pain symptoms (more details below)
  2. Nausea and Vomiting
  3. Fevers and Chills
  4. Upset stomach
  5. Jaundice
  6. Itchy skin
  7. Feeling weak and dizzy
  8. Confusion
  9. Low blood pressure
  10. Feeling cold and clammy

Not all of the 10 gallbladder symptoms are present in an individual patient. Your gallbladder symptoms depend on the specific gallbladder problem that you have.

Where is gallbladder located?

Gallbladder is located in the right upper quadrant of your abdomen. To understand gallbladder location, you can divide your abdomen into four equal parts: right and left with a vertical midline and upper and lower with a horizontal line through the middle of your abdomen. Your gallbladder will be found in the right upper part. To be exact, gallbladder is located just behind your 9th rib on the right side. The front and top side of the gallbladder is located just under the lower border of the liver. The back and lower side of the gallbladder is located on top of your intestines.

Image courtesy of: National Kidney & Urologic Diseases Information Clearinghouse (NKUDIC)

Gallbladder function

The gallbladder is a small pouch that collects bile juice from the liver. The bile is made by the liver and is collected by small tubules that eventually come together and form the common bile duct. As the common bile duct travels towards the upper part of the intestine where it releases the juice, it gives off a small branch called the cystic duct which connects to the gallbladder.

Gallbladder serves to collect and hold the excess juice until it is needed in the intestine. When it is needed, gallbladder contracts and empties its contents. Gallbladder attack symptoms develop when there is some defect in this mechanism. Anything that obstructs the path of bile flow, anything that causes over distension or anything that causes turbulence and infection in the sac can produce pain and other gallbladder attack symptoms.

Gallbladder pain symptoms: Where is gallbladder pain felt?

To understand where gallbladder pain is felt, you need to know the nerve supply of the gallbladder. Gallbladder does not have sensitive pain nerves like the ones in your skin. As an internal organ, gallbladder gets its nerve supply from the autonomic nervous system. These nerves produce difficult to pinpoint vague pain sensation. However, the inner surface of your abdominal wall has sensitive nerves.

At first, gallbladder pain may be felt in the middle of your upper abdomen near your stomach. As your gallbladder gets more inflamed, it causes irritation on the inner surface of your abdominal wall. At that time, gallbladder pain is felt where the gallbladder is located. You will then feel the typical right upper quadrant pain under your ribs. Gallbladder pain is usually sharp and it may get worse when you take a deep breath.

Can you have gallbladder pain on the left side?

Initially, when symptoms of gallbladder attack are just staring, the vague gallbladder pain may be felt in the middle of the upper abdomen. At times, it may be located slightly to the left. However, it is uncommon to have sharp gallbladder pain on the left. When you have gallstone pancreatitis (one of the complications of gallbladder stones), you may have sharp pain that may radiate all the way to your left upper abdomen.

Gallbladder stones

Gallbladder stones are the main cause of gallbladder attack symptoms. However, majority of gallbladder stones do not cause any problems. Here are the types of gallstones that can cause problems:

  1. Small gallbladder stones that get lodged in the neck of the gallbladder
  2. Passing gallstones that travel to common bile duct
  3. Large passing gallstone that passes down to the intestine and cause blockage

As you can see, passing gallbladder stones can cause more problems than gallbladder stones that stay inside the gallbladder.

Problems arising from gallbladder stones:

Biliary colic

Biliary colic is usually self limited and causes only the mildest forms of gallbladder pain symptoms. It occurs when small stones gets lodged in the neck of the gallbladder. They obstruct the flow of bile out of the gallbladder resulting in distension and pain.

Acute Cholecystitis

Acute cholecystitis symptoms are usually more severe than gallbladder symptoms from biliary colic. The distended gallbladder in biliary colic may get infected and inflamed. When that happens, you get acute cholecystitis symptoms. With cholecystitis symptoms, you may have fevers and chills in addition to the gallbladder pain symptoms. You may also have nausea and vomiting.

Common bile duct stone

Passing gallstones may get out of the gallbladder and get lodged in the common bile duct. Once in the common bile duct, they can completely block the flow of bile from the liver.

Acute Cholangitis

When the bile can’t get out of the liver due to common bile duct stone, the bile may get infected. When this happens, it is called cholangitis. Cholangitis is a potentially life threatening complication of gallbladder stones. In addition to gallbladder pain symptoms, people with cholangitis may have additional symptoms such as cold and clammy hands, fevers and chills, low blood pressure, jaundice, confusion and itchy skin.

Gallstone pancreatitis

Passing gallstones may go out and obstruct the flow of digestive juice from the pancreas. The resulting blockage may cause severe inflammation of the pancreas and the surrounding tissue leading to gallstone pancreatitis. Unlike the usual gallbladder pain symptoms, gallstone pancreatitis pain may be widespread and may radiate all the way to the left side and back.

How long do gallbladder attacks last?

The duration of gallbladder attack symptoms depends on the specific problem related to gallbladder stones. Gallbladder attack symptoms from biliary colic only last from 1 to 5 hours. Gallbladder attack symptoms from acute cholecystitis and gallstone pancreatitis usually last longer than 12 hours. Gallbladder attack symptoms from acute cholangitis may develop quickly and deteriorate rapidly, sometimes resulting in shock within 24 hours.

Gallstones treatment

How to get rid of gallstones? How to dissolve gallstones without surgery?

You do not need to get rid of most of the gallstones. If your gallstones are inside your gallbladder and have not caused any problems, you can leave them alone. Only a small percentage of gallbladder stones cause problems and it is hard to predict which gallbladder stones cause problems and which don’t.

Yes, there are ways to get rid of gallstones without surgery and there are medications that can help dissolve certain types of gallstones without surgery. However, these methods of getting rid of gallbladder stones do not have much practical use in modern medicine.

When you have complications from gallbladder stones, you need gallstones surgery. The surgeon will remove your gallbladder and all the stones inside it. When you do not have any problems from your gallbladder stones, you can leave them alone.

However, some people really like to get rid of their gallstones even when the gallstones have not caused any problems. Here are some of the ways you can get rid of gallstones without surgery:

  1. Lithotripsy for gallbladder stones: They use shock waves to break down gallbladder stones. It is mostly safe and effective but does have risk of creating smaller passing gallstones that can go out of the gallbladder and cause problems.
  2. Medications to dissolve gallbladder stones without surgery: These medications only work on certain types of stones and they may take a long time to work. One of the medications that can be used to dissolve gallbladder stones is called Ursodiol and it can cause diarrhea as a side effect.

Mainstay of gallstones treatment: Gallstones surgery

If you already have symptoms of gallbladder attack, the safest and most effective treatment is gallstones surgery. Due to widespread use of laparoscopic surgery, it is now a very safe and effective treatment. However, any surgery has risks and you need to make sure you need the surgery before you decide to get your gallbladder out. If your gallbladder stones have not caused any problems, it is unwise to get gallstones surgery.

Gallbladder pain relief

Gallbladder pain symptoms can be very distressful. It is important to get proper gallbladder pain relief in addition to the definitive treatment of gallbladder stones. Gallbladder pain treatment is an important part of gallstones treatment.

If you are at home and need gallbladder attack relief, you can initially try over the counter pain medications for gallbladder pain relief. Ibuprofen or Tylenol may help to stop a gallbladder attack while it is happening if you do not have nausea and vomiting. If you are vomiting, these pills may not work. You need to go to your doctor’s office or the nearest ER to get immediate gallstone pain relief.

Instant gallbladder pain relief may be achieved in the emergency department or doctor’s office by using IV pain medication. IV morphine is frequently used in ER for immediate gallstone pain relief.

Gallbladder diet

The role of gallbladder diet in gallstones treatment is very limited. Like I said, gallbladder stones without problems can be left alone and gallbladder stones with problems need to be taken out with surgery. However, many people still like to change their diet to prevent gallstones.

Gallbladder foods to avoid

Gallbladder stores the bile and the bile is used to digest fat. When you eat fatty food, you are telling your gallbladder to squeeze more bile out. Fats are the most important foods that aggravate gallbladder. Meats, bacon, sausage, hot dogs, cheese, butter, deep fired chicken, egg yolk are examples of food with high fat and cholesterol. These types of food aggravate your gallbladder and can cause problems with your gallbladder stones. If you really want to follow a good gallbladder diet, just avoid foods with high levels of fats and cholesterol.

Gallstones diet with low cholesterol food may also help prevent formation of certain gallstones in the gallbladder. Majority of gallstones in the United States are cholesterol stones. They are formed with cholesterol deposits. Low cholesterol gallstones diet may help prevent these cholesterol stones.

Gallbladder diet before surgery

If you had problems related to your gallbladder stones, you need surgery. While waiting for surgery, it may be a good ideal to follow gallbladder diet. It makes sense to avoid foods that aggravate gallbladder because you do not want any additional complications that may interfere with your planned surgery.

Gallbladder diet after surgery

After gallstones surgery, you won’t have your gallbladder anymore. Without a gallbladder, you won’t be able to squeeze stored bile after a high fat meal. You have to depend on bile that directly flows out of your liver. It may take a while for your body to get used to this new method of bile supply. It may help if you do not eat high fat food as part of your gallbladder diet after surgery. Overtime you can slowly increase the fat in your food to normal healthy levels.

Gallbladder cancer symptoms

Gallbladder cancer symptoms are very hard to detect. Most patients with gallbladder cancer do not have any symptoms until the cancer has spread causing metastatic disease. Gallbladder cancer symptoms from metastatic gallbladder cancer may depend on the location and extent of the metastatic disease.

Gallbladder cancer symptoms may also be hard to distinguish from other types of gallbladder pain symptoms. For example, patients thought to have cholecystitis symptoms may be found to have gallbladder cancer. After surgery for acute cholecystitis, the gallbladder tissue is sent to the lab for biopsy. Sometimes, early gallbladder cancer is detected incidentally after gallstones surgery. If the cancer is limited to the gallbladder at the time of diagnosis, Gallbladder cancer survival rate is very good. That’s why it’s important to follow up the biopsy result after any gallstones surgery. Gallbladder cancer life expectancy is very poor with metastatic disease.