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Digestive health centre

Gallbladder pain

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Gallbladder pain symptoms continued...

Acute pancreatitis: Severe abdominal pain just below the ribs that builds up over a couple of days; it can radiate to the back and the abdomen will be tender. The pain increases after eating and there may be nausea and vomiting.

Cholangitis: Upper right abdominal discomfort at first, turning into abdominal pain that can be accompanied by  high fever and chills, itching and  jaundice (yellowing of the eyes and skin). This condition needs emergency medical treatment.

You should seek medical advice immediately if you develop abdominal pain that lasts for more than 8 hours, or if the pain is so intense that you cannot find a position that provides relief, or if you have a high temperature or chills, or if there is jaundice.

Gallbladder tests

Abdominal ultrasound: A non-invasive test in which a probe on the skin bounces high-frequency sound waves off structures in the abdomen. Ultrasound is an excellent test for gallstones and to check the gallbladder wall.

HIDA scan (cholescintigraphy): In this nuclear medicine test, radioactive dye is injected intravenously and is secreted into the bile. Cholecystitis is likely if the scan shows bile doesn’t make it from the liver into the gallbladder.

Cholangiography: This procedure involves injecting dye into your bloodstream, which will concentrate in your gallbladder and bile ducts and show up on an X-ray.

Endoscopic retrograde cholangiopancreatography (ERCP): This procedure also uses dye injected into the bile system ducts, but the doctor uses a flexible tube inserted through the mouth, through the stomach, and into the small intestine. The doctor can see through the tube and inject dye into the bile system ducts. Tiny surgical tools can be used to treat some gallstone conditions during ERCP.

Magnetic resonance cholangiopancreatography (MRCP): An MRI scanner provides high-resolution images of the bile ducts, pancreas and gallbladder. MRCP images help guide further tests and treatments.

Endoscopic ultrasound: A tiny ultrasound probe on the end of a flexible tube is inserted through the mouth to the intestines. Endoscopic ultrasound can help detect choledocholithiasis and gallstone pancreatitis.

Abdominal X-ray: Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect gallstones.

Gallbladder treatments

Gallbladder surgery (cholecystectomy): A surgeon removes the gallbladder, using either laparoscopy (also called “keyhole” surgery, in which several small cuts are made) or laparotomy (traditional “open” surgery with a larger incision).

Antibiotics: Infection may be present during cholecystitis. Though antibiotics don’t typically cure cholecystitis, they can prevent an infection from spreading.

Chemotherapy and radiotherapy: After surgery for gallbladder cancer, chemotherapy and radiotherapy may be used to help prevent cancer from returning.

Ursodeoxycholic acid: In people with problems from gallstones who are not good candidates for surgery, this oral medicine is an option. Ursodeoxycholic acid may help dissolve small cholesterol gallstones and reduce symptoms. Another oral solution is called Chenix.

Extracorporeal shock-wave lithotripsy: High-energy shockwaves are projected from a machine through the abdominal wall, breaking up gallstones. Lithotripsy works best if only a few small gallstones are present.

Contact solvent dissolution: A needle is inserted through the skin into the gallbladder, and chemicals are injected that dissolve gallstones. This technique is rarely used.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on March 31, 2014

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