Gallbladder Attack: Symptoms, Causes, Diagnosis & Treatment

Janis

By Janis | Updated December 4, 2023

A gallbladder attack, also known as acute cholecystitis or biliary colic, occurs when gallstones, hardened deposits of digestive fluid, block the flow of bile from the gallbladder to the small intestine. 

These blockages can cause intense pain and lead to various complications, such as inflammation and infection. 

Gallstones typically form due to an imbalance in the substances that make up bile, such as cholesterol and bilirubin. The size of gallstones can range from a grain of sand to a golf ball, making their potential impact on your gallbladder vary greatly. 

Understanding the symptoms, causes, diagnosis, and treatment options enables individuals to seek timely medical intervention and prevent further complications. 

While genetics, age, and gender can increase the risk of developing gallstones, lifestyle factors like diet and weight also play a significant role. 

Symptoms

The symptoms of a gallbladder attack may vary in severity and include abdominal pain, nausea, vomiting, fever, chills, jaundice, and tenderness in the abdomen. 

It is crucial to seek medical help if these symptoms become severe or persistent to prevent further complications.

Intense Abdominal Pain

Gallbladder attack symptoms may vary in severity from person to person. Typically, an individual may experience sudden and intense pain in the upper right or center of their abdomen. 

This abdominal pain may manifest as a steady, sharp, or cramping sensation, potentially radiating to the back or right shoulder, and may persist for a few hours. 

Persistent Nausea and Vomiting

Persistent nausea and vomiting can be distressing signs of a gallbladder attack. These symptoms often result from the gallbladder’s impaired ability to release bile, leading to digestive disturbances.

High Fever with Chills

High fever and excessive temperatures coupled with chills can indicate an infected gallbladder, a condition known as cholecystitis. 

Such infections typically arise from gallstone blockages, necessitating prompt medical attention to prevent complications.

Jaundice

Jaundice, characterized by a yellowing of the skin and eyes, signals a bile duct blockage, often from gallstones. 

It indicates that the liver is unable to process bilirubin normally, necessitating immediate medical evaluation.

When to Seek Medical Help?

It is essential to seek medical help if any of the following symptoms become severe or persistent.

These symptoms may indicate a more severe issue, such as a gallbladder infection or pancreatitis, both of which require prompt medical attention to address the problem and rule out other conditions.

What Causes a Gallbladder Attack?

Gallstones are small, hard deposits that form in the gallbladder, a small organ that stores bile produced by the liver. Bile aids in the digestion of fats and is released into the small intestine through bile ducts.

Gallbladder inflammation or cholecystitis can occur when a gallstone blocks the cystic duct, which connects the gallbladder to the bile duct. 

This blockage prevents the gallbladder from emptying, leading to a buildup of bile and subsequent inflammation. 

Gallstones and Their Types

Cholesterol gallstones and pigment gallstones are considered the two types of gallstones. Cholesterol gallstones, which are the most common, form when there is an excess of cholesterol in the bile. 

On the other hand, pigment gallstones are caused by an excess of bilirubin, a waste product that results from the breakdown of red blood cells.

In some cases, this blockage can also cause infection and even pancreatitis, which is an inflammation of the pancreas.

Aside from gallstones, other factors can contribute to gallbladder attacks and inflammation. These can include:

Bile Duct Abnormalities 

Narrow or kinked bile ducts can hinder the flow of bile, increasing the risk of gallstone formation and subsequent attacks.

These structural irregularities can be congenital or develop later in life, warranting regular monitoring.

Infections 

Infections can cause inflammation in the bile ducts and gallbladder, potentially leading to gallstone formation or aggravating existing gallstones.

Bacterial infections, in particular, can thicken the bile, making stone development more likely. 

Tumors

Tumors in the liver or pancreas can compress the bile ducts, leading to gallbladder attacks by blocking the flow of bile.

While rare, these growths can influence the normal flow of bile, increasing the risk of stone formation and inflammation.

It is essential to identify the specific cause of a gallbladder attack in order to determine the most appropriate treatment and prevention strategies.

Risk Factors

Several factors can increase the risk of developing gallbladder problems, including gallstones and gallbladder attacks.

Age and Gender 

The risk of developing gallstones tends to increase with age, especially for individuals over 40 years old. 

Additionally, women are more likely to be affected due to factors involving hormones like estrogen and pregnancy.

Native American Heritage 

People of Native American ancestry have a higher risk of developing gallbladder issues, including gallstones.

Genetic factors and dietary habits might contribute to this heightened risk, making awareness essential for timely interventions.

Family History 

Individuals with a family history of gallstones or other gallbladder issues may be at a higher risk.

Genetic factors play a role, making some individuals more susceptible to developing gallstones and related complications.

Obesity and Weight 

Being overweight or obese increases the risk of gallstones, as excess body fat can lead to increased cholesterol levels and alter bile composition, making it more likely for stones to form.

Excess weight disrupts the balance of substances forming bile, facilitating stone formation.

Diabetes 

People with diabetes are at a higher risk of developing gallstones due to increased levels of triglycerides. 

This factor has been linked to contributing to the formation of gallstones.

Pregnancy and Hormones

Pregnant women are at higher risk of developing gallstones due to hormonal changes during pregnancy that lead to increased cholesterol levels in bile.

Women using estrogen-based medications, such as hormonal birth control or hormone replacement therapy, have an increased risk of gallstones.

Antibiotics and Pain Medication

Some studies suggest that prolonged use of certain antibiotics may be associated with increased risk of gallstones. However, more research is needed to confirm these findings.

Overuse of pain-relief medication can disrupt digestion and mask the severity of gallbladder complications, leading to delayed treatment.

Cancer and Past Issues

Those who have had previous gallbladder problems, such as inflammation or infections, may be more prone to gallstone formation or other gallbladder issues.

Although rare, gallbladder cancer may be more likely to occur in individuals with a history of gallstones or other gallbladder issues.

By understanding these risk factors and discussing them with a healthcare provider, it is possible to take steps toward the prevention and management of gallbladder-related health concerns.

Diagnosis

Diagnosing a gallbladder attack typically involves a combination of physical examination, medical history, and imaging tests. 

Physical Exam

When you visit your doctor with symptoms of a gallbladder attack, they will first conduct a physical exam to check for tenderness in the abdominal area. 

This would also be the time when you would provide your doctor with information about your medical history and any relevant risk factors.

Ultrasound of Abdomen

One of the primary diagnostic tools for gallbladder issues is an abdominal ultrasound, which uses sound waves to create images of your gallbladder, pancreas, and surrounding areas. 

This can help your doctor identify the presence of gallstones and determine if they are causing the symptoms.

Other Imaging Tests

In some cases, other imaging tests may be recommended, such as a CT scan, MRCP (Magnetic Resonance Cholangiopancreatography), or HIDA scan. 

These tests provide a more detailed view of the digestive system, particularly the bile ducts and the cystic duct, which can help determine if there is a blockage.

Another diagnostic technique is ERCP (Endoscopic Retrograde Cholangiopancreatography), which involves inserting a small camera attached to a flexible tube into the digestive system. 

This allows the doctor to directly view the bile ducts, check for blockages, and use the opportunity to remove any obstructions.

Blood Tests

In addition to the imaging tests, your doctor may also request blood tests to look for signs of an infection or other indicators of gallbladder problems.

If the diagnostic tests confirm a gallbladder attack, your doctor will discuss your treatment options and help you decide on the most appropriate course of action. 

Complications

Gallbladder attacks can lead to various complications if not treated promptly. 

Bile Duct Infection

Infections can also arise due to gallbladder-related issues. Cholangitis is an infection of the bile duct, which can be triggered by gallstones obstructing the bile flow. 

Infections may require the use of antibiotics and, in severe cases, the removal of the gallbladder.

Cancerous Tumor

Gallbladder cancer is a rare but serious complication arising from chronic gallbladder inflammation. 

The tumor can develop within the gallbladder and spread to other organs if left untreated. 

Pregnancy Complications

During pregnancy, women may experience an increased risk of gallbladder complications. Infections in the gallbladder and the bile increase the risk of difficulties for mother and child. These can lead to preterm labor.

In conclusion, it’s crucial to address gallbladder issues early to avoid complications. Consulting a medical professional and following guidance on prevention and treatment methods will promote better overall gallbladder health.

Treatment

Treatment options for gallbladder attacks range from medication and lifestyle changes to more invasive procedures like ERCP or cholecystectomy, depending on the severity of the condition. 

When treating gallbladder attacks, the primary goal is to alleviate the pain and discomfort caused by the condition. A combination of medication and lifestyle changes can help manage the symptoms effectively.

Pain Relievers and Diet

For mild cases of biliary colic, over-the-counter pain relievers can provide relief. 

Avoiding fatty foods can also help prevent further gallbladder attacks, as these types of foods can stimulate the gallbladder to contract, causing pain in the upper right side of your abdomen.

Gallstone Removal

In more severe cases, a medical procedure called endoscopic retrograde cholangiopancreatography (ERCP) may be necessary to remove gallstones blocking the common bile duct. 

This non-surgical treatment involves the use of a flexible tube with a camera and a detection device to locate and remove the gallstones from the bile duct.

Open and Laparoscopic Surgery

However, in cases where gallstones continue to cause symptoms or complications, cholecystectomy, the surgical removal of the gallbladder, may be recommended. 

This surgery can be performed through either a single large incision (open cholecystectomy) or several small incisions (laparoscopic cholecystectomy). 

During a laparoscopic cholecystectomy, a camera and specialized instruments are inserted through the incisions, allowing your surgeon to remove the gallbladder with minimal scarring and a faster recovery time.

After the gallbladder is removed, bile from the liver will flow directly into the small intestine, and your digestive system will continue to function normally. 

It’s important to note that a low-fat diet and other lifestyle modifications may still be necessary after surgery to prevent additional health complications.

Recovery and Prognosis

After a gallbladder attack, the recovery process typically starts with addressing the underlying cause. During the recovery period, it’s essential to follow your healthcare provider’s advice on pain management, wound care, and any dietary restrictions. 

Lifestyle Changes

A low-fat diet may be recommended to help minimize the risk of future gallbladder issues. 

Drinking plenty of water, eating smaller meals, and avoiding high-fat foods can aid in the recovery process and prevent future attacks.

Post-cholecystectomy Syndrome

The prognosis for those who have successfully undergone gallbladder surgery or have had the obstruction removed is generally favorable. 

However, it’s important to note that some patients may experience post-cholecystectomy syndrome, which is a complex of symptoms that can persist after gallbladder removal, including abdominal pain, bloating, and diarrhea. 

In most cases, these symptoms can be managed with adjustments to diet and lifestyle and don’t require additional medical treatment.

Prevention

Maintaining a healthy lifestyle is crucial to prevent gallbladder attacks. These measures will help reduce the risk of gallstone formation and promote overall gallbladder health.

Weight Loss

One of the most effective ways to avoid gallbladder problems is through weight loss. By shedding excess pounds, you can reduce your risk of developing gallstones and other gallbladder issues. 

However, it is essential to approach weight loss gradually, as rapid weight loss may increase the risk of gallstones. Aim for a steady, consistent loss of weight by incorporating a balanced diet and regular exercise.

Balanced Diet and Hydration

Eating a well-rounded diet can help prevent the formation of gallstones. Include foods high in fiber, such as whole grains, fruits, and vegetables. These can help prevent the buildup of cholesterol in your bile, which contributes to gallstone formation. 

Try to minimize your intake of foods high in unhealthy fats and opt for lean proteins and healthy fats instead. Drinking plenty of water throughout the day can also support gallbladder health.

Frequently Asked Questions

What are the common symptoms of a gallbladder attack?

A gallbladder attack usually involves intense pain in the upper right abdomen, which can sometimes spread to the back or shoulder blades. 

Other symptoms can include nausea, vomiting, indigestion, bloating, and gas. Fever and chills may also occur if the gallbladder becomes infected.

How is gallbladder pain diagnosed?

Gallbladder pain is typically diagnosed through a combination of physical examination, medical history, and imaging tests such as ultrasound, CT scans, or MRI. 

Blood tests may also be performed to check for inflammation or infection. 

What factors can trigger a gallbladder attack?

Gallbladder attacks are usually caused by gallstones blocking the bile ducts, which leads to inflammation and pain. 

Risk factors for developing gallstones include obesity, poor diet, genetics, rapid weight loss, and certain medical conditions.

How can one prevent gallbladder attacks?

Preventing gallbladder attacks primarily involves lowering the risk of gallstones. Eating a healthy, balanced diet that is low in fat and high in fiber can help. 

Regular exercise, maintaining a healthy weight, and avoiding rapid weight loss can also lower the risk of developing gallstones. 

What treatments are available for gallstones?

If gallstones are causing symptoms, treatment may be necessary. 

Options include medication to dissolve the stones or surgical removal of the gallbladder, known as a cholecystectomy.

Why do gallbladder attacks often occur at night?

Gallbladder attacks are more likely to occur at night because the release of bile is stimulated by food consumption. 

Since most people eat their largest meal in the evening and then lie down, this can lead to increased pressure on the gallbladder and a higher likelihood of experiencing an attack.