As a general surgeon, I’ve seen countless patients come into the emergency room clutching their abdomen, pale and sweating, convinced they’re having a heart attack. But often, the culprit isn’t the heart—it’s the gallbladder.
So, what does a gallbladder attack actually feel like?
How to know if you’re having a gallbladder attack
Gallbladder attack pain: sharp, sudden, and unrelenting
A gallbladder attack typically begins with a sudden, intense pain in the upper right side of your abdomen, just beneath the rib cage. Patients describe it as:
- Stabbing or knife-like pain.
- A deep, crushing pressure that radiates to the back or right shoulder blade.
- Unrelenting and constant, lasting anywhere from 30 minutes to several hours.
This is the kind of pain that doesn’t improve with movement, passing gas, or using the bathroom.In fact, deep breathing can make it worse.
What triggers a gallbladder attack?
Most attacks happen shortly after eating, especially meals high in fat. That’s because your gallbladder contracts to release bile that digests fat—and if a gallstone is blocking the bile duct, that contraction becomes a painful spasm.
Other symptoms to watch For
In addition to severe abdominal pain, you might experience:
- Nausea or vomiting
- Fever or chills (a sign of possible infection)
- Jaundice (yellowing of the skin or eyes)
- Dark urine or pale stools
If you’re experiencing these symptoms, especially after a meal, don’t ignore them. These symptoms can indicate a more serious complication, such as a blocked bile duct or gallbladder infection, and require immediate medical attention.
Why it’s often misdiagnosed
The pain from a gallbladder attack can mimic a heart attack or even a severe case of indigestion. Because of this, it’s common for people to delay getting help. That’s why, if you experience severe abdominal pain, it’s always best to seek medical care.
Diagnosing a gallbladder attack
If we suspect a gallbladder attack, we’ll typically order an ultrasound to look for gallstones. If stones are present and causing symptoms, we will provide a range of treatment options.
Do you need surgery for a gallbladder attack?
The choice of treatment will depend on the severity of the symptoms, your overall health, the frequency of attacks, and whether complications, such as infection or inflammation, have developed. Here’s a breakdown of the most common treatment options:
Initial management
The immediate goal is to relieve symptoms and stabilize your condition, which may include:
- Pain management with medications, like nonsteroidal anti-inflammatory drugs or opioids.
- IV fluids to prevent dehydration.
- Antibiotics if there’s evidence of infection (e.g., fever, elevated white blood cell count).
- Fasting to rest the digestive system.
Gallbladder surgery
For symptomatic gallstones and recurrent gallbladder attacks, the standard treatment is Laparoscopic Cholecystectomy (Gallbladder Removal). It’s a minimally invasive surgery with a short recovery time and is usually performed within 24–72 hours of an acute attack.
- Pros: It prevents future attacks and has a low complication rate.
- Cons: As with any surgery, there are risks (e.g., bleeding, infection).
Watchful Waiting
Also known as the “watch and wait” approach, watchful waiting is what we recommend if the attack is mild, your first one, and especially if you have other health conditions that make surgery risky.
- Pros: Avoids surgery if attacks are rare.
- Cons: Risk of recurrence or complications like cholecystitis or pancreatitis.
Non-surgical alternatives
These are less common and used in special cases:
- Oral bile acid pills (e.g., ursodiol) to dissolve cholesterol stones. This option can take months or years and only works for certain types of stones.
- ERCP (Endoscopic Retrograde Cholangiopancreatography) to remove gallstones lodged in the bile duct followed by gallbladder removal to prevent future episodes.
Final thoughts
The good news? You can live a perfectly normal life without your gallbladder. If you’ve ever felt a sharp, unrelenting pain in your upper abdomen, especially after a fatty meal, it might not be something you can walk off. It could be your gallbladder sounding the alarm. Please don’t ignore it. Get evaluated. Your body is trying to tell you something important.
NGHS performs surgery across our five NGMC hospital campuses, to schedule a consultation call 770-285-5950 or visit general surgery.