A concerning and fairly common cause of abdominal pain is a problem with the gallbladder. The gallbladder is in the upper right part of the abdomen and is responsible for aiding digestion.
Usually, bile is produced by the liver and drains through a tube into the gallbladder where it is stored until needed. Bile is useful in the digestion of fatty foods. When a fatty meal has been eaten, a signal is sent to the gallbladder to squeeze bile into the intestine to assist with the digestive process.
Gallbladder problems usually begin when bile stored in the gallbladder begins to thicken or even crystallize to form a stone or several stones. Stones in the gallbladder can, in turn, get caught in the opening of the gallbladder. If this occurs, when the gallbladder squeezes, pressure can build up, resulting in pain.
Gallbladder pain is commonly episodic, meaning that it occurs briefly and then resolves, only to reoccur later. The pain itself is commonly located in the right upper part of the abdomen, and it commonly moves to the right flank or right side of the back. Occasionally, people may experience pain in the pit of the stomach or in the lower chest.
Pain from gallstones often occurs soon after a fatty meal. Sufferers may recall eating greasy foods like meat or fried foods up to an hour before the pain strikes.
The pain is rarely helped by over-the-counter pain medications or antacids.
Rarely, gallstones may lead to chronic inflammation and thickening of the lining of the gallbladder. Rarer still is the occurrence of infection in the gallbladder, which is considered a surgical emergency, since such infections can perforate the gallbladder or spread into the bloodstream. Infection occurs when bacteria enter the gallbladder and then cannot get out because of the blockage from a stone. When infection occurs, pain is often both severe and constant. It may be accompanied by fever or general illness.
Other complications of gallstones include passage of the stone into the tube that drains the gallbladder and pancreas into the intestines. Blockage of this tube by the stone can lead to pancreatitis.
The treatment of gallstones often involves surgical removal of the gallbladder along with the stones. Usually, this is done through a small incision in the abdomen to allow placement of a camera and instruments inside the patient to remove the gallbladder. It is not possible to remove the stones surgically from the gallbladder without also removing the gallbladder itself.
In anticipation of gallbladder removal, symptoms may be alleviated by eating a bland diet with specific avoidance of fatty foods. Prescription pain medications are also sometimes recommended.
People with severe abdominal pain or pain accompanied by fever should seek immediate medical attention.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.
