Gallbladder Pain and Other Symptoms of Gallbladder Disease

Characteristics of Gallbladder Pain

Pain arising from the gallbladder or bile ducts usually appears below the right lower rib, 3-5 inches (7-12 cm) from the vertical mid-line. It may spread into the right lower or upper back, shoulder blade or shoulder. Other causes of right upper abdominal pain are liver, right kidney, ureter or adrenal gland, stomach, duodenum, pancreas, skin, muscles and ribs in affected area.

Causes of Gallbladder Pain

Gallbladder pain can be due to:

  • Gallbladder disorders: gallstones in the gallbladder, inflamed gallbladder (with or without gallstones), gallbladder cancer, biliary dyskinesia
  • Bile duct disorders: gallstones, inflammation, fibrosis, cancer in the bile ducts, sphincter of Oddi dysfunction (SOD)

When ultrasonography does not show any gallbladder disorder, bile ducts have to be checked by additional gallbladder tests. When nothing “organic” can be found, motility disorders affecting gallbladder or bile ducts contraction should be checked by special tests.

1. Gallstones in Gallbladder

Gallbladder pain due to gallstones usually appears within an hour after a meal as a muscular spasm below the right lower rib. It is a heavy meal rather than fatty meal that triggers pain. Pain may spread into the right upper back (between shoulder blades) or right shoulder. It may last from 15 minutes to several hours, fade away and appear again later. Pain may be accompanied by nausea or vomiting. Abdominal wall below the right ribs may be (or not) tender to the touch.

Sometimes gallstones, especially when they do not cause gallbladder inflammation, may trigger no symptoms at all even if they are present in the gallbladder for years. Jaundice in gallbladder stones appear only when gallbladder is enlarged to the point where it presses upon the main bile duct and obstruct the flow of the bile from the liver. This increases the pressure within the liver, which pushes bilirubin into the blood and from there into the skin. Itchy skin appears when bile salts appear in the skin.

When gallstones cause inflammation of the gallbladder (cholecystitis), fever may appear. White blood cells are usually increased in the blood.

2. Gallstones in Common Bile Duct

Gallstones in the common bile duct are usually present with the same symptoms as gallstones in the gallbladder. Jaundice is common.

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