Gallbladder Pain Location Diagram, Symptoms, Causes, Relief

Gallbladder pain, as described in this article, can arise from the gallbladder or bile ducts.

The gallbladder is located in the upper right abdomen underneath the lower edge of the liver and the lower border of the rib cage (Diagram 1) ^[1].

Diagram 1. The gallbladder is located
underneath the lower border of the right rib cage.

Where is gallbladder pain felt?

Pain from the gallbladder or bile ducts is usually felt in the upper right abdomen below the rib cage or in the upper central abdomen (Diagram 2) ^[17].

Gallbladder Referred Pain

Gallbladder pain can be referred to the right lower chest, flank, lower back, shoulder or neck, or between the shoulder blades (Diagram 2) ^[17].

Diagram 2. Gallbladder pain and referred pain location

Gallbladder and Chest Pain

Gallbladder problems can cause pain in the lower right or middle chest area, but not likely in the center of the chest. Common causes of upper abdominal pain with central chest pain are gastroesophageal reflux disease (GERD), peptic ulcer or heart disease.

Gallbladder and Back Pain

Gallbladder pain often extends from the right upper abdomen toward the right middle back, between the shoulder blades or into the right shoulder blade. Other common causes of upper abdominal pain and back pain include kidney and liver disease, peptic ulcer and acute pancreatitis.

Gallbladder and Right Shoulder Pain

Gallbladder pain can be referred to the tip of the right shoulder or both shoulders, but not likely only to the left shoulder ^[4]. Shoulder pain arising from the gallbladder is not aggravated by touch or shoulder movements. Other causes of abdominal pain with right shoulder pain include liver or stomach problems, abdominal infections and lung cancer.

Can gallbladder pain be felt on the left side?

Gallbladder pain can extend from the right over the middle toward the left side of the abdomen, but the pain on the left side alone is not typical for gallbladder problems. In a very rare anatomical variant, in which the liver and gallbladder are located on the left side, the pain from gallbladder would be on the left.

What does gallbladder pain feel like?

Characteristics of gallbladder pain ^[2,3,4,13]:

• The pain in the right upper abdomen usually appears suddenly, initially increases in severity and continues as a constant (not crampy) pain that can last from several minutes to few days.
• The pain is usually deep, dull and severe.
• The pain may be aggravated by deep inhalation but not likely by the body movements.
• It can flare up within few hours after a large meal or at any time, commonly at night.
• It is not relieved by antacids, vomiting, passing gas, a bowel movement or by changing body position.
• It is recurrent; it can occur every few days, months or years and there is no pain between the attacks.

How long does gallbladder pain last?

• In gallstones without gallbladder inflammation: several minutes to less than 6 hours ^[2,20]
• In gallbladder inflammation (cholecystitis): 6 hours to few days (but not likely weeks) ^[2]
• In gallbladder dyskinesia and sphincter of Oddi dysfunction: 30 minutes to several hours ^[21]
• In gallbladder cancer: chronic discomfort or dull pain ^[22]

What is gallbladder attack or biliary colic?

The terms gallbladder attack and biliary colic both refer to sudden severe pain arising from the gallbladder or bile ducts ^[16]. Historically, the term biliary colic has been used for pain from gallstones without gallbladder inflammation.

Other Symptoms and Signs of a Gallbladder Disease

Symptoms, other than pain that may appear in a gallbladder disease ^[13]:

• Nausea or vomiting that occurs only when pain occurs
• Fever, jaundice, itchy skin, dark urine and pale stools
• A palpable lump or tenderness in the right upper abdominal quadrant

Indigestion, dyspepsia after fatty meals, abdominal bloating, excessive belching, heartburn, constipation or diarrhea are not specific for a gallbladder disease – they can also occur in other abdominal disorders ^[2,4,13]. Gallbladder disorders do not seem to be directly connected with a headache, but some people believe they can trigger a migraine.

Chart 1: *RUQ = right upper abdominal quadrant

Gallbladder Pain Without Stones

Gallbladder pain without gallstones can appear in:

• Acute acalculous cholecystitis, usually related to severe disease or surgery
• Gallbladder dyskinesia
• Sphincter of Oddi dysfunction
• Gallbladder cancer

Diagnosis

Abdominal ultrasound can reveal:

• Gallbladder stones as small as 2 mm in 95% cases and, sometimes, stones in the common bile duct
• Acute or chronic cholecystitis, gallbladder polyps and cancer ^[2]

Endoscopic ultrasound–via the tube inserted through the mouth into the intestine–can reveal stones in the common bile duct and biliary sludge ^[6].

Magnetic resonance imaging (MRI) can show biliary sludge, gallbladder polyps and cancer.

Magnetic resonance cholangiopancreatography (MRCP) can show stones, tumors and inflammation in the common bile duct ^[2,12,13].

Endoscopic retrograde cholangiopancreatography (ERCP) can reveal stones in the bile duct and enables their removal, drainage of the infected duct and cutting the sphincter of Oddi.

X-ray shows gallstones in only up to 20% cases and CT scan in up to 80% cases ^[15].

Hepatobiliary scintigraphy (HIDA scan) is used to evaluate the gallbladder filling and emptying in gallstones or gallbladder dyskinesia; no filling or poor emptying (ejection fraction <40%) is an indication for the gallbladder removal.

Blood tests may show:

• Increased white blood cells: in cholecystitis and cholangitis
• Increased liver enzymes or bilirubin: in bile duct obstruction

Gallbladder Pain Treatment

Analgesics

Analgesics for either mild or severe pain should be tried in this order ^[11,18]:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs):
   • Ibuprofen
   • Diclofenac (intramuscular injection or a suppository)
   • Ketorolac
2. Narcotic analgesics:
   • Meperidine
   • Codeine, hydrocodone or oxycodone + paracetamol
   • Morphine or pethidine (intramuscular injection)
3. Antispasmodics:
   • Dicyclomine
   • Butylscopolamine (hyoscine butylbromide)

Note, that analgesics can have significant side effects: NSAIDs may cause or worsen peptic ulcer and opiates can cause constipation, nausea and drowsiness.

In the third trimester of pregnancy, certain nonsteroidal anti-inflammatory drugs or NSAIDs (diclofenac, ibuprofen, indomethacin, ketorolac, naproxen) should be avoided because they may cause birth defects, but aspirin, paracetamol and opiates (codeine, fentanyl, morphine, pethidine) appear to be safe ^[7,8].

Fasting

To prevent additional pain from gallbladder contractions during gallbladder attack, do not eat anything and drink only plain water ^[10].

Diet

There are no specific foods to eat or avoid that would prevent gallbladder pain. Avoiding large, especially fatty, meals ^[16] and coffee ^[19] may help prevent recurrent pain attacks caused by gallstones.

Avoiding Stress

In some individuals diagnosed with gallbladder dyskinesia or sphincter of Oddi dysfunction, avoiding stress and learning how to cope with it can prevent pain.

Home Remedies

Remedies that may help relieve gallbladder pain, according to anecdotal reports:

• A heating pad or castor oil compress
• Hot bath

There is no reliable scientific evidence that gallbladder flush or cleanse using the following herbs or beverages helps to ease gallbladder pain ^[9,14]: alfalfa, apple cider vinegar, apple juice, a mixture of beet, carrot and cucumber juice, barberry bark, calendula, catnip, chamomile tea, chicory, dandelion, Epsom salt, fennel seed, garlic, ginger, goldenseal, honey with turmeric, lemonade, milk thistle, nettle, olive oil, peppermint tea, psyllium, quebra pedra, rosemary, salt water, St. John’s Wort, wild yam root, yellow dock and yellow root.

Surgical Gallbladder Removal (Cholecystectomy)

Gallstones that cause recurrent pain or inflammation, and gallbladder cancer are treated by gallbladder removal.

• References
  1. Gallbladder  InnerBody
  2. Steel PAD, Acute Cholecystitis and Biliary Colic  Emedicine
  3. Heuman DM, Gallstones (Cholelithiasis)  Emedicine
  4. Heuman DM, Gallstones (Cholelithiasis), Clinical Presentation  Emedicine
  5. Gallstones and cholecystitis  Patient.info
  6. Rana SR et al, 2012, Role of endoscopic ultrasound in idiopathic acute pancreatitis with negative ultrasound, computed tomography, and magnetic resonance cholangiopancreatography  PubMed Central
  7. Babb M et al, 2010, Treating pain during pregnancy  PubMed Central
  8. Kennedy D et al, 2011, Analgesics and pain relief in pregnancy and breastfeeding  Australian Prescriber
  9. Picco MF, What is a gallbladder cleanse? Is it an effective way to flush out gallstones?  Mayo Clinic
  10. Acute cholecystitis  NHS. uk
  11. 2014, Biliary colic and complications from gallstones  The Best Practice Advocacy Centre New Zealand
  12. Heuman DM; Gallstones (Cholelithiasis), Workup  Emedicine
  13. Gallstones  Merck Manuals Home Edition
  14. Nutritional Approaches to Prevention and Treatment of Gallstones  Alternative Medicine Review
  15. Brunetti JC, Imaging of Gallstones (Cholelithiasis)  Emedicine
  16. Gallstones  NIDDK
  17. Gallstones symptoms and causes  Mayo Clinic
  18. Johnston MJ et al, 2013, Outpatient management of biliary colic: A prospective observational study of prescribing habits and analgesia effectiveness  ScienceDirect
  19. Douglas BR et al, 1990, Coffee stimulation of cholecystokinin release and gallbladder contraction in humans  PubMed
  20. Gallstones  Merck Manuals Home Edition
  21. Zakko SF et al, 2016, Functional gallbladder disorder in adults  UpToDate
  22. Denshaw-Burke M, Gallbladder Cancer, Clinical Presentation  Emedicine

What Does Gallbladder Pain Feel Like: Location, Duration, and More

Gallbladder pain can be sudden, intense, and severe.

The most common reason for the pain is gallstones — hardened deposits of digestive fluid that can form inside your gallbladder. Inflammation or infection of your gallbladder are other possible culprits.

The good news is there are treatments to effectively relieve gallbladder pain.

Read on to learn more about what gallbladder pain feels like and how to alleviate the discomfort.

Your gallbladder is a small sac that’s located in your right upper abdomen, just below your liver. According to the Canadian Society for Intestinal Research, your gallbladder stores bile — a digestive fluid — that’s made by your liver.

Gallstone pain

Bile helps break down fats during digestion and is made up of different substances, such as:

• cholesterol
• salts
• water

Your liver continually makes bile until you consume food. When you eat, your stomach releases a hormone that causes muscles around your gallbladder to release the bile.

Gallbladder pain is an indication that something isn’t right.

When gallstones cause a blockage of one of the ducts that move bile, they can trigger sudden and escalating pain, which is sometimes dubbed a “gallstone attack.”

Pain location

The pain is usually felt in your upper right abdomen but can spread to your upper back or shoulder blade.

Some people also experience pain in the center of their abdomen, just below their breastbone. This discomfort can last several minutes to a few hours.

A 2012 research review showed that up to 15 percent of adults in the United States have or will have gallstones.

Gallstones don’t always lead to pain. According to the Canadian Society of Intestinal Research, studies show that about 50 percent of patients with gallstones don’t experience symptoms.

Gallbladder inflammation pain

Inflammation of your gallbladder, a condition called cholecystitis, commonly happens when gallstones block the tube leading out of your gallbladder. This produces bile buildup, which can cause inflammation.

Other conditions can also trigger inflammation of your gallbladder, including:

• tumors
• serious illnesses
• bile duct problems
• certain infections

Symptoms of cholecystitis may include:

• severe pain in your upper right abdomen or center of your abdomen
• pain that spreads to your right shoulder or back
• tenderness above your abdomen
• nausea or vomiting
• fever

These symptoms often happen after eating, especially following a large or fatty meal. If untreated, cholecystitis can lead to serious, even life threatening complications, such as:

• a gallbladder rupture (where your gallbladder wall leaks or bursts)
• infection
• gangrene (when tissue in your gallbladder dies)

Gallbladder infection pain

A gallbladder infection is another condition that can occur when a gallstone causes an obstruction. When the bile builds up, it can become infected and lead to a rupture or abscess.

Symptoms of a gallbladder infection may include:

• abdominal pain
• fever
• trouble breathing
• confusion

According to Johns Hopkins Medicine and the Canadian Society of Intestinal Research, if you’re having a gallstone attack, you may also experience other symptoms, such as:

• nausea or vomiting
• tenderness in the area surrounding your gallbladder
• low-grade fever
• light-colored stool
• brownish-colored urine
• yellowing or discoloration of your skin or whites of your eyes

According to the National Organization for Rare Disorders, other conditions may cause symptoms that feel similar to gallbladder pain. Some of these include:

• Gallbladder cancer. Gallbladder cancer can cause abdominal pain, itching, bloating, and fever. Imaging tests may help your doctor determine if the pain you feel is due to cancer or gallstones.
• Appendicitis. Appendicitis typically causes pain in the lower right side of your abdomen, while you can usually feel gallbladder pain in the upper to the mid-right area, towards your back.
• Heart attack. According to Johns Hopkins Medicine, sometimes, people mistake gallbladder pain for symptoms of a heart attack. Other heart attack symptoms include shortness of breath, chest pain, weakness, and jaw, neck, or back pain.
• Pancreatitis. Pancreatitis is inflammation of your pancreas. This condition may cause pain that feels similar to a gallbladder attack. But with pancreatitis, you may also experience other symptoms, such as weight loss, a fast heart rate, and oily or foul-smelling stools, according to the University of Iowa.
• Ulcers. Sometimes, ulcers can cause abdominal pain, but they can also trigger burning stomach pain, bloating, a fullness feeling, burping, heartburn, and other symptoms.
• Inflammatory bowel diseases. Certain bowel diseases may mimic signs of gallbladder pain, but they also cause diarrhea, bloody stool, and weight loss.
• Gastroenteritis. Also known as the “stomach flu,” gastroenteritis may be mistaken for a gallbladder issue. Symptoms such as nausea, vomiting, watery diarrhea, and cramping are hallmarks of the stomach flu.
• Kidney stones. Kidney stones can cause sharp pains in your abdomen, side, and back. You might also have pink, red, or brown urine, foul-smelling urine, cloudy urine, or a constant need to urinate.

You should call your doctor if you have any symptoms of gallbladder pain that concern you.

Certain complications of a gallstone attack can be serious or life threatening. You should seek immediate medical care if you develop:

• severe abdominal pain
• yellowing or discoloration of your skin or whites of your eyes
• a high fever with chills

Doctors may perform different tests to diagnose your condition, including an:

• ultrasound
• blood test
• another type of imaging test

According to Johns Hopkins Medicine, there’s not much you can do to stop a gallbladder attack while it’s happening.

You may want to apply a heated compress to the area to relieve the discomfort. Usually, the pain will ease once the gallstone has passed.

Traditional treatment options for gallbladder attack include surgery to remove your gallbladder or medicines to help dissolve the gallstones.

You might be able to prevent a gallstone attack by reducing your fatty food intake and maintaining a healthy weight.

Some other measures that could lower your chances of having gallbladder pain include:

• Eating on a schedule. Skipping meals or fasting may increase the risk of gallstones.
• Eat more fiber. Foods like veggies, fruits, and whole grains contain lots of fiber.
• Try to lose weight slowly. If you lose weight too quickly, you’re at an increased risk for developing gallstones. Aim for 1 to 2 pounds a week.
• Exercise. According to the Canadian Society for Intestinal Research, studies show that regular physical activity can lessen your chances of gallstones.
• Check your meds. Some medicines, such as postmenopausal hormones, may boost the risk of gallbladder disease.
• Try magnesium. Studies suggest that males who consume the most magnesium have a lower risk of developing gallstone disease.

Gallbladder pain is usually caused by gallstones that block bile ducts. This common condition can cause severe pain.

For some people, the discomfort will go away on its own. Others may need treatments or surgery to remove their gallbladder. You can function well and live a full life without a gallbladder.

causes, MRI diagnosis of pain in the gallbladder

Pain in the gallbladder: causes, MRI diagnosis of pain in the gallbladder

1. MRI 24
2. Articles
3. org/ListItem”> Causes of gallbladder pain

MRI of the gallbladder

To begin with, it is necessary to correctly determine the location of the gallbladder. On the right side under the ribs is the liver, its lower part falls on the level of the last rib, without going beyond it. It is in this place that there is a small hole, which is a house for the gallbladder. Even with a slight failure in his work, a person feels discomfort and pain under the right rib.

In some cases, the nature of the pain is sharp, aggressive, it begins suddenly and has such strength that a person cannot restrain a cry during an attack (this condition is called hepatic or biliary colic). The causes of such pain may indicate the presence of stones that form congestion, constriction of the gallbladder. Sometimes this condition is accompanied by a high temperature (40 °), vomiting and incessant nausea. The attack can last from several minutes to several hours and stops as suddenly as it began.

If the pain is dull, muffled, disturbs irregularly, then this may indicate inflammatory diseases of the gallbladder.

Determining the nature of pain and its localization in diseases of this area is quite easy, so it is important to remember all the sensations and be ready to accurately describe them to a specialist.

Cholelithiasis

• chronic cholecystitis. This is an inflammatory disease more common in women than in men. It can occur as a result of bacterial damage, and be of a toxic and allergic nature. Pain in chronic cholecystitis is most often dull, aching, occurs regularly, usually a couple of hours after eating. Sometimes attacks are accompanied by bitter taste in the mouth, flatulence, nausea and insomnia.
• cholelithiasis. This pathology occurs due to the formation of cholesterol with a decrease in the secretion of bile acids and phospholipids. Salt stones are formed. An important role here is played by a hereditary risk factor, obesity and diabetes mellitus. Gallstone disease can hide and be asymptomatic for many years, after which biliary colic begins, the symptoms of which are described above.
• cholesterosis. The disease in most cases develops in middle-aged overweight women. This is due to a pronounced violation of the metabolism of fats in the body and an excess of cholesterol in the blood. It is he who is deposited on the walls of the gallbladder, causing regular dull aching pains in the right hypochondrium, which are aggravated by physical exertion, fast walking and uneven driving.
• diseases of parasitic origin. Most common in childhood and adolescence. The gallbladder is affected by giardiasis, fascioliasis, ascariasis and other parasitic pathologies. In addition to pain, there is a malfunction in the intestines, in some cases weight loss, fever, itching and chills.
• benign/malignant tumors of the gallbladder. Clinical symptoms may be completely absent, which is the main obstacle to timely diagnosis. The most common cancer is gallbladder cancer. It accounts for about 8% of all cancers.

Be sure to see a doctor if you experience these symptoms:

• discomfort or pain in the right hypochondrium
• pain radiating to the right shoulder or to the area between the shoulder blades
• regular feeling of nausea
• bitter or metallic taste in the mouth
• visible plaque in the area of ​​the tongue, its redness
• Urine bright yellow, cloudy

Remember, even minor malfunctions of the gallbladder lead to a disruption in the functioning of natural detoxification. Toxic substances accumulate, and their decay begins to damage healthy organs.

If you have problems with your gallbladder, see a gastroenterologist or general practitioner.

If there is no time for doctors – do an MRI of the gallbladder and its ducts. This type of diagnosis will give 95% accuracy, and the MRI doctor will give a complete conclusion on the state of the gallbladder.

MRI feature:

• full safety
• shots in 30 minutes
• 95% image accuracy (ultrasound – up to 65%).

Make an MRI of the gallbladder in Moscow >>>

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• Shaunswors • 11/15/2021

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• Ivan • 09/29/2016

  What diseases can be detected by MRI of the gallbladder?

  Ivan, hello.
  MRI of the gallbladder can reveal stones, polyps, changes in the shape, size and structure of the organ, neoplasms, inflammatory processes.

  Best regards, Kulikova O.E., radiologist of the highest category.

• Vladimir • 09/28/2016

  Hello, is there a way to get rid of gallstones without surgery?? I was diagnosed with such a diagnosis, and I am very afraid of the operation, tell me please.

  Vladimir, hello.
  Gallbladder stones come in many types, compositions, sizes, shapes and numbers. Operative or medical tactics of treatment depends not only on the characteristics of the stones, but also on the presence of complications, concomitant diseases and many other factors. In some cases, it is possible to dissolve or grind stones with therapeutic methods. But this question you should consider at the doctor’s appointment.

  Best regards, Kulikova O.E., radiologist of the highest category.

About the author

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Pathologies of the biliary (biliary) system – symptoms, diagnosis, treatment at NCC No. 2 (CCH RAS)

Biliary dyskinesia is a violation of the outflow of bile from the liver through the biliary tract. The main symptom of the pathology of the biliary (biliary) system is pain in the right hypochondrium and epigastric region.

Causes of pain in the right hypochondrium

Most often, the causes of this condition are a spasm of the smooth muscles of the gallbladder and its sphincters, as well as an increase in pressure in the biliary tract. This happens due to the following factors:

• inflammatory changes in the gallbladder and its ducts

• biliary tract motility disorder

• exposure to the contents of the gallbladder cavity, which fills most of the lumen of the organ (suspension, internal inclusions and other dense structures).

Also, the motor reaction of the gallbladder (GB) and the sphincter of Oddi depends on the emotional state of the person, the quantity and quality of the food he takes.

Types of violations

In case of violation of the motor activity or motility of the gallbladder, its ducts and sphincters, clinical symptoms will be characteristic of both organic pathology (changes in the organ itself) and functional (disturbances in the function of the organ).

There are primary and secondary dysfunctional disorders:

1. Primary. Most often, they occur in connection with a decrease in the muscle mass of the gallbladder, a decrease in its sensitivity to nerve impulses, or an identified genetic predisposition.

2. Acquired. They are found in inflammatory, dystrophic and metabolic disorders in the body.

Secondary (acquired) dysfunctional disorders of the biliary tract can be observed in hormonal disorders, including premenstrual syndrome, pregnancy, systemic diseases, diabetes and hepatitis.

Inflammatory processes in the liver lead to disturbances in the rhythmic activity of the biliary system, leading to a decrease in the formation of bile, a noticeable decrease in pressure in the ductal system and the gallbladder. In this regard, there is a constant spasm and contraction of the sphincter of Oddi.

Various surgical interventions (cholecystectomy, resection of the stomach) in history can also cause biliary motility disorders.

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Symptoms of biliary tract disease

Common symptoms found in various forms of gallbladder dysfunction are bitterness in the mouth, bloating, and loose stools. But most often, dysfunctional disorders of the biliary tract are complex and manifest as:

• colicky pains spreading to the right half of the abdomen, back and left hypochondrium (with the participation of the ductal system of the pancreas)

• frequent manifestations of irritability of the gallbladder

• dull pain in the right hypochondrium, a feeling of pressure, fullness, aggravated by a change in body position (more typical for hypofunction of the gallbladder).

For episodes of severe persistent pain in the gallbladder or in the upper midline and right upper quadrant of the abdomen, the following features are characteristic:

• duration of pain and discomfort up to 20 minutes

• more than two episodes per year

• are permanent aching pains after errors in diet and physical activity with a decrease in daily activity.

Severe pain associated with emotional outbursts are direct indicators of gallbladder disease.

Gallbladder dyskinesia is manifested by the presence of one or more syndromes:

1. Pain.

2. Syndrome of biliary dyspepsia (impaired outflow of bile).

3. Inflammatory (with exacerbation of chronic cholecystitis).

4. Involvement in the process of other organs and systems.

5. Astheno-neurotic (psycho-emotional).

Signs of biliary dyskinesia (BDD) on ultrasound

It is possible to determine the degree of contractility and motor ability of the gallbladder of the bile ducts and to see the signs of JVP on ultrasound with an ultrasound examination of the contractile function of the gallbladder. The high accuracy of the method allows obtaining valuable information for gastroenterologists when making a clinical diagnosis and the need to prescribe drug therapy.