Gallstones are hardened deposits of digestive fluid in the gallbladder. The gallbladder is a small, pear-shaped organ located on the right side of the abdomen, just beneath the liver. The gallbladder stores bile, a digestive fluid that is released into the small intestine.
Gallstones can be as small as a grain of sand or as large as a golf ball in size. Some people develop one gallstone at a time, while others develop several gallstones at the same time.
Gallstones that cause symptoms usually necessitate gallbladder removal surgery. Gallstones that do not cause any symptoms usually do not require treatment.
Causes of Gallbladder Pain
The major gallbladder problems that produce gallbladder pain are biliary colic, cholecystitis, gallstones, pancreatitis, and ascending cholangitis. The two major causes of pain can either it can be originated from the gallbladder or it involves in the gallbladder directly. They are due to intermittent or complete blockage of any of the ducts by gallstones; or gallstone sludge and/or inflammation that may accompany irritation or infection of the surrounding tissues when it will partial or the complete obstruction of the ducts which causes pressure and ischemia to develop in the adjacent tissues.
Gallstones usually form in the gallbladder, but may form in any of the ducts. If the gallbladder is compressed, then the bile usually goes out through the ducts into the GI tract. However, if the gallstones or gallstone sludge is present, then it can be partial or complete blockage of the ducts with pressure on the surrounding tissue, sometimes enough to cause local ischemia.Infection of the biliary ducts and the gallbladder, can occurs after the gallstone obstruction can cause the pain.
Symptoms
Gallbladder pain may vary or feel different depending on the cause. Many people with gallstones never experience pain. However, there are some variations in gallbladder pain that help the doctor to make a diagnosis.
Biliary colic :
It occurs Sudden and rapidly increasing the pain (ache or pressure) in the right upper abdomen or epigastric area. some people will have pain radiating to the right shoulder (or back pain in the tip of the scapula) and/or also develop nausea and vomiting. The pain usually gets in about 1 to 5 hours although if a mild ache can also persist.
Cholecystitis :
Severe steady pain in the right upper abdomen that may radiate to the right shoulder or back, abdominal tenderness when touched or pressed, sweating, nausea, vomiting, fever, chills, and bloating; discomfort lasts longer than with biliary colic.
Acalculous cholecystitis (No gallstones) :
Acalculous Cholecystitis is the complication of other problems such as trauma or burns, patients have severe symptoms and appear very ill.
Pancreatitis:
Gallstones from the gallbladder can block the pancreatic duct and cause pancreatitis (inflammation of the pancreas) with upper abdominal pain that may radiate to the back, tender abdomen, more pain after eating, with nausea and vomiting.
Ascending cholangitis :
It can cause fever, abdominalpain, jaundice and even hypotension(low blood pressure), and confusion; it is a medical emergency.
Treatment
If you have no gallbladder pain (even if you have gallstones but never had pain), you need no treatment. Some of the patients who had one or two attacks may elect them to avoid treatment. Pain during an acute attack is often treated with morphine. Medical treatments include
Oral bile salt therapy (50% effective)
Ursodiol (Actigall, for example)
Dissolution
Lithotripsy (shock waves)
Complications
The complications of gallbladder pain include discomfort with eating, poor food intake, weight loss, electrolyte abnormalities, consumption of pain medications, and disruption of daily activities. Complications of gallbladder includes in bile duct blockage, serious infections (empyema and gangrene of the gallbladder), pancreatitis, peritonitis, and also infrequently cancer.
Symptoms of a gallbladder problem are-Pain, Vomiting or nausea, Fever or chills, Diarrhea that persists, Jaundice, Unusual stools or urine.
You can live a perfectly normal life if you don't have a gallbladder. Your liver will continue to produce enough bile to digest your food, but instead of storing it in your gallbladder, it will drip continuously into your digestive system.
A gallbladder attack usually begins with a sharp gnawing pain that worsens. It could be in your upper right or centre belly, your back between your shoulder blades, or your right shoulder. You may also vomit or feel nauseous. The pain usually lasts between 20 minutes and an hour.
They eventually cause complications such as inflammation, infection, and pain. Gallstones are commonly the cause of acute cholecystitis. Gallstones are typically very small, measuring only a few millimetres in width. They can, however, grow to be several centimetres long.
When gallstones become lodged in the duct (tube) leading to the stomach, they block the outflow of bile, causing the gallbladder to spasm. This usually causes sharp pain under the rib cage in the upper right side or centre of the abdomen, similar to being cut with a knife.
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