A gallbladder attack, often referred to as biliary colic, occurs when a gallstone temporarily blocks a bile duct, typically the cystic duct. The gallbladder is a small, pear-shaped organ located beneath the liver that stores and concentrates bile, a digestive fluid. When the stone blocks the duct, the gallbladder spasms as it tries to push bile out, leading to intense pain.
The Defining Pain Sensation
The sensation of a gallbladder attack centers on severe abdominal discomfort that usually begins suddenly. The pain is most commonly located in the upper right quadrant of the abdomen, situated just beneath the rib cage. The quality of the pain is often described as sharp, stabbing, or a severe, sustained cramp. It is a steady pain that rapidly escalates in intensity, frequently becoming debilitating. The pain can sometimes be mistaken for a heart attack or severe indigestion due to its intensity and location. When the blockage is temporary and the pain subsides within a few hours, it is classified as biliary colic. If the blockage persists, causing prolonged inflammation (acute cholecystitis), the pain becomes constant and unremitting. The pain’s severity is a direct result of the increased pressure and muscle spasms within the gallbladder.
Associated Symptoms and Pain Radiation
The primary abdominal pain is frequently accompanied by pain radiation to other areas of the body. The pain commonly spreads from the upper abdomen to the back, often felt between the shoulder blades or specifically at the tip of the right shoulder. Accompanying the intense pain are various gastrointestinal symptoms related to the disruption of the digestive process. Nausea is a common feature and can progress to vomiting. Digestive distress may also manifest as bloating or general indigestion. These secondary symptoms reflect the body’s response to the gallbladder’s inability to release bile effectively, which is needed to break down fats.
Triggers and Duration of Pain
The onset of a gallbladder attack is often linked to the digestive cycle. Attacks are typically precipitated by eating a heavy or fatty meal. Consuming fat signals the gallbladder to contract and release bile, which increases the pressure inside the organ if a gallstone is blocking the outflow duct. The pain of a standard biliary colic episode usually reaches its peak intensity within an hour of onset. This intense pain typically lasts anywhere from 30 minutes to a few hours, often resolving as the gallstone either moves or falls back from the duct opening. Attacks sometimes occur during the night.
Warning Signs Requiring Immediate Care
Certain symptoms signal that a gallbladder attack has progressed beyond a temporary obstruction, requiring immediate medical attention. Pain that does not subside and lasts longer than five or six hours suggests a persistent blockage and inflammation of the gallbladder (acute cholecystitis). The presence of a high fever, accompanied by chills, indicates that an infection or significant inflammation has developed. Another sign of complications is jaundice, which is a yellowing of the skin and the whites of the eyes. Jaundice occurs when the bile is completely blocked and backs up into the bloodstream. Additionally, if stools become clay-colored or urine turns dark like tea, it suggests a complete obstruction of the bile flow.