Can Gallbladder Pain Come and Go (for Weeks or Months)? Gastroenterologist Explains.
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What are the causes of gallbladder pain?
The gallbladder typically presents with biliary colic. The most common cause of gallbladder pain is gallstones. Uncomplicated gallstone disease causes gallbladder pain that comes and goes. However, Complicated gallbladder pain often persists Summary of the causes of gallbladder pain.
- Gallstones (uncomplicated): gallstones are the most common cause of recurrent gallbladder pain.
- Acute cholecystitis: acute inflammation and infection of the gallbladder due to the obstruction of its neck by a stone. The obstruction is often permanent and associated with prolonged gallbladder pain and fever.
- Stone in the bile duct (cholelithiasis): smaller stones can slip into the duct connecting the gallbladder and hepatic ducts to the duodenum. Obstruction of the common bile duct may lead to jaundice and prolonged gallbladder pain.
- Cholangitis: the obstruction of the bile ducts can lead to infection and inflammation in the bile ducts.
- Perforated gallbladder: prolonged or severe acute cholecystitis may lead to the rupture of the gallbladder. It often leads to intolerable abdominal pain.
- Also, Gallstones may obstruct the pancreatic duct (gallstone pancreatitis) and the last part of the small intestine (small intestinal obstruction or gallstone ileus).
Gallbladder pain often is classified into two categories:
1 . Typical Gallbladder pain (biliary colic).
The typical gallbladder pain often comes and goes. The typical gallbladder pain is caused by:
- Uncomplicated gallstones:
- Functional gallbladder pain.
- Sphincter of Oddi dysfunction.
Functional gallbladder pain is defined as typical gallbladder pain without the presence of a stone inside your gallbladder. We still don’t fully understand the mechanism of functional gallbladder pain. However, abnormal motility and contractions of the gallbladder are the most accepted theory. The sphincter of Oddi is a muscle ring at the end of the bile duct opening in the duodenum. Abnormal function or contractions of the sphincter of Oddi may cause typical gallbladder pain. Characters of a typical gallbladder pain (biliary colic):
- Episodes of constant pain: The term (colic) is inaccurate because the biliary colic is often constant, not colicky. The episodes of biliary colics often come and go.
- Trigger: the pain often is triggered by eating fatty meals. However, gallbladder pain can come and go without triggers.
- NOT triggered by movement, and it is not relieved by bowel movement or passage of flatus.
- The character of pain: is intense, dull ache. It increases in intensity gradually and may reach extreme levels (some describe the biliary colic as worse than labor pain.
- Site: Classically, you feel the pain in the right upper quadrant below the rib cage. It commonly spreads to the upper-middle stomach area (epigastrium) and the back (the right shoulder blade).
- Duration of the attack: The pain increases gradually, lasting at least 30 minutes. Often it reaches its maximum intensity and plateaus within an hour; then, it slowly resolves. It can last for up to 6 hours.
- The typical gallbladder pain often comes and goes. But the timing of recurrence of biliary colic is highly variable. For example, you may experience recurrent biliary colic within a few hours, and it may disappear for years.
- Commonly associated symptoms: Nausea after eating, vomiting, excessive sweating during the attack.
2. Complicated Gallbladder pain.
Gallbladder pain may be a result of complicated gallbladder conditions such as:
- Acute cholecystitis.
- Cholidolethiasis and cholangitis.
- A ruptured gallbladder.
The pain from a complicated gallbladder is similar in character and site to the typical biliary colic. Complicated gallbladder pain tends to be more constant (doesn’t come and go) and prolonged. The following are the characters of complicated gallbladder pain:
- It lasts for more than 6 hours: it is often an indication of complicated gallbladder disease. The two most common complications are acute cholecystitis and bile outflow obstruction. The pain is often continuous rather than intermittent.
- Associated with: fever, general ill-looking with biliary colic indicates acute cholecystitis.
- Severe tenderness at the right side below the rib cage (Murphy’s sign).
- Associated with: yellowish discoloration of your skin, eye whites, dark urine, and pale stool are signs of an impacted stone obstructing the bile outflow.
|Typical (uncomplicated) gallbladder pain||Complicated gallbladder pain|
|1. Site||Usually, The right upper quadrant of your abdomen||The same.|
|2. Spread||– The pain may spread to the back of the right shoulder.
– Also, it spreads to the epigastric area.
builds up then disappeared gradually.
|The same, but more severe and more prolonged.|
|4. Duration||At least 30 minutes. It may last up to 6 hours.||It can last more than 6 hours.|
|5. Relation to food||– Triggered by foods (especially fatty food and large meals.
– However, it can start spontaneously.
|Often persistent. regardless of eating.|
|6. Comes and goes?||Yes||No|
|7. Nausea, vomiting.||Often Present.||Present, but very severe and persistent.|
|8. Associated symptoms||– Heartburn and chest pain.
– Bloating, fullness.
– Early satiety.
– Epigastric pain.
|The same, but more severe.|
|9. Fever.||Absent.||Often present.|
|10. Jaundice||Absent||Present with Bile duct stones.|
|11. Murphy’s sign (tenderness over the gallbladder area)||Often absent.||Often present.|
Can gallbladder pain come and go for months?
Gallbladder pain can come and go in attacks for months. The frequent on and off pattern of gallbladder pain is often an indication to consult your doctor. Recurrent or poorly controlled gallbladder pain from gallstone is an indication of gallbladder surgery.
Can gallbladder pain go away and come back after months or years?
Gallbladder pain due to gallstone can go away for long periods. However, it may come back again at any time even after years. The new onset gallbladder pain can be a symptom of complicated gallstones. Check your doctor if you have symptoms of complicated gallstones such as fever, prolonged biliary colic that is not going away, jaundice, or persistent vomiting.