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If you experience sudden pain in the middle or upper right section of your abdomen, you may be having a gallbladder attack. The pain may last a few minutes to a few hours, and it may lessen or disappear, only to recur. Or, the pain may be located in your back, either between your shoulder blades or in your right shoulder. Other symptoms of a gallbladder attack include nausea, vomiting, sweating, fever, and chills. Your urine may become dark yellow or even a brownish color, and your stools may be clay-colored.
These symptoms indicate the possibility that gallstones have blocked the flow of bile from the gallbladder to the small intestine.
What Causes Gallstones?
Gallstones form in your gallbladder, an organ that is located on the right side of your abdomen beneath your liver. Your gallbladder stores bile, which is a fluid that contains water, acid, cholesterol, bilirubin, and lecithin, and is produced by your liver. (See our post “Liver Pain: What It Could Mean.”)
When you consume foods that contain fat, your gallbladder releases bile into ducts (tubes) that carry the bile to your small intestine, where it assists in the breakdown of fat.
If the bile contains too much cholesterol or bilirubin, these substances can form crystals that clump together and become gallstones. Gallstones that are very small pass through the ducts and cause no problems. However, larger gallstones may become lodged in one of the ducts, where they can block the flow of bile, cause inflammation in your gallblad-der, and produce pain and other symptoms.
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DIAGNOSING A GALLBLADDER ATTACK
To find out whether the symptoms you’re experiencing are caused by a gallbladder attack, see a doctor. Tests that can aid in identifying gallstones include an abdominal ultra-sound and/or a computerized tomography scan (called a CT scan or CAT scan). These tests create images of your gallbladder that can show if gallstones are present.
What Is My Gallstone Risk?
You’re at higher risk of having a gallbladder attack if you:
- have a family history of gallstones
- eat foods that are high in fat and/or cholesterol and low in fiber
- are overweight or obese
- have diabetes
- lose weight very quickly, such as after gastric bypass surgery
- are female
- take medications that contain estrogen, such as hormone therapy drugs
- are an American Indian or a Mexican American.
Treating a Gallbladder Attack
If you have gallstones that are causing symptoms, the most common treatment is gallbladder surgery, during which your entire gallbladder is removed.
Gallbladder removal is called a cholecystectomy. An “open” cholecystectomy (also called a “traditional” or “conventional” cholecystectomy) involves making a surgical incision in the abdomen and removing the gallbladder. This type of gallbladder surgery may require a hospital stay of up to one week, and recovery time is generally four to six weeks.
More commonly, gallbladder removal is performed via laparoscopy; in this procedure, small incisions are made in the abdomen, and a camera and instruments are inserted through the incisions. A laparoscopic cholecystectomy is less invasive than an open cholecystectomy, so patients often may be able to leave the hospital 24 hours after the procedure, and the recovery period is usually about two weeks.
Some patients are advised by their doctors to have gallbladder surgery, but they refuse or postpone gallbladder removal because they’re concerned about the risks associated with surgery and/or anesthesia. However, it is important to understand the possible complications of leaving the gallbladder in place. They include inflammation of the gallbladder, which can result in a ruptured gallbladder; an infection of the bile duct, which may also affect other organs, including the liver; and pancreatitis (an inflamed pancreas) if gallstones block the bile duct. Since these complications can be serious and even life-threatening, it is important to discuss all of the risks and benefits of gallbladder surgery with your doctor before making your decision.
Some patients are unable to have either an open or a laparoscopic cholecystectomy due to other medical conditions they have or because they have previously had abdominal surgery. These patients may be prescribed medication that may help dissolve the gallstones. However, sometimes the medication is ineffective, or it may take months or years for the gallstones to dissolve, and more gallstones may develop in the future.
Another option is lithotripsy, a procedure that utilizes a focused sound wave to break the gallstones into smaller pieces that are then eliminated naturally by the body.
Take Steps to Prevent Gallstone Symptoms
Avoiding some foods and eating more of other foods can help reduce your risk of having a gallbladder attack.
Eating a “gallbladder diet” that is high in fat, especially saturated fat, has been linked with an increased chance of gallstones. A good-for-your-gallbladder diet contains few or no fried foods, fatty meats (including fatty cuts of beef and pork), processed meats (sausage, bacon, hot dogs, lunch meats), or dairy foods made from whole milk (yogurt, cheese, ice cream, butter). Other foods to limit or avoid include highly processed foods, especially packaged baked goods such as cookies, cakes, pies, doughnuts, and pastries, and packaged snack foods such as potato and tortilla chips.
A diet that is rich in plant-based foods, including vegetables, fruits, nuts, seeds, and whole grains, may help prevent gallstones. Healthy protein sources include skinless poultry, fish, and shellfish that is baked, broiled, or grilled (remember, avoid fried foods), and legumes (beans, peas, and lentils). Lean meat can be included occasionally; choose lean cuts of beef or pork, such as eye of round, sirloin tip, top or bottom round, and top sirloin, which are lower in saturated fat than other cuts.
If you’re overweight or obese, eating a healthy diet may also help you lose weight, especially if you combine it with regular physical activity.
For further reading on gallbladder health, see the following University Health News posts:
- “How to Identify Gallbladder Pain“
- “Gallbladder and Gallstones: How to Protect Yourself from Painful Attacks“
- “The Gallbladder Diet: How Your Food Choice Can Lower the Risk of Gallstones“
Originally published in June 2016 and updated.