Gallbladder Pain: Reasons Why Your Belly Hurts

Your gallbladder is a small, pear-shaped organ that’s tucked below your liver. You probably don’t think much about it -- until it hurts.

Your gallbladder releases a greenish fluid called bile every time you eat to help your body digest fats and vitamins. The bile flows down to your small intestine through tubes called ducts. When something goes wrong with your gallbladder or the bile ducts, the upper right side of your belly may hurt. You may also feel:

  • Pain in your back or chest, especially when you take deep breaths
  • Feverish
  • Like throwing up
  • Bloated
  • Itchy
  • Tired

Other common symptoms include yellow skin and eyes (known as jaundice), weight loss, and color changes in your pee or poop.

Causes

Gallstones . These are the top reason for gallbladder pain. You get them when bile clumps together into hard masses. Gallstones can be tiny specks or the size of a golf ball. If they get big enough, these stones can block bile from flowing out. That can lead to a gallstone attack, a sudden pain in the upper right part of your belly.

These attacks often happen after a big steak dinner or other fatty meals, and they can last for many hours. But most people who have gallstones don’t know it. These “silent” stones don’t cause problems in your organs. An ultrasound or other imaging tests can show if you have gallstones. Your doctor can get rid of them with surgery, medication, or even shockwaves.

Bile duct stones. These are either gallstones that get stuck in your bile ducts or stones that form there. They may give you no trouble until they block the bile ducts. Then you might have serious pain in your belly that comes and goes for hours at a time. Your skin and eyes might turn yellow, and you might feel like throwing up. Your doctor can remove the stones by threading a thin tube with a light at the end called an endoscope through your mouth down to the bile ducts.

Perforated gallbladder. This can happen when your gallstones over time wear a hole in the walls of your organ. It’s rare, but it can be deadly. The upper right part of your belly might hurt. You also may have a high fever, nausea, and vomiting. You’ll need medical treatment or surgery right away.

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Gallbladder inflammation. Also called cholecystitis, this can happen if bile builds up in your gallbladder from gallstones. Less often, other culprits can include tumors, certain bacteria, or problems in your bile ducts. When your gallbladder gets inflamed and swollen, symptoms include pain in your belly, including the area just above your stomach. You also may feel an ache in your back or right shoulder blade.

Usually, an ultrasound and other imaging tests can diagnose it. You may need surgery to remove your gallbladder. (Your body can work fine without it.) Without treatment, the organ can burst.

Primary sclerosing cholangitis (PSC). This is a liver disease that damages your bile ducts. It’s progressive, meaning it gets worse over time. About 4 out of 5 people who PSC also have inflammatory bowel disease. PSC can lead to liver failure. Many people have no symptoms. Or you might feel tired or have pain in the upper right side of your abdomen or itchy skin. This condition is often found when routine blood tests show your liver isn’t working right.

Gallbladder cancer . This is rare and hard to diagnose. More often than not, you won’t have symptoms until the cancer has spread. Signs may include abdominal pain, especially on the upper right side, as well as weight loss, jaundice, and belly bloating. A family history of gallstones; being older, female, or obese; and eating unhealthy foods can make you more likely to get cancer in the gallbladder.

Bile duct cancer . You may not have symptoms in the early stages of this cancer. If you do, it’s often because the bile duct is blocked. Jaundice is the most common symptom, along with itchy skin and light-colored or greasy poop. If your tumors are big enough, you may have belly pain, especially below your ribs on the right side. Surgery gives you the best chance at a cure. But most bile duct cancers are found too late for that. In that case, you may need radiation or chemotherapy to shrink the tumors first.

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Bile duct scars. Narrowed bile ducts from scar tissue can keep the bile from flowing out of your liver and gallbladder into the small intestine. That can make you hurt on the right side of your abdomen where the organs are. You also might be itchy or tired, have a lack appetite, and have jaundice, night sweats, or a fever.

A number of things can cause the scars, including bile duct stones, injury, infections, and alcohol and drugs. Your doctor can confirm it with a procedure called endoscopic retrograde cholangiopancreatography (ERCP), which gives them an inside peek into your bile and pancreatic ducts.

What You Can Do

Lifestyle changes can help keep your gallbladder shipshape.

Load up on fiber and cut back on sugar and carbs. Problems with your gallbladder often can be traced back to too much cholesterol -- a fat from meat, dairy, and other animal sources. But don’t be afraid of good unsaturated fats from foods like olive and canola oil, salmon and other fatty fish, and nuts.

Exercise regularly. Aim for 30 minutes of brisk walking and other moderate workouts every day.

Keep a healthy weight. If you’re heavy, aim to lose pounds slowly and avoid fasting. Otherwise, it can make the level of cholesterol in your gallbladder go up.

When to Call Your Doctor

Problems with your gallbladder or bile ducts should be checked out. Talk to your doctor right away if you:

  • Feel bad pain in your belly for many hours
  • Are nauseated or throwing up
  • Are sweaty
  • Have chills or a fever
  • Have yellow skin or eyes
  • Notice your pee is darker or your poop is lighter than usual
WebMD Medical Reference Reviewed by Minesh Khatri, MD on July 02, 2019

Sources

SOURCES:

John Hopkins Medicine: “Gallstones,” “Primary Sclerosing Cholangitis.”

Mayo Clinic: “Gallbladder Cancer,” “HIDA Scan.”

American Cancer Society: “Bile Duct Cancer,” “Signs and Symptoms of Gallbladder Cancer.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Eating, Diet, & Nutrition for Gallstones.”

CDC: “Gallbladder Cancer Incidence and Death Rates.”

World Journal of Gastroenterology: “Diagnosis and treatment of gallbladder perforation.”

Radiopaedia.org: “Gallbladder perforation.”

UpToDate: “Acute calculous cholecystitis: Clinical features and diagnosis,” “Primary sclerosing cholangitis in adults: Clinical manifestations and diagnosis.”

Virginia Mason: “Bile Duct Strictures.”

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