Gallbladder Attack

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How do I know if I have a Gallbladder Attack?

We never think about our gallbladder, until we experience the severe, shooting pain of a gallbladder attack. The pain may be dull and achy, or it may be severe, shooting pain that is disabling and very humbling. Many tough people have been reduced to crying out in pain with a gallbladder attack. There is a tremendous variation in the different types of symptoms that people experience. The typical “attack” happens after eating a high-fat meal and can last from 30 minutes to 2 hours or even more. A fatty meal is not always the cause of the attack and sometimes patients with bad gallbladders do not have pain after some high fat meals, but then experience the pain after a different meal with less fat. The most common presentation begins with pain in the upper-right side of the abdomen below the rib cage and may spread to the right shoulder in the front or back, between the shoulder blades, and across the upper abdomen or lower chest. Nausea or vomiting may also occur with these symptoms. Less common, the pain may be located within the left upper quadrant of the abdomen or the right lower quadrant. Sometimes only nausea is present without consistent abdominal pain. Because of this variability, medical providers need to have a high suspicion when evaluating patients with any of these complaints.

How are Gallstones formed?

The gallbladder is a small pear-shaped organ just below the liver which stores and releases extra bile into the small intestine for the digestion of fats. If bile contains too much cholesterol or bilirubin, it may lead to the formation of gallstones. Gallstones may also form if the gallbladder does not empty entirely or frequently. The excess material in bile forms crystals which clumps together to form stones. Gallstone size varies from a particle of sand to a golf ball, but mostly they are pebble-sized.

Gallstone attacks from gallstone disease happen when gallstones become infected with bacteria on their surface, when they irritate the inside of the gallbladder during gallbladder contraction, or when they move outside the gallbladder and block the bile flow by plugging a bile duct. The pain is not due to the stones, but because of the spasm of the gallbladder or bile ducts as they swell with the obstructed bile. The gallbladder itself can even become inflamed if too much bile gets trapped. Many patients that do not even have gallstones experience gallbladder attacks. This is due to dysfunction of the gallbladder or even infection which can be called acalculous cholecystitis. A large number of gallbladder surgeries are performed for patients that do not have stones, but suffer from gallbladder dysfunction, or ‘chronic cholecystitis”.

What are the symptoms of a Gallbladder Attack?

Pain caused by a gallbladder attack typically differs from other kinds of stomach pain. You may experience:

Sudden sharp pain that may last for several minutes or hours
Cramping or dull pain in the upper right part of the abdomen
Radiation of the pain to the upper back or shoulder
Stabbing pain just below the breastbone
Tenderness in the upper or even lower right abdomen when you bend forward
Lower chest pain which is sometimes confused for a heart attack

You may also have some other symptoms during a gallbladder attack, like:

Fever
Chills
Nausea
Vomiting
Yellowing of the skin and the whites of the eye
Dark urine
Light-colored or pasty appearing stools

A gallbladder attack can lead to some complications. For example, it can cause liver problems. Blockage of the duct can push the bile into the liver. This may trigger jaundice and cause yellowing of eyes and skin.

What is the treatment for a Gallbladder Attack?

Gallbladder attack may resolve on its own if gallstones safely pass through. Although your symptoms may subside, they can reappear, and you may need treatment.

To confirm that the pain is from the gallbladder, your doctor will suggest some tests and scans like:

Ultrasound
CT scan
Abdominal X-ray
A liver function blood test
HIDA scan

Surgery is the Most Common and Recommended Treatment for Gallstones

The surgery done to remove the gallbladder is called Cholecystectomy. It is one of the most common surgeries done on adults in the USA. Since the gallbladder is not an important organ, you can live normally without it.

Usually, general anesthesia is given for this surgery. Once the gallbladder is removed, bile can flow from the liver directly into the small intestine through the hepatic duct, instead of being stored in the gallbladder.

Two Types of Gallbladder Surgeries can be Performed by a Surgeon

Laparoscopic Cholecystectomy

The vast majority of cholecystectomies are done through laparoscopy as an outpatient procedure, meaning the patient can go home on the same day. Laparoscopic cholecystectomy became the standard of care operation in the early 1990’s instead of the older “open cholecystectomy” in which an incision (often large) is created under the rib cage in the upper right abdomen.

Open Cholecystectomy

This operation may be required if the gallbladder is severely infected, inflamed, or scarred. But, these operations should be rare with today’s technology and surgeon experience with that technology. In fact, facilities are now being rated to ensure that surgeons do not perform too many open procedures when a laparoscopic procedure could have been performed for the patient. With the open procedure hospital stay is extended, postoperative pain is increased, and complications such as postoperative adhesions and incisional hernias occur more frequently. Open gallbladder operations should be performed rarely and only as a last resort.

When to seek help for a Gallbladder Attack

A Gallbladder Attack is a warning sign which needs immediate evaluation. You should never try to endure or ignore gallbladder pain. Dr. Steven Williams has performed thousands of gallbladder surgeries since 1997, typically uses 1 less port site than most surgeons whether performing the surgery robotically or laparoscopically, has proven, excellent outcomes and the possibility of the patient awakening with a conversion to an “open” gallbladder procedure is so rare it is negligible.

To schedule an appointment with Dr. Williams regarding your gallbladder, call: (208) 321-4790.