Gallbladder Trouble or Upset Stomach? Know the Signs

Is it just an upset stomach or something else?

We all experience a multitude of GI issues over the course of our lifetime. Most of the time, the symptoms resolve quickly with rest and TLC.

When symptoms like bloating, nausea, vomiting and upper abdominal pain become chronic or severe, it’s time to seek medical care.

Gallbladder disease is one of the most common conditions in the United States. Approximately 10% of U.S. adults will develop gallbladder disease requiring surgery to alleviate symptoms.

Fortunately, when gallbladder symptoms are recognized, the surgery is most likely straight-forward, and the recovery period is brief.

What Does the Gallbladder Do?

The gallbladder is a small, pear-shaped organ located beneath the liver below the right rib border. Its primary function is to store bile, a digestive juice produced by the liver that helps break down fats we consume. The gallbladder also serves as a pump, moving bile and other digestive enzymes to the small intestine.

When not functioning properly, the gallbladder can cause a range of symptoms and potential complications.

What Causes Gallbladder Disease?

The most common cause of gallbladder disease is gallstones, which are hardened deposits that form from bile inside the gallbladder. These stones can block the normal flow of bile, leading to pain and inflammation. Gallstones can also block the flow of digestive enzymes formed in the pancreas.

Gallbladder disease can develop without gallstones, too. In some cases, the gallbladder is not performing properly as a pump, moving bile from the liver to the small intestine. Less commonly, gallbladder polyps or cancer can cause symptoms. 

Common Symptoms of Gallbladder Disease

Many people with gallstones have no symptoms. However, when symptoms occur, they often include:

• Pain in the upper right abdomen, sometimes radiating to the back or right shoulder
• Bloating, nausea or vomiting, often after a rich or fatty meal
• Fever or chills
• In later stages, jaundice (yellowing skin or eyes)

Symptoms can appear suddenly and may last between 30 minutes to several hours. Persistent pain, fever or jaundice require urgent medical attention.

How is Gallbladder Disease Diagnosed?

Diagnosis typically begins with a medical history and physical examination by a patient’s primary care provider or the Emergency Department team in the case of severe symptoms. An ultrasound is the most common test to identify gallstones or inflammation of the gallbladder.

When gallstones are not present, but a poorly functioning gallbladder is suspected, a type of nuclear medicine exam called a HIDA scan can help determine pump function. A HIDA scan uses an injected radioactive tracer and a special scanning camera to track the flow of bile from the liver to the small intestine.

CT scans and blood work can aid in determining extent of the disease as well.

Medical Management of Gallbladder Disease

If gallstones are present but not causing symptoms, surgery may not be necessary. Gallstones are sometimes revealed by medical imaging of the abdomen for other common conditions such as kidney stones, appendicitis and diverticulitis. For mild or occasional symptoms, dietary modification, particularly reducing fatty foods, can sometimes help decrease discomfort.

Unfortunately, medical management often does not permanently resolve gallbladder disease.

Surgical Treatment: Cholecystectomy

For patients with recurrent symptoms, surgical removal of the gallbladder (cholecystectomy) is the standard treatment. This is one of the most commonly performed surgical procedures.

Most gallbladder surgeries are done laparoscopically using small incisions and a camera. Typically, laparoscopic cholecystectomies are outpatient procedures, and most patients go home the same day. Patients may need to stay in the hospital longer if advanced gallbladder issues have arisen, such as gangrene of the gallbladder or inflammation of the pancreas.

Patients can usually return to normal activities in a few weeks. In more advanced cases, an open incision is required, and the healing process takes longer.

When to Seek Care for Gallbladder Disease

If you experience persistent abdominal pain, fever, vomiting or jaundice, seek medical attention promptly. Early evaluation and treatment can prevent serious complications. 

Gallbladder disease is common and highly treatable. With appropriate medical treatment, most people achieve complete relief of symptoms and return quickly to normal activities.