Gallbladder Pain: Reasons Why Your Belly Hurts

Medically Reviewed by Zilpah Sheikh, MD on March 22, 2024
11 min read

Your gallbladder is a small, pear-shaped organ that’s tucked below your liver. You probably don’t think much about it -- until it hurts.

The gallbladder stores and releases bile, a greenish-colored fluid that helps your body digest fats. Whenever you eat, your gallbladder contracts and releases the bile. The bile then flows to your small intestine, the duodenum.

When something goes wrong with your gallbladder or the bile ducts, the upper right side of your abdomen may hurt. You may also feel:

  • Pain in your back or chest, especially when you take deep breaths
  • Feverish
  • Like throwing up
  • Bloated
  • Itchy
  • Tired

Other common symptoms include yellow skin and eyes (known as jaundice), weight loss, and color changes in your urine or bowel movements.

You have several organs in your abdomen, and if you have pain in that area, it can be challenging to figure out what's causing it. Here are some conditions that could mimic gallbladder pain:

Pancreatitis. Your pancreas is in the back of your abdomen, near the duodenum. If it’s inflamed, it can cause abdominal pain similar to gallbladder pain. The main difference, however, is that with pancreatitis, you usually also have nausea, vomiting, and unexplained weight loss. Your heart may race and your bowel movements may be foul-smelling.

Kidney stones. Although your kidneys are at the back, kidney stones can cause abdominal pain as well as back pain. You may notice that your urine is a different color than usual (red, brown, or pink), and it may be cloudy or foul-smelling.

Stomach ulcers. Pain in your stomach from an ulcer may feel like gallbladder pain, but you would also probably feel bloated. You may also have heartburn and burp a lot.

Inflammatory bowel disease, or IBD (Crohn’s disease or colitis). IBD can cause abdominal pain, but it usually causes diarrhea too. You may see blood in your bowel movements and lose weight unintentionally.

Gastroenteritis. This infection in your gut, sometimes called stomach flu, can cause the same types of symptoms as gallbladder pain, except it usually also causes diarrhea, nausea, vomiting, and cramping.

There are several reasons why you may feel gallbladder pain. They include:

Gallstones

This is the top reason for gallbladder pain. You get them when bile clumps together into hard masses. Gallstones can vary in size, ranging from tiny specks to as large as a golf ball. If they get big enough, these stones can block bile from flowing out. That can lead to a gallstone attack, which may feel like a sudden pain in the upper right part of your belly.

These attacks often happen after a big steak dinner or other fatty meals, and they can last many hours. But most people who have gallstones don’t know it. These “silent” stones don’t cause problems in your organs. Diagnostic tests such as ultrasound, magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), blood tests, or other imaging tests can show if you have gallstones. Your doctor can get rid of them with surgery, medication, or even shockwaves.

Bile duct stones

These are either gallstones that get stuck in your bile ducts or stones that form there. They may give you no trouble until they block the bile ducts. Then you might have serious pain in your belly that comes and goes for hours at a time. Your skin and eyes might turn yellow, and you might feel like throwing up. Your doctor can remove the bile duct stones by threading an endoscope (a thin tube with a light at the end) through your mouth down to the bile ducts.

Perforated gallbladder

This can happen when your gallstones over time cause a hole in the walls of your organ. It’s rare, but it can be deadly. The upper right part of your belly might hurt. You also may have a high fever, nausea, and vomiting. You’ll need medical treatment or surgery right away.

Gallbladder abscess(empyema)

Empyema of the gallbladder is caused by an infection from the buildup of bile resulting from duct obstruction (including gallstones). The infection may resist treatment with antibiotics, and the abscess may need to be drained. A serious abscess can result in a tear, allowing the infection to enter the inside lining of the abdomen (peritonitis).

Gallbladder inflammation

Also called cholecystitis, gallbladder inflammation can happen for several reasons, including trauma, illness, infection, or tumors. It may also result from bile buildup in your gallbladder due to gallstones. Less often, other culprits can include certain bacteria or problems in your bile ducts. When your gallbladder gets inflamed and swollen, symptoms include pain in your belly, including the area just above your stomach. You also may feel an ache in your back or right shoulder blade.

Usually, an ultrasound and other imaging tests can diagnose it. You may need surgery to remove your gallbladder. (Your body can work fine without it.) Without treatment, the organ can burst.

Primary sclerosing cholangitis (PSC)

PSC is a liver disease that damages your bile ducts. It’s progressive, meaning it gets worse over time. About 4 out of 5 people who have PSC also have inflammatory bowel disease. PSC can lead to liver failure. Many people have no symptoms. You might feel tired or have pain in the upper right side of your abdomen or itchy skin. This condition is often found when routine blood tests show your liver isn’t working right.

Gallbladder cancer

Gallbladder cancer is rare and hard to diagnose. More often than not, you won’t have symptoms until the cancer has spread. Signs may include abdominal pain, especially on the upper right side, as well as weight loss, jaundice, and belly bloating. A family history of gallstones; being older, female, or obese; and eating unhealthy foods can make you more likely to get cancer in the gallbladder.

Bile duct cancer

You may not have symptoms in the early stages of this cancer. If you do, it’s often because the bile duct is blocked. Jaundice is the most common symptom, along with itchy skin and light-colored or greasy poop. If your tumors are big enough, you may have belly pain, especially below your ribs on the right side. Surgery gives you the best chance at a cure. But most bile duct cancers are found too late for that. In that case, you may need radiation or chemotherapy to shrink the tumors first.

Bile duct scars

Narrowed bile ducts from scar tissue can keep the bile from flowing out of your liver and gallbladder into the small intestine. That can make you hurt on the right side of your abdomen where the organs are. You also might feel itchy or tired, have a lack of appetite, and get jaundice, night sweats, or fever.

Several things can cause the scars, including bile duct stones, injury, infections, alcohol and drugs. Your doctor can confirm it with a procedure called endoscopic retrograde cholangiopancreatography (ERCP), which gives them an inside peek into your bile and pancreatic ducts.

Some of the more minor complications include:

  • Trouble eating
  • Weight loss
  • Electrolyte abnormalities
  • Consumption of pain medications
  • Disruption of daily activities

More serious complications of gallbladder disease include:

  • Bile duct blockage
  • Infections, such as peritonitis
  • Empyema
  • Gangrene of the gallbladder (parts of the gallbladder tissue die off)
  • Pancreatitis
  • Cirrhosis of the liver
  • Gallbladder rupture
  • Gallbladder cancer (rarely)

Gallbladder pain treatment depends on what’s causing the pain in the first place. If you think you have gallbladder pain, you should speak with your doctor as soon as possible. This is important so you can be diagnosed as early as possible to prevent complications.

In the meantime, you may want to try some home treatments to ease the gallbladder pain. You can:

  • Apply a warm compress to the painful area. If you use a heating pad, ensure it’s not too hot. If you use a hot water bottle, ensure it’s not damaged before filling it with water, to prevent burns.
  • Drink peppermint tea. The warmth and the peppermint may help soothe the pain.
  • Take a magnesium supplement. People with diabetes, intestinal diseases, heart disease, or kidney disease should always check with their doctor before taking a magnesium supplement.
  • Sleep on your left side so your gallbladder isn’t compressed.

Once you’ve seen your doctor, other options for gallbladder pain treatment may be:

  • Pain medications
  • Antibiotics, if the gallbladder pain is caused by a bacterial infection
  • Endoscopy, where a small tube is inserted through your mouth and into your digestive system until it reaches your gallbladder. Your doctor would be able to remove small gallstones from the ducts, take tissue samples for testing, or place a stent (a tiny tube) to open the ducts.

If these treatments don’t work or aren’t an option, your doctor may refer you to a surgeon for surgery to remove your gallbladder.

If you have a lot of gallstones that can’t be removed, your gallbladder is inflamed or infected (called cholecystitis), or you have cancer, you might need a gallbladder removal (cholecystectomy).

This surgery can be done in one of three ways:

Laparoscopic. Most cholecystectomies are done this way now because it’s easier on the patient and has fewer complications. Instead of one large incision (cut), laparoscopic surgery is done through three or four small incisions. Using long-handled tools, one that has a camera on the end (laparoscope), the surgeon can look on a screen to see inside the abdomen and remove the gallbladder through one of the incisions. A laparoscopic cholecystectomy is called a minimally invasive surgery.

Open. Before laparoscopic gallbladder removal, open surgeries were the only way to remove the gallbladder. Now, they’re done only if the gallbladder disease is too complicated or if your doctor suspects you may have cancer. Your surgeon would make one large incision, about 4-6 inches long, to get to your gallbladder. Recovery from this type of surgery takes longer.

Robotic. A newer way to remove a gallbladder, robotic surgery is another type of minimally invasive surgery. Long-handled surgical tools and a camera are inserted in small incisions, just like with laparoscopic surgery. However, instead of the surgeon using the tools, the tools are controlled by the surgeon at a computer console. The advantage of robotic surgery is that the tools can bend and move in ways a surgeon’s hands can’t.

Gallbladder pain after removal

You may expect to not have gallbladder pain after it’s been removed, but there is a condition called post-cholecystectomy syndrome that affects up to 40% of people who have the surgery.

If you have this syndrome, you may feel much like you did before the surgery. You can have abdominal pain, nausea, and vomiting. Doctors don’t know for sure what causes the syndrome. But many think it’s caused by bile that leaks into the stomach and the surrounding area, or stones that are still in the bile ducts. The symptoms don’t last long for most people, but they can last longer (for many months) in a few. If it’s too severe or lasts long, you may need another surgery so the doctor can find out what's causing the pain.

Lifestyle changes can help keep your gallbladder healthy.

Refresh your diet. Here are some recommendations:

Eat more:

  • Fiber, which is found in foods such as potatoes (with skin), brown rice, lentils, black beans, and almonds
  • Lean meats and fish
  • Fruits and vegetables
  • Whole grains, such as barley, quinoa, oatmeal, whole wheat flour, and whole wheat pastas and cereals
  • Low-fat dairy products

Try to cut back on foods that may cause gallbladder pain:

  • Saturated fats (found in foods such as butter, cream, cheese, palm oil, and coconut oil)
  • Sugar
  • Salt/sodium (sodium can hide in many popular foods, particularly canned and processed foods)
  • Red meat
  • Fried foods

Problems with your gallbladder often can be traced back to too much cholesterol -- a fat from meat, dairy, and other animal sources. But don’t be afraid of good unsaturated fats from foods such as olive and canola oil, salmon and other fatty fish, and nuts.

Exercise regularly. Aim for 30 minutes of brisk walking and other moderate workouts every day.

Keep a healthy weight. If you’re heavy, aim to lose pounds slowly and avoid fasting. Otherwise, it can raise the level of cholesterol in your gallbladder.

Problems with your gallbladder or bile ducts should be checked out. Talk to your doctor right away if you:

  • Feel bad pain in your abdomen for many hours
  • Are nauseated or throwing up
  • Have chills or a fever
  • Have yellow skin or eyes (jaundice)
  • Notice the color of your bowel movements look lighter than usual and your urine looks darker

If you had gallbladder surgery, call your doctor if you:

  • Continue to have pain that feels like the gallbladder pain you had before
  • Have any signs of infection, such as redness around the incision, increased tenderness, discharge coming from an incision, fever, or increasing pain in the area

Gallbladder pain can have several causes. Some people can manage or reduce how often they have gallbladder pain by changing their diet and exercising. Others may need surgery to remove their gallbladder. Contact your doctor if you have gallbladder pain so you can be diagnosed and treated as early as possible, possibly avoiding any complications.

What will the ER do for gallbladder pain?

If your pain is severe, you should be checked as soon as possible to rule out something more serious and to make you more comfortable. The emergency room doctor will likely do an ultrasound to look for stones and to check how big your gallbladder is. If necessary, your doctor may also order other imaging tests, such as a CT scan, MRI, or hepatobiliary iminodiacetic acid (HIDA) scan to get a view of what is going on inside.

How do I know if my pain is from my gallbladder?

Only a doctor can confirm if you're having pain from your gallbladder. There are other conditions that may mimic gallbladder pain. So, it’s important to see your doctor as soon as possible if you are having gallbladder pain.

What does a gallstone attack feel like?

Gallstones can cause sudden and severe pain. The duration of the gallbladder pain attacks may vary, ranging from as short as 30 minutes to several hours long. You might feel the pain from gallstones in the upper mid-back (between the shoulder blades), in the right shoulder, or the upper part of the right side of your abdomen. Other symptoms include nausea and vomiting.