The gallbladder is a pear-shaped organ that sits under the liver, where it stores and concentrates the bile that the liver produces and later releases it to aid in fat digestion. Gallbladder pain often begins under the ribs in the upper right belly and then radiates to the right shoulder and lower chest.
Many people mistake gallbladder pain for a stroke or heart attack. Because of the gallbladder’s role in food digestion, the pain may suddenly worsen after eating.
In most cases, gallstones are responsible for gallbladder pain. These hard particles form when the gallbladder cannot properly release bile or when there are imbalances in the bile itself. Gallstone formation is a slow process and it is possible to have gallstones without any symptoms.
Gallstones are usually responsible for biliary colic, which is sudden pain due to a blockage of the biliary tract. The pain can last from 15 minutes to several hours, usually coming on after a meal or while sleeping.
Another common source of gallbladder pain is cholecystitis or gallbladder inflammation. Usually, cholecystitis is the result of a gallstone blocking an area of the biliary tract, leading to bile building up and triggering inflammation. Other causes include tumors, infections, and scarring of the bile duct.
When a person has cholecystitis, the pain is often dull and cramp-like. They may also have flu-like symptoms.
Rarely, the accumulating bile of cholecystitis causes the gallbladder to rupture. Injuries from sports or motor vehicle accidents can also be responsible for a rupture, but this is even rarer.
When a person’s gallbladder ruptures, the pain develops suddenly and is both severe and persistent. Other symptoms vary but may include nausea, vomiting, fever, chills, and jaundice.
Poor motility of the gallbladder and other parts of the biliary tract can sometimes lead to gallbladder pain. Essentially, the muscles responsible for squeezing the bile out of the gallbladder are unable to contract properly. This condition, biliary dyskinesia, can cause brief episodes of sharp pain that usually occur right after eating.
The pain of dyskinesia may be severe enough to affect a person’s daily life and limit their activities. Other signs are nausea, vomiting, and bloating. Poor motility often resembles biliary colic.
A bacterial infection in the common bile duct that connects to the gallbladder, called acute cholangitis, may result from a gallstone or any other cause of biliary colic. The main symptoms of acute cholangitis include gallbladder pain, jaundice, and flu-like symptoms.
Severe cholangitis may lead to sepsis. In these cases, a person may develop confusion and their blood pressure may drop.
Bile in the gallbladder will sometimes thicken, thanks to poor motility and a variety of small particles. Sediments include materials like calcium bilirubinate, calcium salts, cholesterol crystals, mucin, and many others.
Because biliary sludge is so much thicker than typical bile, it travels much slower and may cause blockages. This causes gallbladder pain, as well as issues like biliary colic, cholecystitis, cholangitis, and pancreatitis.
The gallbladder may experience extreme calcification, called porcelain gallbladder, where the wall of the gallbladder becomes hard and brittle. Experts believe this is often a complication of excessive gallstones, but the cause remains unknown.
People with porcelain gallbladder typically have no symptoms, but the condition sometimes triggers severe pain along with jaundice and vomiting.
Gallbladder pain can sometimes be a sign of bile accumulating in the abdominal cavity, called biloma. This occurs when there is a bile leak due to gallbladder removal, abdominal trauma, or biliary surgery.
The pain may remain localized in the upper right of the abdomen or slowly spread across the body. Some people also experience swelling or inflammation, but these symptoms are less common.
Cancer of the gallbladder is uncommon, and when it does develop, it is usually occurring later in life. The glands that line the surface of the gallbladder are the most likely to be affected. Gallbladder cancers regularly cause bouts of pain, as well as jaundice and weight loss.
Experts have found links between cancer and gallstones, large gallbladder polyps, and porcelain gallbladders.
A person may be born with a unique gallbladder that does not show issues until much later in life. While these events are rare, experts have reported several congenital gallbladder issues, including multiple compartments, atypical shapes, and growths along the walls.
In one case, a man was born with two separate gallbladder compartments, which eventually caused intermittent gallbladder pain.
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