Gallbladder pain

And the first national endoscopic minimally invasive gall preserving lithotomy conference five anniversary commemoration meeting

What are the causes of gallbladder pain?

The major gallbladder problems that produce gallbladder pain are biliary colic, cholecystitis, gallstones, pancreatitis, and ascending cholangitis. There are two major causes of pain, that either originate from the gallbladder or involve the gallbladder directly. They are due to :

  1) intermittent or complete blockage of any of the ducts by gallstones;

or

  2) gallstone sludge and/or inflammation that may accompany irritation or infection of the surrounding tissues, when partial or complete obstruction of ducts causes pressure and ischemia (inadequate blood supply due to a blockage of blood vessels in the area) to develop in the adjacent tissues.

Gallstone formation usually happens in the gallbladder, but may form in any of the ducts. When the gallbladder is compressed (squeezed by musculature), bile usually goes out through the bile ducts into the GI tract; however, if gallstones or gallstone sludge is present, there can be partial or complete blockage of the ducts with pressure on the surrounding tissue, sometimes enough to cause local ischemia. Other processes such as trauma can cause gallbladder pain. Infection of the biliary ducts and the gallbladder, usually occurring after gallstone obstruction also can cause pain.

What is biliary colic?

Biliary colic is a term used to describe the type of pain related to the gallbladder, when the gallbladder contracts and the cystic duct is partially or completely blocked by a gallstone. The symptoms are described below.

Gallbladder pain may vary or feel different depending on the cause. Many people with gallstones never experience pain. However, there are some variations in gallbladder pain, that help the doctor to make a diagnosis:

Biliary colic (intermittent duct blockage): Sudden and rapidly increasing pain (ache or pressure) in the right upper abdomen or epigastric area; some people will have pain radiating to the right shoulder (or back pain in the tip of the scapula) and/or also develop nausea and vomiting. The pain usually subsides in about 1 to 5 hours although a mild ache may persist for about a day.

Cholecystitis (inflammation of the gallbladder tissue secondary to duct blockage): severe steady pain in the upper-right abdomen that may radiate to the right shoulder or back, abdominal tenderness when touched or pressed, sweating, nausea, vomiting, fever, chills, and bloating; discomfort lasts longer than with biliary colic.

Acalculous cholecystitis (no gallstones) has similar symptoms to cholecystitis but occurs as a complication of other problems like trauma or burns; patients have severe symptoms and appear very ill.

Pancreatitis: Gallstones from the gallbladder can block the pancreatic duct and cause pancreatitis (inflammation of the pancreas) with upper abdominal pain that may radiate to the back, tender abdomen, more pain after eating, with nausea and vomiting.

Ascending cholangitis (or simply cholangitis or infection of the biliary system) causes symptoms and signs that include fever, abdominal pain, jaundice and even hypotension (low blood pressure), and confusion; it is a medical emergency.

What is the treatment of gallbladder pain?

If you have no gallbladder pain (even if you have gallstones but never had pain), you need no treatment. Some patients who have had one or two gallstone attacks may elect to avoid treatment. 

Send us your gallbladder ultrasound (images and conclusion) and get the necessary prescription.