The gallbladder in your body stores and releases bile or a fluid that promotes digestion. A high-fat diet and accumulation of cholesterol in the bile can cause gallstones or hardened deposits of the bile. Formations of gallstones and blockage in the bile ducts are known as gallbladder attacks. There can also be several other medical conditions for gallbladder problems.
A gallbladder attack causes sharp pain in your abdomen with many other symptoms. This is a severe medical condition treated with medications and surgical methods. Left untreated, this can cause torn gallbladder, gangrene, and other life-threatening conditions.
Want to know more about these attacks, their causes, symptoms, treatments, prevention, and more? Here is a complete guide.
What Are Gallbladder Attacks?
Gallbladder attacks refer to the formation of gallstones and the pain they cause by obstructing bile movements. However, there are some other reasons, like inflammation, gallbladder polyps, gallbladder dyskinesia, gallbladder rupture, or cancer behind gallbladder problems.
Gallbladder attacks cause intense pain in the middle or upper right part of your abdomen, and most of the time, the pain is accompanied by nausea, vomiting, and chills.
What Are Gallstones?
As mentioned earlier, gallstones are responsible for gallbladder attacks. Gallstones can vary in size and are similar to hard pebbles in their appearance.
Gallstones are formed with hardened deposits of bile along with proteins, minerals, and fats in our bodies. These gallstones further block the bile ducts or tubes, causing bile buildup, swelling, and pain. The pain goes away with the movements of these stones, unblocking the bile ducts.
Gallbladder stones are of two types: cholesterol and pigment gallstones.
Cholesterol gallstones are white or yellow in appearance. These stones or pebbles are made of fat or cholesterol accumulation.
Pigment gallstones are black or dark brown in color. These gallstones are formed if your bile has a higher-than-usual percentage of bilirubin.
Formation of gallstones may be asymptomatic with no pain. Pain occurs when these pebbles obstruct bile’s release and movement.
How Often Do Gallbladder Attacks Happen?
The frequency of gallbladder attacks differ from one person to another. However, if you experience gallbladder pain once, you are likely to experience another bout in a short interval. Usually, pain caused by gallbladder attacks is experienced around the same time of the day and can be the most intense in the evening.
To explain further, if you eat heavy meals with high-fat content, your liver will release more bile for digesting that fat. You can feel gallbladder pain around that time.
How Long Does Pain In Gallbladder Attacks Last?
Based on the severity of your condition, pain induced by gallbladder attacks will last from an hour to a day. You must consult a doctor immediately if the pain refuses to go even after 24 hours.
However, the pain in gallbladder attacks is intense, and it is difficult to sit with. So, the person feeling this pain may need to be rushed to emergency care.
Who Are At Greater Risks Of Having Gallbladder Attacks?
Women are at greater risk of having gallbladder attacks than men. Women are more prone to having these attacks because the female reproductive hormone estrogen boosts the liver to remove cholesterol from the blood. This cholesterol is further transformed into bile.
Pregnancy and hormone replacement therapy among women can also invite gallbladder attacks. Especially while undergoing hormonal replacement therapy and experiencing a sudden boost of estrogen in our bodies, the amount of triglyceride in the blood will shoot up. Thus, there are chances of the formation of cholesterol gallstones.
Nevertheless, along with women, there are many other groups who are at greater risk of getting affected by gallbladder attacks.
- Genetics with a mutation in the gene ABCG8 and other factors
- People consuming a diet filled with refined sugar, high protein, cholesterol, and fat
- Diabetic people
- Obese people
- People undergoing a rapid change in weight
- People undergoing bariatric surgery
- Ones with metabolic syndrome causing a low HDL and a high triglyceride cholesterol level
- People above the age of 40
- Children who need intravenous feeding or have impaired immune system, spinal injury, sickle-cell anemia, and a history of abdominal surgery
Certain ethnicities, like Mexicans, Hispanics, and Native Americans, are more prone to gallbladder attacks.
Causes Of Pain In Gallbladder
The causes of gallbladder attacks are not limited to gallstones only. Let’s know about the reasons in detail.
Cholelithiasis Or Gallstones
In cholelithiasis, your gallbladder has small or big pebble-like formations. These are formed with the accumulation of bile, fats, minerals, and proteins. These pebbles can be like salt grains or as big as golf balls.
These pebbles create obstructions in the release and movement of bile, causing swelling and pain.
Cholecystitis Or Inflammation Of The Gallbladder
As the gallstones obstruct the flow of the bile and stop bile from moving out of your gallbladder, you can experience inflammation of the gallbladder.
The bile gets trapped, and infection can occur due to bacteria attacks.
Choledocholithiasis Or Bile Duct Stones
The gallstones can sometimes travel out of your gallbladder and get stored in the common bile duct or the largest bile duct in your body. This condition is called choledocholithiasis.
Stones in bile ducts can cause severe health problems like pancreatitis.
The tissues inside your gallbladder lining can grow abnormally and cause gallbladder polyps. Polyps can further lead to inflammation in the gallbladder, and a small percentage of those polyps (around 5%) can cause gallbladder cancer.
Gallbladder Disease, Including Cholangitis And Biliary Dyskinesia
If you have gallstones, the bile ducts may get blocked, causing inflammation. Cholangitis occurs when there is a bacterial infection inside your bile-trapped gallbladder. Cholangitis happens suddenly, but it can get transformed into a chronic or long-term disease and autoimmune disease.
Biliary dyskinesia, on the other hand, makes the gallbladder less functional for the movement of bile.
Cholangiocarcinoma Or Bile Duct Cancer
Extrahepatic cholangiocarcinoma or other forms of bile duct cancers can cause gallbladder attacks. In these health conditions, the cancer reaches outside the liver. The most alarming thing about bile duct cancer is that it does not get diagnosed until its advanced stage.
Malignant cells can start growing in the inner layer of your gallbladder and spread to other parts of the body.
Symptoms of Gallbladder Attacks
A sharp pain caused by spasm in the gallbladder is the most prominent symptom of gallbladder attacks. The intensity of the pain even makes it difficult to breathe properly. The sharp pain lasting for hours will spread to your chest, right shoulder, back, and other parts of the body.
Other symptoms of gallbladder attacks are:
- Fever or chills
- Urine in brownish color
- Stool in a light color
- Yellowing of eyes or skin
Is Pain In Gallbladder Attacks Different?
Yes, the pain you experience in gallbladder attacks is completely different from other abdominal discomforts you experience.
The pain in gallbladder attacks occurs all of a sudden and lasts for hours. The intensity of the pain increases as you breathe, and it makes you immobile.
In gallbladder attacks, the pain is very sharp in the middle of your abdomen or just below the chest bone. However, the pain you feel in the right upper abdomen resembles cramps and is dull.
The pain spreads to the right shoulder, back, and between shoulder blades with time.
What Are The Preventive Measures To Avoid Gallbladder Attacks?
Preventive measures to avoid gallbladder attacks include a healthy diet daily. Your diet must not have a high-fat percentage. Here is a quick rundown of the food items to have and avoid to prevent gallbladder attacks.
Food Items To Have
- Dairy products with a low-fat percentage
- Fish and lean meat
- Fiber-rich food
- Vegetables and fruits
- Whole grains
- Plant-based food items
Food Items To Avoid
- Fried and junk food items
- Refined carbohydrates
- Red meat
- Saturated fats
Along with maintaining a healthy diet, it is also important to maintain a proper eating schedule. You cannot skip meals, as rapid weight loss can lead to gallbladder attacks. Obesity is another major reason for having a high risk of gallbladder attacks.
You should always try to maintain a healthy weight and exercise regularly to prevent the formation of gallstones.
How Are Gallbladder Attacks Diagnosed?
We remain unaware of gallbladder attacks until pain and other symptoms start showing. And many people can have gallstones without further medical complications or consequences.
If you experience sharp pain in the abdomen and other symptoms related to gallstone formations, your doctor will recommend the following tests for diagnosis.
- Abdominal ultrasound
- HIDA scan
- Liver function blood test
- CT scan
- Abdominal X-ray
Treatments For Gallbladder Attacks
On diagnosis and detection, gallbladder attacks are treated with medicines and surgical procedures.
Gallstones are treated with medicines like Urso or Actigall, which has ursodeoxycholic acid or ursodiol. These medicines break and dissolve the gallstones.
However, these medicines can only be effective if you have a few tiny gallstones. Gallstones of a maximum of 2-3 millimeters can be treated with these medicines.
Your doctor will ask you to take these medicines for a few months or years based on your specific gallbladder problems. And once you stop taking these medicines, gallbladder formation can happen again.
Your doctor may also prescribe antibiotic medicines, painkillers, and ursodeoxycholic acid medications.
Surgical methods are more effective for the treatment of gallbladder attacks. Your doctor will recommend any of the methods mentioned below to help you get rid of gallstones.
Endoscopic Retrograde Cholangiopancreatography
Endoscopic retrograde cholangiopancreatography is a less invasive method for the removal of gallstones. In this method, the doctor will make a flexible and thin scope enter your body through the mouth. A camera will accompany the scope and will reach your bile duct opening.
Thus, it will locate and remove the gallstones at the same time. Many doctors and patients prefer this method as it needs very little time for recovery.
The entire surgical procedure is performed under anesthesia.
For cholecystectomy, you will be under anesthesia. The doctor will remove the gallbladder in this method. This is the most effective method when you have many stones in the gallbladder or other severe issues related to the gallbladder.
Cholecystectomy can be done in multiple methods like open, robotic, and laparoscopic methods.
If your gallbladder has severe inflammation or you have a scarred gallbladder, your doctor will ask for an open cholecystectomy. Doctors also recommend open surgery to patients at risk of gallbladder cancer.
The doctor will cut open your abdomen through a major incision. This is a critical surgery, needing a recovery time of weeks and months. Post-operative care is also very important in this surgery.
Laparoscopic cholecystectomy is very popular these days. A doctor will cut small incisions on your abdomen. A small camera will go through one incision, and the surgical tool to remove gallbladder stones will be inserted through another incision.
Laparoscopic cholecystectomy needs less recovery time and involves fewer complications. However, there are risks of having a Trocar site hernia after laparoscopic cholecystectomy.
It is the most advanced form of cholecystectomy; very few medical facilities offer this service.
Percutaneous Cholecystostomy Tube
When the doctor places the tube into your gallbladder, a patient sleeps under general anesthesia. The doctor also creates a small incision to insert the cholecystostomy tube.
The doctor performs the entire drainage activity with an ultrasound or X-ray imaging guidance. A bag is connected to the tube where the excess bile and stones are drained.
How To Treat Gallbladder Attacks During Pregnancy?
Pregnancy puts women at a higher risk of having gallstones, and at the same time, gallbladder attacks during pregnancy can create complications and promote preterm birth.
Doctors usually go for medications, including pain relievers and intravenous fluids, to treat gallbladder attacks during pregnancy.
However, surgical processes are recommended if the complications do not go away with medications. Doctors try to ease out the complications so that the surgery can be deferred till after the delivery of the baby if it cannot be completely avoided.
If the surgery cannot be scheduled after delivery and has to be done during pregnancy, doctors choose “second or early third trimester” for the treatment of gallbladder attacks. But if it is an emergency, the surgery has to be done on an immediate basis.
Doctors prefer endoscopic retrograde cholangiopancreatography for gallbladder surgery during pregnancy, as it is the least invasive method among the surgical methods available for treatment.
If you have undergone the treatments for gallbladder attacks and your gallbladder is removed, you may suffer from diarrhea for a while. But if your diarrhea is not cured within one month or you face digestive issues, you must consult your doctor immediately.
Many live under the impression that removing gallbladder means surviving on bland food. It’s not true. Even after the operation, your liver will not stop producing bile. The only difference will be that it will move directly into the intestines and not get stored in the gallbladder. So, there will be no problem in digesting the food you eat. To put it simply, your diet does not have to be stringent, but of course, you need to cut on fat intake and eat healthy.
Further, a sharp pain in the upper abdomen does not necessarily indicate gallbladder attacks. But if you feel similar pain and experience other symptoms, consult a doctor for early detection and treatment.
Frequently Asked Questions (FAQs)
Gallbladder attacks feel like stabbing pain in the middle of your abdomen. The pain is so sharp and intense that you may find it difficult to draw a breath or sit properly.
As the pain moves towards the upper abdomen, it becomes numb and feels like cramps. The pain slowly spread to the right shoulder and between shoulder blades.
These attacks also cause fever, chill, nausea, and vomiting.
Yes, stress can cause gallbladder attacks as excessive stress boosts bile secretion. Excessive bile can get stored inside your gallbladder and cause swelling, inflammation, and pain.
Again, when your small intestine receives excessive bile from the gallbladder, it refluxes back some of it to your stomach. This will cause heartburn.
Consumption of coffee or caffeine can worsen gallbladder attacks. If you have gallstones and drink coffee, your gallbladder will contract, causing more pain and discomfort.
For quick relief from gallbladder attacks, you can lie on your left side so that the gallbladder placed on the right side of your abdomen does not get compressed further.
Also, you can try a warm compress to relieve the pain. Taking peppermint tea or magnesium supplements can also help in alleviating the pain.
However, gallbladder attacks need medical attention at the earliest possible, as leaving your gallbladder problems untreated can cause life-threatening problems.