Pain in the upper right side of the abdomen, where the gallbladder is located, is the most common symptom of gallbladder disease. Depending on the type of gallbladder disease and whether there are any complications, it can also cause fever, nausea, vomiting, and/or jaundice.

The complications of gallbladder disease are mainly due to the presence of gallstones and may include an infection of the common bile duct (called ascending cholangitis), inflammation of the pancreas (called pancreatitis), gangrene of the gallbladder (called gangrenous cholecystitis), or bowel obstruction from a gallstone (called gallstone ileus).

Frequent Symptoms

The common symptoms of gallbladder disease may help differentiate the usual causes.

Abdominal Pain

Most gallstones stay in the gallbladder and don’t cause symptoms. Some become lodged in the cystic duct (a tube located at the neck of the gallbladder) or in the common bile duct (a tube that carries bile from the gallbladder to the intestines).

  • A gallstone in the common bile duct is called choledocholithiasis and may cause intermittent or constant discomfort.A gallstone obstruction of the cystic duct is called biliary colic.

Besides a gallstone attack, upper right-sided abdominal pain may occur in other gallbladder diseases, such as:

Biliary colic is an intense, dull ache that usually is located in the upper right side of the abdomen. It also can occur in the upper middle part of the abdomen (called the epigastrium) or, less often, beneath the sternum. Sometimes the pain travels (radiates) to the right shoulder blade or to the back. The pain caused by biliary colic can be steady or intermittent and it can be triggered by eating a meal that’s high in fat.

  • Cholecystitis: This condition refers to gallbladder inflammation. While it most commonly occurs as a complication of gallstones (called acute cholecystitis), it may also occur without gallstones (called acalculous cholecystitis). Unlike a gallstone attack, the biliary-like pain of cholecystitis lasts longer than six hours and is usually associated with fever and an elevated white blood cell count.
  • Biliary dyskinesia: This condition causes upper abdominal pain and occurs when the sphincter of Oddi (a muscular structure located at the junction where the bile ducts drain into the small intestine) does not function properly, causing bile blockage.
  • Functional gallbladder disorder: This disorder causes episodes of upper abdominal pain without gallstones or problems with the sphincter of Oddi.
  • Advanced gallbladder cancer: Gallbladder cancer generally does not cause symptoms. As the cancer grows, though, pain in the upper right side of the abdomen may begin, along with palpable lumps on the belly, jaundice, nausea, fatigue, and weight loss.

Jaundice

Jaundice, signaled by yellowing of the whites of the eyes and skin, may occur with gallbladder diseases that obstruct the bile ducts.

Nausea and Vomiting

Nausea and vomiting may occur with a gallstone attack but are more common with cholecystitis (inflammation of the gallbladder) or pancreatitis (inflammation of the pancreas).

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Fever

Fever should not occur with a gallstone attack but may occur with gallbladder inflammation or with infection/inflammation of the biliary tract.

Rare Symptoms

There are also less common symptoms of gallbladder disease. Sometimes it isn’t clear whether the symptoms are caused by gallstones or by another coexisting medical condition, like gastroesophageal reflux disease (GERD) or peptic ulcer disease.

Pruritus

Pruritus (itching) is another symptom, occurring commonly with a condition called primary sclerosis cholangitis, a chronic, inflammatory disease of both the gallbladder and liver. The pruritus that occurs with these conditions is often very debilitating and likely occurs as a result of bile acid accumulation.

Less Common Symptoms

Some of the less common symptoms include:

Primary sclerosing cholangitis can also cause upper right-sided abdominal pain, jaundice, and fatigue.

Pruritus can also occur with advanced forms of pancreatic cancer due to blockage of the bile duct.

Complications

Several complications may occur as a result of gallbladder disease.

Acute Cholangitis

Acute cholangitis is caused by a bacterial infection of the biliary tract associated with biliary obstruction. In addition to fever and upper right-sided abdominal pain, the condition can cause jaundice, low blood pressure, and confusion.

Pancreatitis

Pancreatitis refers to inflammation of the pancreas and most commonly occurs as a complication of gallstones. This is because the gallbladder and pancreas share a bile drainage duct, so an obstructing gallstone can prevent the flow of pancreatic enzymes.

Gangrenous Cholecystitis

This is the most common complication of cholecystitis, especially for older people, people with diabetes, or anyone who delays seeking treatment for their gallbladder attacks. Gangrenous cholecystitis is considered a medical emergency, requiring surgical removal of the gallbladder (a cholecystectomy) right away.

Symptoms of gallstone pancreatitis include a rapid onset of severe, epigastric pain, as well as nausea and vomiting. Treatment entails hospitalization for nutrition and fluids, pain control, and monitoring for severe complications, including necrotizing pancreatitis, which can be life-threatening. Usually, procedures to remove the duct blockage, or the entire gallbladder, also are performed.

Gallbladder Perforation

If the gallbladder becomes gangrenous, a perforation (a hole in the wall of the gallbladder) may develop, resulting in a pericholecystic abscess (a collection of pus within the gallbladder). This complication is serious and life-threatening, requiring an emergent cholecystectomy.

Cholecystoenteric Fistula/Gallstone Ileus

If a hole forms in the gallbladder, a fistula (passage) into the small intestine may develop. If a gallstone passes through the fistula, a bowel obstruction may occur (called gallstone ileus).

Emphysematous Cholecystitis

Infection of the wall of the gallbladder with gas-forming bacteria may lead to emphysematous cholecystitis. Older age and diabetes increase the risk of this complication.

When to See a Healthcare Provider

If you are experiencing any abdominal pain, it’s important to see your healthcare provider for a proper diagnosis. If your healthcare provider diagnoses you with gallstones, they may refer you for a surgical evaluation, especially if you are experiencing recurrent episodes of biliary colic.

If you are experiencing abdominal pain that is severe, persistent, and/or associated with fever, severe nausea, vomiting, and/or jaundice, be sure to seek medical attention right away at the hospital.

Gallbladder Disease Doctor Discussion Guide

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Frequently Asked Questions

  • What are the symptoms of gallbladder disease?
  • Pain in the upper right quadrant of the abdomen (where the gallbladder is located) is the hallmark symptom of gallbladder disease, which is an umbrella term for any condition affecting the gallbladder. Depending on the specific condition, other symptoms may commonly include:FeverJaundiceNausea and vomitingPruritis (itching)Be sure to contact your healthcare provider if you have any type of severe abdominal pain, and especially if you have signs of jaundice, such as yellowing of the eyes, as serious complications may arise.
  • What does gallbladder pain feel like?
  • Gallbladder pain, most typically a result of gallstones, may feel like a sharp, burning pain in the upper right portion of the abdomen, and may radiate to the back and right shoulder blade. Your abdomen may feel very tender and you may have an upset stomach. The pain from a gallstone attack can last between a few minutes to a few hours. Gallbladder pain also can occur without gallstones, such as in the case of acalculous cholecystitis.
  • How can I tell if I have gallbladder disease or another condition?
  • Your healthcare provider can rule out other diagnoses based on a physical exam, medical history, blood tests, and an abdominal ultrasound, along with other imaging tests. There are several conditions that can cause symptoms that may feel similar to those of gallbladder disease, including:Gastroesophageal reflux disease (GERD)AppendicitisGastroenteritis (stomach flu)Irritable bowel syndrome (IBS)Gallbladder cancerPancreatitisKidney stonesGastritisPeptic ulcer disease
  • What causes gallbladder disease?
  • Gallbladder disease is most commonly caused by gallstones, which are crystals that form inside the gallbladder when too much cholesterol or bilirubin (a byproduct of red blood cell breakdown) is present. High cholesterol is a major risk factor for gallstones, and there may also be a hereditary link. Gallbladder disease may also be caused by gallbladder inflammation (cholecystitis), biliary dyskinesia, gallbladder cancer, and primary sclerosing cholangitis.

Pain in the upper right quadrant of the abdomen (where the gallbladder is located) is the hallmark symptom of gallbladder disease, which is an umbrella term for any condition affecting the gallbladder. Depending on the specific condition, other symptoms may commonly include:

Gallbladder pain, most typically a result of gallstones, may feel like a sharp, burning pain in the upper right portion of the abdomen, and may radiate to the back and right shoulder blade. Your abdomen may feel very tender and you may have an upset stomach. The pain from a gallstone attack can last between a few minutes to a few hours. Gallbladder pain also can occur without gallstones, such as in the case of acalculous cholecystitis.

Your healthcare provider can rule out other diagnoses based on a physical exam, medical history, blood tests, and an abdominal ultrasound, along with other imaging tests. There are several conditions that can cause symptoms that may feel similar to those of gallbladder disease, including:

Gallbladder disease is most commonly caused by gallstones, which are crystals that form inside the gallbladder when too much cholesterol or bilirubin (a byproduct of red blood cell breakdown) is present. High cholesterol is a major risk factor for gallstones, and there may also be a hereditary link. Gallbladder disease may also be caused by gallbladder inflammation (cholecystitis), biliary dyskinesia, gallbladder cancer, and primary sclerosing cholangitis.