Stomach pain is usually just stomach pain, but sometimes it can be a sign of a gallbladder attack. Here are the signs you should know.
https://www.self.com-By Korin Miller-Sergey Filimonov/Adobe Stock
Chances are you barely know what your gallbladder is, let alone the gallbladder attack symptoms to look out for. When you have really bad stomach pain, it’s easy to chalk it up to that double bean burrito you ate an hour ago. Or, if it’s abnormally painful, your mind may jump to appendicitis.
But there’s another health condition that can cause bad stomach pain and probably isn’t on your radar: a gallbladder attack. Keep reading to learn what the heck your gallbladder is and what it does, plus the signs of a gallbladder attack you should know about.
What is your gallbladder, and what does it do?
Excellent question. Your gallbladder sits under your liver on the right side of your midsection below your ribs. It helps your body digest fat and stores bile, a fluid your liver secretes to help with digestion, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “When you eat, your gallbladder contracts and shoots bile into the intestine,” Kyle Staller, M.D., M.P.H., a gastroenterologist at Massachusetts General Hospital, tells SELF. “That serves as soap to help break up fats.”
Your gallbladder is a lot like your appendix. “You’re perfectly fine if it’s gone,” Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. Your liver still produces bile without your gallbladder, so it’s really not necessary to digest your food, according to the NIDDK.
What is a gallbladder attack exactly?
Just like pretty much every other body part, things can go wrong with your gallbladder. Enter: Gallstones, which can block your ducts and cause a gallbladder attack, according to the NIDDK.
Gallstones are little deposits of hardened digestive fluid that can range in size from a speck of sand to a golf ball, per the Mayo Clinic. If you have gallstones, when your gallbladder contracts to try to push bile out, the deposits can get wedged inside the duct that goes to the small intestine. As you can imagine, this feels beyond terrible. (There’s a reason it’s called a gallbladder attack instead of, say, a gallbladder nudge.) “It’s exquisitely painful,” Dr. Staller says.
What causes a gallbladder attack in the first place?
It’s clear that gallbladder attacks happen when gallstones block your bile ducts. But to really understand what causes a gallbladder attack, we need to discuss what causes gallstones to form. There are two types of gallstones. Cholesterol gallstones are usually made up of undissolved cholesterol that joins to form a stone, Dr. Staller says. Fun (and disgusting) fact: They’re typically yellow, according to the NIDDK. Pigment gallstones, on the other hand, are often dark brown or black. They occur when your bile contains too much bilirubin, a chemical your body produces as it breaks down red blood cells.
A few other factors can contribute to stone formation, like your bile not having enough bile salts (compounds that help break down your fat) and your gallbladder not emptying correctly or often enough, according to the Mayo Clinic. All told, about 10 to 15 percent of the U.S. population has had gallstones and about 1 million people are diagnosed with gallstones every year, according to the NIDDK. So, yeah, gallstones that can cause a gallbladder attack (and gallbladder attack symptoms) are pretty common.
Here are the gallbladder attack symptoms to look out for.
You can have gallstones and not even know it—or you can really know you have them due to certain symptoms.
Gallbladder attacks can last anywhere from minutes to hours, Diya Alaedeen, M.D., a general surgeon at the Cleveland Clinic who specializes in gallstone removal in addition to other abdominal health issues, tells SELF.
Plenty of people are clueless that they have gallstones because they have no symptoms, Dr. Bedford says. And even without symptoms, gallstones also increase your risk of gallbladder cancer, the Mayo Clinic says. It’s a rare form of the disease, according to 2020 statistics from the American Cancer Society, with only around 4,792 new diagnoses this year in the United States. Only around one in five of these are found in the early stages when the cancer hasn’t spread to other organs and is easier to treat, the American Cancer Society explains.
If your gallstones do happen to be symptomatic instead of silent, here are common signs of a gallbladder attack you should be aware of, according to the Mayo Clinic:
- A sudden, intense, “stabbing, gnawing, cramping” pain in the upper right section of your abdomen
- A similar pain in the center of your abdomen, under your chest, that might make you wonder if you’re having a heart attack
- Pain in between your shoulder blades
- Pain that radiates into your right shoulder
If your gallbladder attack continues without treatment, the symptoms, as per the NIDDK, can become even more serious and progress to:
- Abdominal pain that lasts for hours and is so severe you can’t sit still
- Jaundice (when your skin and the whites of your eyes take on a yellow tinge)
- Pee that looks tea-like
- Poop that is strangely light
Your gallstones can also affect your pancreas in what’s known as gallstone pancreatitis, which is when your gallstones block the movement of digestive enzymes from your pancreas, leading to inflammation, according to the American College of Gastroenterology. The symptoms are similar to regular gallstone symptoms, but with a few extras thrown in:
- Sharp, squeezing pain in your upper left abdomen
- Similar pain in your back
If you’re having any of the above symptoms, seek medical attention immediately.
What are the chances of having a gallbladder attack?
While anyone with a gallbladder can develop gallstones, there are many known risk factors for developing them. Here are some common ones, per the NIDDK:
- Being a woman: This is because estrogen can boost bile’s cholesterol levels and make your gallbladder contract less.
- Being over 40: As you age, the chance of developing gallstones increases.
- Losing weight too quickly: Losing a lot of weight very quickly is hazardous because it makes your liver excrete more cholesterol into your bile, raising your risk of gallstones.
- Obesity and diabetes: Obesity can increase the cholesterol in your bile, so it’s also a risk factor, as are type 1 and type 2 diabetes.
- Having certain health conditions: Conditions like Crohn’s disease that screw up your body’s absorption of nutrients can also lead to gallstone formation. Additionally, people with hemolytic anemias, which are conditions where red blood cells continuously break down (like sickle cell anemia), are at increased risk. That’s because of how those damaged red cells can increase bilirubin, the chemical we mentioned that can raise your risk of pigment gallstones.
- Having a family history of gallstones: If members of your immediate family have had gallstones, you’re at a higher risk of having them, too.
- Being of a certain cultural descent: Indigeneous people have the highest rate of gallstones. The reason: Certain genetic factors can increase the cholesterol in this population’s bile. Mexican Americans also have a high risk of developing gallstones.
When should you see a doctor for a gallbladder attack?
If you’re experiencing symptoms of gallstones, you should talk to your doctor as soon as possible, according to the Mayo Clinic. This is because gallstones and gallbladder attacks can get progressively worse if left untreated, and complications can even be fatal in some cases, the NIDDK says.
Treatment depends on whether you’re having a regular gallbladder attack or are experiencing gallstone pancreatitis. To figure out what’s going on, your doctor will likely do an imaging test like a CT scan or ultrasound; tests to check the state of your bile ducts; blood tests; or use a thin, flexible tool known as an endoscope to evaluate your stones. These exams and tests can also help your doctor rule out conditions like appendicitis, ulcers, and gastroesophageal reflux disease, which happens when acid in your stomach frequently flows back into your esophagus, according to the Mayo Clinic. Your physician may also give you medications for the pain, the NIDDK explains.
If your doctor realizes you have gallstones blocking the way to your small intestine rather than to your pancreas, they’ll either try to remove them with an endoscope or simply remove your gallbladder altogether. This might sound startling, but gallbladder removal, or cholecystectomy, is one of the most common surgeries in the United States, per the NIDDK. And, as we mentioned, you can live your life normally without your gallbladder.
There are two types of cholecystectomies: laparoscopic cholecystectomy and open cholecystectomy, the NIDDK says. Laparoscopic cholecystectomies are more common. During this procedure, your doctor will remove your gallbladder using a laparoscope (a small tube that allows surgeons to work by making minimal incisions), according to the NIDDK. In most cases, you’ll be able to go home when the procedure is done, the NIDDK says. Open cholecystectomies are used when your gallbladder is really inflamed, infected, or scarred, the NIDDK says. Sometimes your doctor will opt for an open cholecystectomy when the laparoscopic method isn’t working. If you have an open cholecystectomy, you might need to stay in the hospital for up to a week, the NIDDK says, but you can typically return to normal activities within a month.
After a cholecystectomy, a minority of people have changes in their bathroom habits—more specifically, they experience softer stool, and they find themselves pooping more frequently, the NIDDK explains. This typically happens because bile is flowing more freely without those obstructions, and it’s usually temporary, the NIDDK says. Still, you’ll want to discuss those changes with your doctor.
If for whatever reason, you can’t undergo surgery, your doctors may prescribe medications to dissolve the stones. This is the less ideal option since they can take months to work, and people with one instance of gallstones often get them again, according to the NIDDK. Even if you’ve only had one gallstone attack, doctors will usually want to remove the organ to prevent future attacks and also to eliminate your risk of gallbladder cancer.
If your doctors realize you have gallstone pancreatitis, you might get a slightly different course of treatment. In that case, doctors will typically recommend avoiding eating or drinking anything for a few days while you receive intravenous fluids or nutrients so the pancreatic inflammation can go down, the NIDDK says. They may also remove fluids from your stomach to ease any intense vomiting and also give you anti-nausea medications. Again they’ll either try to remove the badly behaving gallstones or excise the entire gallbladder.
If you’re experiencing such severe symptoms you suspect you’re having a gallbladder attack, it’s time to take action. “Once you have one bad attack, see a doctor,” Dr. Alaedeen says. It’s really best not to sit on it.
Korin is a former New Yorker who now lives at the beach. She received a double B.A. in International Relations and Marketing from The College of William & Mary (which she doesn’t use at all now) and an M.A. in Interactive Journalism from American University.