The gallbladder, a small organ in the right upper abdomen, stores bile, the substance secreted by the liver that aids in the digestion of fats. Gallstones form when the fluid inside the gallbladder remains there too long and hardens. This process is called cholelithiasis. If the stones become lodged in the duct leading out of the gallbladder, the organ can become inflamed, and this is called cholecystitis. Each of these conditions has unique symptoms.
General Pain Pattern in Cholelithiasis, or Gallstones
There is no pain associated with having gallstones.The symptoms occur when the stones become lodged in the bile ducts. When this happens, pain starts suddenly in the upper right side of the abdomen, quickly intensifies and spreads left, towards the center of the chest You might also feel pain wrapping around the right side of the back and up into the right shoulder.
Differentiating Gallstone Pain from Other Causes
The pattern of pain specifically associated with gallstones was outlined in the January 2006 edition of the "Scandinavian Journal of Gastroenterology." Studying 220 patients with cholelithiasis, researchers found that their pain started at night 77 percent of the time, and that almost all had signs of heartburn or gastric reflux disease for a while before their gallbladder pain began. The urge to walk around, which is the body's way of trying to dislodge the stone, was reported in 71 percent of patients, whereas in other causes of abdominal pain, people to want to stop moving and rest. This pattern is an important way to differentiate the cause, and one, which the patient may easily forget to tell the doctor unless he knows in advance that it indicates gallstones. The average length of pain in an episode of cholelithiasis was found to be one hour.
The pain from an episode of cholelithiasis usually comes to an end after the stone in the duct becomes dislodged, but stones remaining in the gallbladder can cause another event. For this reason, surgical removal of the gallbladder is performed.
Signs and Symptoms of Cholecystitis
Gallstones, in 90 to 95 percent of cases, cause inflammation of the gallbladder, or cholecystitis. The Mayo Clinic describes the pain pattern of cholecystitis as a steady, constantly severe pain in the right upper abdomen that radiates towards the right shoulder, or wraps around the right middle area of the back. There is usually tenderness to the abdomen in this area when touched, and bloating, which do not occur in a simple episode of gallstone pain. Nausea and vomiting are common, as are sweating and chills.
Danger Signs in Gallbladder Disease
When gallbladder pain fails to resolve after a few hours, the possibility of life-threatening complications grows. Gangrene of the gallbladder, the most frequent of these conditions, occurs when the blood supply to the organ is interrupted. If not treated this can lead to the rupture of the gallbladder. Gangrene happens after several days of increasingly severe pain accompanied by a fever and weakness, according to J. David Lane, M.D. of the Walter Reed Army Medical Center.
Responding to Mild Symptoms
Clay-colored stools, multiple, very soft bowel movements each day and a feeling of discomfort after eating foods high in saturated fats are signals indicating a need for change. Revising your eating habits to prevent further gallstones, according to the National Institutes of Health, requires decreasing saturated fat, sugar and refined carbohydrates. Eating more omega-3 fatty acids such as avocado, salmon and nuts will make the gallbladder contract periodically, keeping it stone-free. And if estrogen products, including hormone replacement therapy or birth control pills are being used, these signs indicate they may be increasing the risk for gallstones and may need to be discontinued.
References
- American Colllege of Gastroenterology: Biliary Tract Disorders
- Mayo Clinic: Symptoms of Gallstones
- "Scandanavian Journal of Gastroenterology"; Pain attacks in non-complicated and complicated gallstone disease have a characteristic pattern and are accompanied by dyspepsia in most patients; Tewelde Bertherone, M.D. et al ; January 2006
- Mayo Clinic: Symptoms of Cholecystitis
- National Institutes of Health:Stools, Pale of Clay-Colored
