Could Gallstones Be the Cause of Your Stomach Pain?

08/13/2024

Understanding Gallbladder

• The gallbladder is a 3–4-inch small, pear-shaped sac with a muscular wall that is located at the upper right abdomen under the liver. Most of the fluid is removed from the bile here (the liver produces about 0.6 to 1.2 liters of bile in a day), leaving only a few tablespoons of concentrated bile.

• The gallbladder stores the bile (which is a green-yellow fluid produced by the liver) until it is required in the intestine to digest fat. This need is signaled by the hormone cholecystokinin, which is produced when food enters the small intestine.

• The gallbladder contracts and delivers bile into the intestine because of cholecystokinin, which breaks down fatty molecules and helps your body digest fats.

• This part of the digestive process allows the emulsified (broken down) fat, along with important fat-absorbable nutrients (Vitamins A, D, E, and K), to go through the intestinal lining and get into the bloodstream.

What are Gallstones? 

Gallstones are small, hard, pebble-like masses that form in your gallbladder. They are a very common cause of pain in the abdomen, with around 200,000 cases per year in the USA. However, about 10% of people who have been diagnosed with gallstones are likely to develop symptoms within 5 years. Their size can be small, like a grain of sand, or large, like a golf ball. It is possible that someone has gallstones but they do not experience any symptoms.

However, if the stones get stuck in the duct and cause blockage, you may experience symptoms.

What is a Gallbladder Attack?

When gallstones get stuck traveling through the duct to your stomach, they block the outflow of the bile, which causes the gallbladder to spasm. This leads to sharp pain, like being cut by a knife, under the breastbone, in the upper right side, or in the center of the abdomen. A gallbladder attack can be so severe that it can feel like heartburn, a peptic ulcer, or even a heart attack.  

It usually happens after eating a meal because our bodies release bile when we eat food. If you’ve suffered gallbladder attacks in the past, the risks of getting another one are higher. 

Symptoms of Gallstones

About 90% of gallstones cause no symptoms. The chances of developing pain during the first 10 years after gallstones form are very small (2%). After 10 years, the chances of symptoms developing decline. On average, it takes about 8 years for symptoms to develop. Although the cause of the decline in symptoms after 10 years is unknown, some doctors conclude that "newer and younger"  stones may be more likely to cause gallstone symptoms than larger, older ones.

Here are a few symptoms you are most likely to experience if you have gallstones.

Biliary pain or colic: Steady gripping or gnawing moderate to severe ache in the upper right abdomen near the rib cage, which can emit to the upper back. Some people may experience pain behind the breastbone.

Nausea or vomiting may occur. Normal treatments such as over-the-counter medications, changing positions, or reliving gas do not soothe the symptoms. Pain typically disappears after 1 to several hours and may occur at the same time of day, but the frequency can be less than once a week. Large or fatty meals are likely to trigger the pain. It might take several hours or wake the patient at night.

Fatty food dyspepsia: The feeling of ingestion, blenching, flatulence, bloating, and acidity, especially after eating oily foods. Digestive complaints such as blenching, feeling uneasy after meals, bloating, heartburn (a burning sensation behind the Saternum(also known as the breast bone), or hurl (backup acid in the esophagus) might not be caused by gallstones.

Acute cholecystitis: Between 1 to 3% of people with gallstones develop inflammation in the gallbladder. The signs of acute cholecystitis are similar to those of biliary colic but are more severe and persistent.

Patients may also have fever and chills, which are unlikely in biliary colic.

Jaundice: If a gallstone moves out of the gallbladder, enters the bile duct, and blocks the flow of the bile, you may get jaundice. Jaundice leads to the yellowing of the skin and whites of the eyes. 

Diagnosis of Gallstones

The challenge of diagnosing gallstones is to verify that stones, not some other condition, cause the pain in the abdomen. There are so many conditions that have similar symptoms of gallstones that it might be hard for even healthcare professionals to distinguish between them just based on the symptoms you are experiencing. That is why they might recommend some diagnostic tests for you. These tests help your doctor see inside your body and understand the reason behind your pain. These tests may include:

• Ultrasound

• Abdominal CT scan

• Gallbladder radionuclide scan

• Blood tests

The most common and precise method to diagnose gallstones is through an abdominal ultrasound. It will show the stones in the gallbladder. It will also show other unnoticed complications that might have occurred or are about to occur.

Treatment of Gallstones

Gallstones that do not have symptoms or show signs of complications are left alone. Acute gallstone pain is usually treated in hospitals, where diagnostic procedures are completed to rule out other conditions and complications. Treatment will be decided on the size and location of the gallstones.

Gallstone treatment options are as follows:

• Surgery

• Medicines

• Lithotripsy

• Dietary modification

 Around 80% of people with gallstone symptoms will need surgery. Surgeons may remove the entire gallbladder or just the stones from the bile ducts.

Conclusion

Gallstones are common in wealthy countries, affecting 10% to 15% of adults. 90% of gallstones do not cause pain or show other symptoms, so most people with gallstones do not even know they have them. If you notice symptoms that can be related to gallstones, seek medical care immediately, as most of the symptoms related to gallstones are common to many other conditions and can be confusing. Medical professionals can diagnose and understand the cause through some tests. If you are not diagnosed with gallstones, you will be at ease, and if you happen to have gallstones, you will get the proper treatment at the right time.

FAQs

1. What are the first signs of having gallstones? 

• A sharp and severe pain in the mid- or right portion of the abdomen

• Back pain between the shoulders

• Chronic diarrhea

• Jaundice. It causes your eyes and skin to become yellowish.

• Dark urine, lighter stools, or both

• Fever and chills

• Nausea and vomiting

• Rapid heartbeat and sudden blood pressure drop

• Pain in the right shoulder

• Itchy skin

• Intolerance of fatty foods

• Belching or gas

• Loss of appetite

2. What can be mistaken for gallstone pain?

Gallstones have very similar symptoms to other complications. Your body is packed with organs in the stomach area, so it is tough to differentiate between the symptoms of these complications.

Some common mistaken complications for gallstones are: 

• Fatigue and dizziness are caused by low blood pressure. However, low blood pressure can be a side effect of gallstones.

• Heartburn from indigestion

• Heart attack

• Acute appendicitis

• Inflammatory bowel disease (Crohn's disease or ulcerative colitis)

• Pneumonia

• Stomach ulcers

• Gastroesophageal reflux

• Hiatal hernia

• Viral hepatitis

• Kidney stones

• Urinary tract infections

• Diverticulosis or diverticulitis

• Pregnancy complication 

3. What triggers gallstone pain?

You experience gallstone symptoms when gallstones block your bile duct. It can cause your gallbladder to spasm. You may feel sharp stabbing or cutting pain when this happens. Your belly may be hurting so bad that you might experience trouble catching your breath. Gallstone pain may also be triggered by eating fatty foods or after a large meal. It can occur at any time of the day and may wake you up at night.

4. How do you get rid of gallstone pain ASAP?

Once gallstone pain starts, there is nothing you can do to stop it. The pain may last for several hours, but it goes away automatically. You can put on a warm compress to the area where it hurts, drink peppermint tea to relieve the pain, or take a magnesium supplement to empty the gallbladder. If the pain continues, you will need a proper treatment plan. Visit a certified doctor and explain the situation. They will typically perform a surgical treatment that solves the problem permanently.