What causes a gallbladder attack

⚡ Gallbladder Attack: Symptoms, Treatment, Outlook, and More

Am I having a gallbladder attack?

A gallbladder attack is also known as a gallstone attack, acute cholecystitis, or biliary colic. If you have pain in the upper right side of your abdomen, it may be related to your gallbladder. Remember that there are other causes of pain in this area as well. This includes:

  • Heartburn (GERD)
  • Appendicitis
  • Hepatitis (inflammation of the liver)
  • Gastric ulcer (stomach)
  • lung infection
  • Diaphragmatic hernia
  • Kidney infection
  • Kidney stones
  • Liver abscess
  • Pancreatitis (inflammation of the pancreas)
  • Shingles infection
  • severe constipation

What is the Gallbladder?

The gallbladder is a small sac in the upper right abdomen below the liver. It looks like a sideways pear. Their main job is to store around 50 percent of the bile (bile) produced by the liver.

Your body needs bile to break down fats. This liquid will also help you get some vitamins from food. When you eat fatty foods, bile is released into the intestines from the gallbladder and liver. The food is mainly digested in the intestines.

Could it be gallstones?

Gallstones are tiny, hard "pebbles" that are made up of fats, proteins, and minerals in your body. A gallbladder attack typically occurs when gallstones block the bile duct or bile ducts. When this happens, bile builds up in the gallbladder.

The blockage and swelling cause pain. The seizure usually stops when the gallstones move and bile can drain away.

There are two main types of gallstones:

  • Cholesterol gallstones. These are the most common type of gallstones. They look white or yellow because they are made up of cholesterol or fat.
  • Pigment gallstones. These gallstones are created when your bile contains too much bilirubin. They are dark brown or black in color. Bilirubin is the pigment or color that makes red blood cells red.

You can have gallstones without having a gallbladder attack. In the United States, about 9 percent of women and 6 percent of men have gallstones without any symptoms. Gallstones that don't block the bile duct usually don't cause symptoms.

What about other gallbladder problems that cause pain?

Other types of gallbladder problems that can cause pain are

  • Cholangitis (inflammation of the bile duct)
  • Blockage of the gallbladder sludge
  • Gallbladder rupture
  • Excessive gallbladder disease or gallbladder dyskinesia
  • Gallbladder polyps
  • Gallbladder cancer

Symptoms of a gallbladder attack

A gallbladder attack usually occurs after a large meal. This happens because your body produces more bile when you eat fatty foods. You are more likely to have a seizure in the evening.

If you've had a gallbladder attack, you are at a higher risk of having another. Gallbladder attack pain is typically different from other types of stomach pain. You may have already had one:

  • sudden and severe pain lasting from minutes to hours
  • dull or cramping pain that quickly gets worse in the upper right part of your abdomen
  • Shooting pain in the middle of your abdomen, just below your sternum
  • severe pain that makes it difficult to sit still
  • Pain that doesn't get worse or change when you move
  • abdominal tenderness

Pain from a gallbladder attack can spread from the abdomen to the abdomen:

  • Back between your shoulder blades
  • right shoulder

You may also have other symptoms of a gallbladder attack, such as

  • nausea
  • Vomit
  • fever
  • chills
  • Yellowing of the skin and eyes
  • dark or tea-colored urine
  • light or clay-colored stools

A gallbladder attack can lead to other complications that would cause other symptoms. For example, it can cause liver problems. This happens because a blockage in the passage can cause bile to build up in the liver. This can cause jaundice - yellowing of the skin and the whites of the eyes.

Sometimes gallstones can block the way to the pancreas. The pancreas also produces digestive juices that help you break down food. Constipation can lead to a complication called gallstone pancreatitis. The symptoms are similar to those of a gallbladder attack. You may also have pain in your left upper abdomen.

When do you see a doctor?

Only about a third of people with gallstones will have a gallstone attack or serious symptoms. A gallbladder attack is a medical emergency that requires immediate care. You may need treatment to prevent complications.

Don't ignore the pain or try to treat yourself with over-the-counter pain relievers. See a doctor right away if you have any of these signs of a gallbladder attack:

  • strong pain
  • high fever
  • chills
  • Skin yellowing
  • Yellowing of the whites of your eyes

Treatment of a gallbladder attack

At first, a doctor will give you pain medication to relieve the pain. You may also be given nausea medication to relieve symptoms. If the doctor determines that you can go home without further treatment, then perhaps you should try natural pain relief methods as well.

Your gallbladder attack may go away on its own. This can happen if the gallstones pass safely and aren't causing complications. You still need to make a check-up visit to your doctor.

You may need scans and tests to confirm that the pain is from a gallbladder attack. This includes:

  • Ultrasonic
  • X-ray of the abdomen
  • CT examination
  • Liver function blood test
  • HIDA scanning

An abdominal ultrasound is the most common and quickest way for a doctor to determine if you have gallstones.


An oral drug called ursodeoxycholic acid, also called ursodiol (Actigall, Urso), helps dissolve cholesterol gall stones. It may be right for you if your pain goes away on its own or you have no symptoms. It acts on a small number of gallstones that are only 2 to 3 millimeters in size.

This medication can take months to work and you may need to take it for up to two years. When you stop taking the drug, gallstones can return.


You may need an operation if the pain persists or if you have repeated attacks. Surgical treatments for a gallbladder attack include:

Cholecystectomy. During this operation, the entire gallbladder is removed. It prevents you from getting gallstones or a gallbladder attack again. You will sleep for the procedure. It will take you a few days to a few weeks to recover from the surgery.

Gallbladder surgery can be done with keyhole surgery (laparoscope) or open surgery.

Endoscopic retrograde cholangiopancreatography (ERCP). With ERCP, you sleep under anesthesia. Your doctor will insert a very thin, flexible telescopic sight with a camera through your mouth to the opening of the bile duct.

This procedure can be used to find and remove gallstones in the duct. It cannot remove stones in the gallbladder. You only need a very short recovery time, as the ERCP typically does not involve making an incision.

Percutaneous cholecystostomy tube. This is a procedure used to drain the gallbladder. While you are under general anesthesia, a tube will be inserted into your gallbladder through a tiny incision in your stomach. Ultrasound or X-rays help the surgeon with orientation. The hose is connected to a bag. Gallstones and extra bile drain into the pouch.

Prevent further attacks

Gallstones can be genetic. However, you can make some lifestyle changes to lower your risk of developing gallstones and having a gallbladder attack.

  • Lose weight. Being overweight or obese increases your risk. This is because it can make your bile richer in cholesterol.
  • Practice and move. An inactive lifestyle or spending too much time sitting increases your risk.
  • Slowly moving towards a more balanced lifestyle. Losing weight too quickly increases your risk of gallstones. This happens because rapid weight loss causes your liver to produce more cholesterol. Avoid trying fad diets, skipping meals, and taking diet supplements for weight loss.

Stick to a healthy daily diet and regular exercise to lose weight safely. A gallstone prevention diet includes avoiding unhealthy fats and sugary or starchy foods. Eat more foods that help lower cholesterol. This also includes high fiber foods, such as

  • fresh and frozen vegetables
  • fresh, frozen and dried fruits
  • Whole wheat breads and whole wheat pasta
  • Brown rice
  • lenses
  • Beans
  • quinoa
  • couscous

What are the prospects?

If you have a gallbladder attack, talk to your doctor about how to prevent another one. You may need to have gallbladder removal surgery. You can have normal, healthy digestion without a gallbladder.

Be aware that you can get gallstones even if you eat a healthy, balanced diet and exercise a lot. You cannot control such causes:

  • Genetics (gallstones run in the family)
  • being female (estrogen increases bile cholesterol)
  • are over 40 years old (cholesterol increases with age)
  • who have a Native American or Mexican heritage (some races and ethnicities are more prone to gallstones)

There are conditions that can increase your risk for a gallbladder attack

  • Type 1 diabetes
  • Type 2 diabetes
  • Crohn's disease

Talk to your doctor or health care professional if you have a family history of gallstones or if you have one or more risk factors. An ultrasound can help find out if you have gallstones. If you've had a gallbladder attack, see your doctor for any follow-up appointments, even if you didn't need treatment.