Common Causes of Gallbladder Pain—and How To Treat It

Medically reviewed by Kumkum Sarkar Patel, MD

Gallbladder pain occurs in the upper right quadrant of your abdomen. The gallbladder is a pear-shaped organ located in the upper right side of the abdomen below the liver. This organ helps with the storage, concentration, and release of bile during digestion. Pain in this area can sometimes radiate to the center of the abdomen or lower chest, which can be confused with the pain that you feel during a heart attack.

Several conditions can cause gallbladder pain, such as gallstones, inflammation of the gallbladder, and gallbladder cancer. Early diagnosis of the underlying condition that's causing your gallbladder pain is important for treating the condition and preventing complications.

What Does Gallbladder Pain Feel Like?

Gallbladder pain feels like a severe gripping pain in the upper right side of the abdomen. Nausea and vomiting can often accompany the pain. Sometimes the pain may occur at the center of the abdomen or even in the lower chest and feel like a heart attack. Most people who experience gallbladder pain feel more severe symptoms after eating a heavy meal or when lying down at night.

Some people also experience referred pain, which means that the pain originates from one part of the body but is felt in a different part. Referred pain originating from the gallbladder can sometimes be felt below the right shoulder or between the shoulder blades.

Potential Causes

A variety of gallbladder-related conditions can cause pain to develop in your abdomen.

Gallstones

Gallstones are hard, pebble-like deposits made of cholesterol and bilirubin. These stones develop due to imbalances of substances in bile (the digestive fluid produced by the liver and released by the gallbladder) or when the gallbladder does not empty its contents completely or frequently enough.

If you have gallstones, it's possible to experience sudden gallbladder pain, especially if they block the bile ducts of your biliary tract. Some healthcare providers also refer to this pain as biliary colic or gallbladder attack. In some cases, the pain can improve if the stone passes onto the first part of the small intestine. But for the pain to fully go away, treatment to pass the gallstone is often necessary.

Cholecystitis

Cholecystitis is a condition that causes inflammation in the gallbladder. This condition occurs when gallstones block the cystic duct—the duct that helps bile enter and leave the gallbladder. Cholecystitis can also occur due to gallbladder cancer or conditions such as diabetes. Pain from cholecystitis lasts for at least 30 minutes and often also causes nausea and vomiting.

Biliary Dyskinesia

Biliary dyskinesia is a functional disorder that occurs when your gallbladder isn't able to contract or release bile effectively. This condition occurs due to problems with motility (how something moves) in the bile duct and sphincter of Oddi—which is a smooth and circular muscle that controls the flow of bile and pancreatic fluid into the small intestine.

Having this condition can cause a build-up of bile in the gallbladder, but it does not lead to the formation of gallstones. If your gallbladder can't drain or release bile properly, it may result in gallbladder pain along with other symptoms such as nausea and vomiting.

Gallbladder Cancer

Gallbladder cancer is a rare but serious type of cancer that occurs when gallbladder cells grow uncontrollably. Besides gallbladder pain, people with gallbladder cancer may also experience nausea, vomiting, abdominal lumps, and jaundice (or, the yellowing of the skin and whites of the eyes).

Choledocholithiasis

Choledocholithiasis is a condition that develops when at least one gallstone is present in the bile duct. When this happens, your flow of bile can become obstructed (blocked), leading to right-side abdominal pain. It's also possible to experience inflammation, swelling, and jaundice with this condition.

Cholangiopathy

Cholangiopathy is a type of disorder that affects the bile ducts. This group of conditions may include acute cholangitis (a bacterial infection of the bile ducts) or sclerosing cholangitis (an autoimmune disorder that attacks your bile ducts). Serious cases of cholangitis can cause narrowing or blocking of the bile ducts, eventually leading to the build-up of bile in the liver and severe gallbladder pain.

When to Contact a Healthcare Provider

If you experience any of the following symptoms alongside your gallbladder pain, it is important to see a healthcare provider as soon as possible:

• Abdominal pain that lasts for a few hours

• High fever with chills

• Severe nausea or vomiting

• Jaundice

These symptoms may be a sign of a serious infection or inflammation of the gallbladder and its bile ducts. If left untreated, bile duct blockages can be life-threatening.

Diagnosis

To learn what's causing your gallbladder pain, your healthcare provider will ask you about your symptoms, eating habits, and personal and family medical history. Once they learn this information, they'll likely perform a physical exam to check for abdominal pain and swelling. To confirm the exact cause of your gallbladder pain, your provider may order one or more of the following tests:

• Blood tests: Blood tests such as complete blood count, liver function tests, and bilirubin level tests can help to detect signs of infection or inflammation of the gallbladder, bile ducts, or liver.

• Ultrasound: This imaging scan uses high-energy ultrasound waves to create images of your internal organs. An ultrasound can also help determine the presence of gallstones or any blockages in the bile duct.

• Computed tomography (CT) scan: A CT scan uses X-rays and computer technology to create images of the gallbladder and bile ducts to detect any abnormalities.

• Magnetic resonance imaging (MRI): An MRI uses radio waves and magnets to produce images of your internal organs. It can detect gallstones as well as bile duct blockages.

• Cholescintigraphy: This procedure, also called a hydroxyl iminodiacetic acid scan (HIDA scan) uses a radioactive material to create images of your biliary tract. Results from this test can determine the presence of bile duct blockages or abnormal gallbladder contractions.

• Endoscopic retrograde cholangiopancreatography (ERCP): An ERCP uses X-rays along with an endoscope (a thin tube that has a light and camera on it) to locate gallstones and affected bile ducts. Healthcare providers can also use this procedure to remove gallstones in the common bile duct.

Treatment

Fortunately, treatment can help reduce your gallbladder pain. However, your exact treatment plan will depend on the underlying cause of your pain and symptoms. In most cases, healthcare providers recommend medications or surgery.

Medications

Your healthcare provider may recommend non‐steroid anti‐inflammatory drugs (NSAIDs) such as diclofenac, flurbiprofen, or tenoxicam for relieving gallbladder pain. They sometimes also recommend opioid drugs such as codeine or morphine to reduce gallbladder pain.

Antibiotics such as Principen (ampicillin), Cipro XR (ciprofloxacin), or Vancocin (vancomycin) may be useful for people with gallbladder or bile duct infections. In some cases, your provider may also recommend a bile acid pill to treat gallbladder disorders. Medications like Actigall (ursodiol) can help dissolve cholesterol-type gallstones.

Surgery

Healthcare providers recommend removal of the gallbladder (also known as a cholecystectomy) for serious cases of gallbladder pain. This procedure is one of the most common surgeries performed in the United States.

There are two primary types of gallbladder surgeries:

• Open cholecystectomy: This procedure removes the gallbladder through a large cut in the abdomen. Healthcare providers recommend this surgery in case your gallbladder is severely infected or inflamed. You may need to stay at the hospital for about a week after the surgery.

• Laparoscopic cholecystectomy: This procedure is less invasive and removes the gallbladder through a small cut in the abdomen. You may be able to go home on the same day of the surgery.

A Quick Review

Gallbladder pain is a sudden pain that you might feel on the upper right side of your abdomen. The pain can occur due to several underlying health conditions, such as gallstones, bile duct infections, or gallbladder inflammation, among others. Getting treatment for your pain early can help prevent the possibility of serious complications. In most cases, treatment involves either medication or surgery.

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