Gallbladder Pain

The Gallbladder

The gallbladder is a small organ with a shape similar to a pear. It is located in the right side of the rib cage just beneath the liver. It functions as a storage receptacle for the bile, a substance produced by the liver that aids in the digestion of fats from food and in removing toxins, such as drugs, bacteria, viruses, and other foreign substances, from the liver.[1]

Picture 1: The gallbladder
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  • The bile is a yellow-colored fluid made up of cholesterol, calcium, lecithin, acids, bile salts and waste materials. Upon ingestion of food, bile is released to the small intestine.[1]
  • It passes to and from the gallbladder via bile or cystic duct, which connects the gallbladder directly to the small intestine. The cystic duct joins with the common hepatic duct to form the common bile duct, which runs through the liver to the small intestine. It is then connected with a duct from the pancreas to form the ampulla of Vater.
  • The ducts are surrounded by the sphincter of Oddi, which regulates the release of bile. When the sphincter of Oddi is open, the bile concentrated in the gallbladder flows to the duodenum of the small intestine. When it is closed, the bile produced in the liver goes to the gallbladder.[2]

Gallbladder Pain

Gallbladder pain is a painful sensation felt on the upper right side of the abdomen. The pain is usually severe, but the intensity may fluctuate over time. It appears suddenly, and usually disappears gradually. The duration of the pain may last from 15 minutes up to several hours.[3]

Gallbladder Pain Location

Moderate to severe gallbladder pain is specifically felt on the lower part of the rib cage. Pain can also be felt on the upper abdomen in a condition called biliary colic. Rarely, the pain may radiate to the right shoulder or to the right shoulder blade in the back.[4]

Picture 2: Location of gallbladder pain
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Gallbladder Pain Causes

There are two major causes of gallbladder pain: gallstones and cholecystitis. [3]


Gallstones, or biliary calculi, are formed when there is an imbalance in the levels of cholesterol in the body. When the gallbladder does not empty efficiently, gallstones may also form.[4] The size of gallstones varies from one millimeter up to several millimeters. Usually, gallstones do not cause any health problem, but when these already block a duct, medical attention is already needed.[3]

There are three types of gallstones according to their composition:

  • Mixed stones. This is the most common type of gallstones. It is composed of cholesterol and bile salts. This type of gallstones usually develops in batches.
  • Pigment stones. This type is made up of bile pigments, making the gallstones appear greenish-brown in color.
  • Pigment stones are usually small, but they are abundant in number.
  • Cholesterol stones. This is mainly composed of cholesterol. The stones formed are usually large that it can obstruct the flow of bile in bile ducts.[4]

Picture 3: Gallstones
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Gallbladder pain develops when the gallstones becomes stuck in the bile ducts. This is a condition called biliary colic. Since the bile cannot flow properly, the bile ducts distend, leading to biliary colic. The pain felt when gallstones are present is usually exacerbated after eating a fatty meal.[3]

Aside from abdominal pain, the symptoms of gallstones include jaundice, or the yellowing of the skin and eyes, and fever. Worse cases may lead to the following conditions:

  • Pancreatitis, or the inflammation of the pancreas
  • Cholangitis, or the inflammation of the bile ducts
  • Cholecystitis, or the inflammation of the gallbladder[4]


Cholecystitis, or the inflammation of the gallbladder, is usually caused by the formation of gallstones, but this may also be caused by infections and tumors. Bile duct blockage caused by scarring or kinking of the bile ducts can also lead to cholecystitis. The symptoms include:

  • Gallbladder pain
  • Tenderness of the abdomen
  • Nausea
  • Vomiting
  • Sweating
  • Chills
  • Fever
  • Bloating[5]

Other Causes

Aside from gallstones and cholecystitis, gallbladder pain can be caused by sensitivity to certain foods, including fatty meats, eggs, dairy products, and fruits that are highly acidic.[6] Other diseases and medical conditions can also lead to gallbladder pain. Patients with liver diseases may also experience gallbladder pain. However, gallbladder pain can be easily mistaken from other diseases, such as acute pancreatitis.[6]

Gallbladder Pain Symptoms

The symptoms associated with gallbladder pain include the following:

  • Nausea
  • Vomiting (in some cases)
  • Diaphoresis (sweating)
  • Malaise
  • Shortness of breath
  • Light-headedness
  • Problems in bowel movement
  • Belching
  • Abdominal bloating [3]

Gallbladder Pain Treatment

  • The most effective treatment for gallbladder pain regardless of the cause is cholecystectomy, or the removal of the gallbladder[3]. Cholecystectomy can be performed through an open surgery or through laparoscopy.
  • In open cholecystectomy, the gallbladder is removed out of a single, large cut in the abdomen. The cut usually measures around 10-15cm. This is a more invasive procedure than laparoscopic cholecystectomy; hence, this is the less preferred procedure.
  • However, this becomes the preferred procedure due to safety concerns. The surgeon may also switch from laparoscopic procedure to an open surgery when severe bleeding occurs. Since this is more invasive, the recovery time is longer, taking up to six weeks.
  • Laparoscopic cholecystectomy, on the other hand, involves three to four small incisions in the abdomen. Two or three cuts will be made on the right side of the abdomen, and a single cut is made by the belly button area.
  • A laparoscope, an optical device with a light and a camera, is inserted on one of the cuts of the abdomen. A tube connected to a carbon dioxide source is also inserted in one of the cuts. This functions to inflate the abdomen so that the surgeon can properly observe the abdomen and the internal organs.
  • Special surgical instruments used to remove the gallbladder are inserted in the remaining holes. After the gallbladder is removed, the cuts are stitched and covered with dressing.
  • The operation usually takes place for about 1 to 1 ½ hours. The recovery is also shorter than in open surgery. In fact, the patient can go home after the operation is performed. Within two weeks, the patient can resume his or her daily normal activities. [7]

Picture 4: Open cholecystectomy vs. laparoscopic cholecystectomy
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  • Aside from surgery, medications such as NSAIDs can also be given to alleviate gallbladder pain and inflammation. In cases of cholecystitis, antibiotics are also given when it is caused by an infection.[5]
  • The diet is also essential in managing gallbladder pain. It is advised that patients avoid foods high in fats and cholesterol. It is recommended that they consume more fish, green vegetables, and whole grains.[6]



Published on by under Pain Management.
Article was last reviewed on September 7th, 2016.

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