When to Go to the Hospital for Gallbladder Attack? Gastroenterologist Explains.
Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.
What you need to know:
Go to the hospital for a gallbladder attack if:
- The gallbladder pain lasts for more than six hours.
- You experience severe abdominal tenderness and pain over the gallbladder area.
- You have a fever with gallbladder pain.
- You experience frequent vomiting that lasts for hours.
- You have jaundice (yellow eye whites), dark or tea-colored urine, pale or clay-colored stool.
1. A gallbladder attack that lasts more than 6 hours.
Gallbladder pain is a sign of both uncomplicated and complicated gallstone disease. Uncomplicated gallstone causes a typical form of pain called (biliary colic).
Moreover, a gallstone can cause complications such as (reference):
- Acute cholecystitis: a complete obstruction and subsequent inflammation of the gallbladder.
- Ruptured gallbladder: a complication of severe or neglected acute cholecystitis.
- Colidolithiasis: obstruction of the bile duct connecting the gallbladder to your intestine.
- Gallstone pancreatitis: gallstones can obstruct the pancreatic opening causing acute pancreatitis.
- Other complications such as intestinal obstruction (gallstone ileus), gallbladder cancer, etc.
Uncomplicated gallstone disease.
Gallstones are often asymptomatic. However, uncomplicated gallstones can cause intermittent attacks of gallbladder pain.
The typical gallbladder pain (biliary colic) arising from uncomplicated gallbladder stones characteristics are (reference):
|Biliary colic (Uncomplicated gallstone).||Description|
|1. Site||Usually, The right upper quadrant of your abdomen|
|2. Spread||– The pain may spread to the back of the right shoulder.|
– Also, it spreads to the epigastric area.
|3. Character||Constant builds up then disappears gradually.|
|4. Duration||At least 30 minutes. It may last up to 6 hours.|
|5. Relation to food||– Triggered by foods (especially fatty food and large meals.|
– However, it can start spontaneously.
|6. NOT related to:||Movement, bowel movements, nor the passage of flatus.|
|7. Nausea||Often Present, severe.|
|8- Commonly associated symptoms||Vomiting, sweating during the attack.|
|6. Unusual symptoms.||– Heartburn and chest pain.|
– Bloating, fullness.
– Early satiety.
– Isolated epigastric pain.
|6. Symptoms NOT associated:||– Fever.|
– Prolonged pain for more than 6 hours.
– Extreme tenderness over the gallbladder (Murphy’s sign).
– Vomiting of blood, blackish stool (PUD).
Uncomplicated gallstone causes biliary colic that often lasts an hour or two. Gallbladder pain that lasts six or more hours is often a sign of complication (reference).
You have to go to the hospital if the gallbladder attack lasts for six hours.
Gallbladder pain lasting for more than 6 hours is a sign of either gallbladder inflammation (acute cholecystitis) or bile duct obstruction. The pain is often persistent regardless of eating or fasting.
In such a case, you’ll need urgent medical attention in the emergency hospital room.
What to expect at the hospital:
Your doctor will take a clinical history and perform an examination. If he suspects complicated gallstones, he will order an abdominal ultrasonography scan to confirm the condition.
Gallbladder removal (cholecystectomy) is the ultimate treatment for acute cholecystitis.
But if you have bile duct obstruction with a stone, your doctor may perform a special type of endoscopy called Endoscopic Retrograde Cholangiopancreatography (ERCP) to relieve the obstruction.
2. Severe tenderness over your gallbladder (Peritoneal signs).
Uncomplicated gallstones don’t cause severe tenderness over the gallbladder area. Complicated gallstones cause irritation and inflammation of the peritoneum.
The peritoneum is a double-layered membrane that envelopes your intestinal organs. It gets inflamed with complicated gallbladder stones such as acute cholecystitis and ruptured gallbladder.
Inflammation of the peritoneum produces a group of symptoms called (peritoneal signs).
The presence of peritoneal signs with gallbladder pain is an indication of complication. If the below symptoms/signs present with your gallbladder pain, please go to the hospital to get help.
Peritoneal signs include (reference):
- Extreme pain at your right upper abdomen (over the gallbladder).
- The pain is tender to touch; it greatly increases when you touch or press over the gallbladder area (right upper abdomen just below the ribs).
- Reflex contraction of your abdominal muscles (rigid abdominal muscles).
- The condition is often associated with loss of appetite, fever, nausea, and vomiting.
- The pain is often constant (irrespective of eating), and it doesn’t go away with fasting.
When the above signs are present with gallbladder pain, it is often a sign of complicated gallbladder. Go to the hospital and get immediate medical care.
Fever is a sign of infection (especially bacterial infection) or severe inflammation. A combination of new-onset fever and gallbladder pain is an indication to go to the hospital.
Fever can be a sign of:
- Acute cholecystitis: acute inflammation and infection of the gallbladder due to the obstruction of its neck.
- Acute cholangitis: acute inflammation and/or infection of the bile ducts (often due to its obstruction with a stone).
- Gallbladder rupture.
- Gallstone pancreatitis.
Chills or shivering is a sign of fever. Measure your temperature with a home thermometer if you suspect fever.
4. Persistent vomiting.
Vomiting once or twice with a gallbladder attack is accepted. However, when vomiting becomes persistent for hours, you need to go to the hospital.
The more severe vomiting gets, the more likely you have a complicated gallbladder stone.
5. Dark urine, Yellowish skin, and eye whites.
Gallbladder stones (gallstones) can slip into the main bile duct (common bile duct). Bile is delivered into your intestine (duodenum) through the common bile duct.
When the common bile duct gets obstructed by a stone, it causes a condition called obstructive jaundice (reference).
Sometimes, obstructive jaundice is accompanied by inflammation and/or infection of the bile ducts. A condition called cholangitis.
Bile obstruction is an urgent medical condition; you need to go to the hospital immediately if you have:
- Dark-colored urine (very dark yellow or brown urine).
- Clay stool (pale or greyish stool).
- Yellowish discoloration of your eye whites and skin (jaundice).
- Severe constant gallbladder pain.
- Sometimes, it is associated with fever, vomiting, nausea, and anorexia (loss of appetite).
6. Other indications to go to the hospital.
- Severe abdominal distension, frequent vomiting, and constipation (suspected intestinal obstruction due to gallstone ileus).
- Severe upper-middle abdominal pain referred to the midback (suspected gallstone pancreatitis).
- Arrange a routine visit to your surgeon or gastroenterologist if you experience frequent uncomplicated biliary colic.
- Severe diarrhea or constipation. Blackish stool, vomiting of blood.