I had a gallbladder attack. Now what? 

If you’re reading this, you’ve probably developed some pretty severe abdominal pain. You may have had to call out of work, find someone to take care of your kids, or cancel those plans you were really looking forward to. You may have been to the emergency room or seen by your doctor and had an ultrasound done where gallstones were found.

A gallbladder attack can come on suddenly and be described as severe pain in the upper abdomen. These attacks can come any time and besides being extremely painful, can cause a significant disruption to your life. 

These attacks are usually caused by gallstones and are very common. Patients will often tell us that once they talk about these symptoms with friends and family, they start to realize that this problem has affected many people around them. Many of those people have gone on to have surgery to have their gallbladder removed.  

This article will give you the information you need about what causes gallbladder problems, what symptoms you might experience during an attack, and what treatments are available to you. 


What is the purpose of the gallbladder? 

The gallbladder is located in the right upper abdomen and serves as storage for bile, a liquid used by your body in digestion. Bile is made in the liver and stored in the gallbladder which squeezes in response to eating. When the gallbladder squeezes, bile is delivered into the intestine to mix with food and digest fats. 

While bile is normally liquid, some of the substances that normally make up bile can stick together and form gallstones - the most common stones are formed from cholesterol. The size of these stones can vary from tiny to large and any size stone can cause symptoms. 

Up to 15% of Americans have gallstones but most people don’t have symptoms related to those stones. Most of the time, surgery is not needed unless a person has related symptoms. (Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172-187. doi:10.5009/gnl.2012.6.2.172)


What are the symptoms of a gallbladder attack?

Stones can block the exit of the gallbladder or the ducts that drain the gallbladder. Both circumstances can cause significant pain in the upper abdomen. Pain is commonly in the right upper abdomen but also can occur in the mid upper abdomen, right side, and back. This pain can come on suddenly and last minutes to hours, or even days if the gallbladder becomes inflamed

Because the bile that is stored in the gallbladder is needed for digestion, blockage of the gallbladder can result in digestive symptoms like nausea, bloating, belching, development of foul smelling gas, or irregular bowel movements. 

Unfortunately nothing can be done to stop the symptoms and they usually only resolve once the stone has moved out of a position where it is blocking the gallbladder. Stones sometimes pass through the ducts or move from where they are stuck within the gallbladder. 


How do I know if I’m having a gallbladder attack? 

Sometimes these symptoms can be confusing and if you are having severe unrelenting pain, it is a good idea to go to the emergency room to be evaluated. It can be difficult to determine if your pain is from your gallbladder or if it could be related to other problems like heart attack or other abdominal surgical emergencies. Evaluation by a medical professional can help diagnose the problem. 


What can I do to prevent gallbladder attacks?  

If you have gallstones and gallbladder attacks, there is a good chance you will keep having them. The only thing you can do to limit the likelihood of another attack is to reduce your fatty food intake because eating fatty food stimulates the gallbladder to squeeze. Here is a helpful link for information on how to eat a low fat diet. For some patients, this can provide improvement in symptoms and nothing more is needed. For others, symptoms may continue and further treatment should be considered. 


What treatment is available for gallbladder attacks? 

Gallbladder pain attacks related to gallstones can only really be treated by removing the gallbladder. Removing the gallstones themselves is not done because the gallbladder will just make more stones. Unfortunately, the problem is with the gallbladder itself and the stones are a byproduct of this problem. 

Surgery to remove the gallbladder is usually completed laparoscopically. This is a minimally invasive procedure where tiny incisions (usually 4 incisions) are made in the upper abdomen instead of the larger incision over the gallbladder. These tiny incisions allow the operation to be completed without having to cut muscle. General anesthesia is required to remove the gallbladder. With this laparoscopic approach, patients usually go home the same day they have surgery and have a quicker recovery period with less pain. 


What is recovery like after surgery for gallbladder removal? 


Recovery after laparoscopic cholecystectomy is relatively quick and tolerated very well. Even with small incisions, some pain is normal after surgery and for the most part managed with over the counter pain medications like tylenol and ibuprofen.

It’s a good idea to walk as much as possible after surgery because this reduces risks of complications like pneumonia and blood clots. Some activities will cause pain at your incisions, especially things that strain the core, and these activities should be avoided while they are painful. 

Once the gallbladder is removed, your body adjusts to no longer having the gallbladder as a part of your digestive system. The gallbladder used to act as a storage center for bile. Once removed, your body learns to send bile straight into the intestine to help digest food. This can happen right away after surgery but sometimes can take a couple weeks. This adjustment period can result in some patients having loose bowel movements after eating fatty food in the weeks after surgery. If you have problems with loose bowel movements after gallbladder surgery, consider transitioning to a low fat diet and taking fiber supplements (metamucil and citrucel are some examples). 

Overall, recovery will vary depending on each individual patient but usually patients can get back to work within a week and can be active right away.