Symptoms of Gallbladder Disease

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The most common symptom of gallbladder disease is pain in the upper right side of the abdomen, where the gallbladder is located. Depending on the type of gallbladder disease present and whether any complications are occurring, a person may also experience fever, nausea, vomiting, and/or jaundice.

The complications of gallbladder disease result mainly from the presence of gallstones and may include an infection of the common bile duct (called ascending cholangitis), inflammation of the pancreas (called pancreatitis), gangrene of the gallbladder (called gangrenous cholecystitis), or a bowel obstruction from a gallstone (called gallstone ileus).

gallbladder disease symptoms
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Frequent Symptoms

Pain in the upper right side of the abdomen is the most common symptom of gallbladder disease and most frequently results from gallstones.

Abdominal Pain

While most gallstones stay in the gallbladder and cause no symptoms, some become lodged in the cystic duct (a tube located at the neck of the gallbladder) or in the common bile duct (a tube that carries bile from the gallbladder to the intestines). This obstruction causes abdominal pain, referred to as biliary colic.

Biliary colic is traditionally described as an intense, dull pain that is constant (not really colicky, despite its name). While the pain is usually located in the upper right side of the abdomen, it's sometimes located in the upper middle part of the abdomen (called the epigastrium) and, less commonly, beneath the breastbone. Sometimes the pain travels (radiates) to the right shoulder blade. Biliary colic occurs in episodes and is often, but not always, triggered by eating a fatty meal.

Besides a gallstone attack, upper right-sided abdominal pain may occur in other gallbladder diseases, such as:

  • Cholecystitis: This condition refers to gallbladder inflammation. While it most commonly occurs as a complication of gallstones (called acute cholecystitis), it may also occur in people without gallstones (called acalculous cholecystitis). Unlike a gallstone attack, the biliary-like pain of cholecystitis lasts longer than six hours and is usually associated with fever and an elevated white blood cell count.
  • Biliary dyskinesia: This condition causes upper abdominal pain and occurs when the sphincter of Oddi (a muscular structure located at the junction where the bile ducts drain into the small intestine) does not function properly, causing bile blockage.
  • Functional gallbladder disorder: In this disorder, a person has no evidence of gallstones or sphincter of Oddi problems but continues to experience episodes of upper abdominal pain.
  • Advanced gallbladder cancer: A person with gallbladder cancer generally does not have symptoms. As the cancer grows, though, pain in the upper right side of the abdomen may occur along with palpable lumps on the belly, jaundice, nausea, fatigue, and weight loss.

    Jaundice

    Jaundice, signaled by yellowing of the whites of the eyes and skin, may occur in gallbladder diseases that obstruct the bile ducts.

    Nausea and Vomiting

    Nausea and vomiting may occur with a gallstone attack but are more commonly seen in cholecystitis (inflammation of the gallbladder) or pancreatitis (inflammation of the pancreas).

    Fever

    Fever should not occur with a gallstone attack but may occur with gallbladder inflammation or with infection/inflammation of the biliary tract.

    Rare Symptoms

    Besides upper right-sided abdominal pain, people have reported other symptoms of gallbladder disease. Due to their atypical nature, though, experts question whether these symptoms are actually part of a coexisting disease; in other words, a person may be experiencing gallstones and another medical condition, like gastroesophageal reflux disease (GERD) or peptic ulcer disease.

    Some of these less common symptoms include:

    • Chest pain
    • Burping
    • Feeling full sooner than usual after eating
    • Regurgitating fluids
    • Bloating
    • Burning sensation behind the breastbone or in the upper central abdomen
    • Nausea and/or vomiting without biliary colic

    Pruritus

    Pruritus (itching) is another symptom, occurring commonly with a condition called primary sclerosis cholangitis, a chronic, inflammatory disease of both the gallbladder and liver. The pruritus is often very debilitating and likely occurs as a result of bile acid accumulation. People with primary sclerosing cholangitis may also experience upper right-sided abdominal pain, jaundice, and fatigue.

    Complications

    There are several complications that may occur as a result of gallbladder disease.

    Acute Cholangitis

    Acute cholangitis is caused by a bacterial infection of the biliary tract in a person with biliary obstruction. In addition to a fever and upper right-sided abdominal pain, a person may experience jaundice, low blood pressure, and confusion.

    Pancreatitis

    Pancreatitis refers to inflammation of the pancreas and most commonly occurs as a complication of gallstones. This is because the gallbladder and pancreas share a bile drainage duct, so an obstructing gallstone can prevent the flow of pancreatic enzymes.

    Symptoms of gallstone pancreatitis include the often rapid onset of severe, epigastric pain, as well as nausea and vomiting. Treatment entails fluids, pain control, monitoring, and removing the blockage. Removal of the gallbladder is also generally done.

    Gangrenous Cholecystitis

    This is the most common complication of cholecystitis, especially in older people, people with diabetes, or people who delay seeking treatment for their gallbladder attacks. Gangrenous cholecystitis is considered a medical emergency, requiring surgical removal of the gallbladder (a cholecystectomy) right away.

    Gallbladder Perforation

    If the gallbladder becomes gangrenous, a perforation (or a hole in the wall of the gallbladder) may develop resulting in a pericholecystic abscess (a collection of pus within the gallbladder). This complication is serious and life-threatening, requiring an emergent cholecystectomy.

    Cholecystoenteric Fistula/Gallstone Ileus

    If a hole (perforation) forms in the gallbladder, a fistula (passage) into the small intestine may develop. If a gallstone passes through the fistula, a bowel obstruction may occur (called gallstone ileus).

    Emphysematous Cholecystitis

    Infection of the wall of the gallbladder with gas-forming bacteria may lead to emphysematous cholecystitis. People most at risk for this gallbladder complication include those of an older age and those with diabetes.

    When to See a Doctor

    If you are experiencing any abdominal pain, it's important to see your doctor for a proper diagnosis. If your doctor diagnoses you with gallstones, he will likely refer you for a surgical evaluation, especially if you are experiencing recurrent episodes of biliary colic.

    If you are experiencing abdominal pain that is severe, persistent, and/or associated with fever, severe nausea, vomiting, and/or jaundice, be sure to seek medical attention right away at the hospital. 

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