Gallbladder pain is not always obvious at first. It can feel like indigestion, reflux, wind pain, or even pain in the back or shoulder. Some people feel sick after meals. Others think it is indigestion, reflux, wind, or something they ate.
The pattern is often what gives it away. As a general surgeon in Perth, I often see people after they have had a few of these attacks and started to notice the same thing happening again. Fatty or rich meals can be a trigger. The pain may build up, last for a while, then settle. Then it may come back days or weeks later.
When upper abdominal pain keeps returning like that, especially after meals, gallbladder disease is one of the things we need to consider.
Your gallbladder is a small organ that sits under your liver. It stores bile, a fluid made by the liver that helps break down fat in your food.
When you eat, especially a rich or fatty meal, the gallbladder contracts and releases bile into the bowel. This is why gallbladder pain often comes on after eating. If there are gallstones or inflammation, the gallbladder may try to squeeze against a blockage, and that can cause pain under the ribs, nausea, or pain going through to the back.
The gallbladder is useful, but it is not essential. If it is causing repeated problems, surgery may be considered as part of your treatment options.
The most common gallbladder problem I see is gallstones. These are small, firm deposits that form inside the gallbladder.
Gallstones usually form because the bile inside the gallbladder becomes unbalanced. If it contains too much cholesterol, or if the gallbladder does not empty properly, tiny crystals can start to form. Over time, these crystals can grow into stones.
Some people have gallstones and never get symptoms. Others get pain when a stone blocks the opening of the gallbladder.
Gallbladder disease can also include inflammation, infection, sludge (thickened bile), or stones that move into the bile duct. These problems can range from mild discomfort to a medical emergency.
Gallbladder symptoms can be quite typical once you know what to look for. You may notice:
A gallbladder attack can last for minutes or hours. People often describe it as a heavy, gripping or squeezing pain. It is usually stronger than normal indigestion, and it often comes back in a similar pattern.
Please do not sit on severe symptoms. If you have ongoing strong pain, fever, repeated vomiting, yellowing of the skin or eyes, dark urine, or pale bowel motions, you should seek urgent medical care.
When I see you, I want to understand what has actually been happening. Where is the pain? How long does it last? Does it follow meals? Have you had fevers, vomiting, or jaundice? Have you recently lost weight?
Most assessments involve an examination, blood tests, and an ultrasound. An ultrasound is the best and easiest scan as it can show gallstones and signs of inflammation. If there is concern about a stone in the bile duct, you may need further imaging.
The scan is only one part of the decision. Many people are sent to see me because an ultrasound has shown gallstones, but the real question is whether those stones are actually causing your symptoms. Gallstones can sometimes be found by accident when a scan is done for another reason. In that situation, surgery may not be needed.
So I look at the whole picture: your symptoms, your scan, your blood tests, and whether the pattern fits gallbladder disease. That helps us decide whether gallbladder surgery is likely to help, or whether we should be looking for another cause.
If your gallbladder is causing repeated problems, gallbladder surgery may be considered as part of your treatment options.
The standard operation is called a laparoscopic cholecystectomy. That means keyhole gallbladder removal. It is usually done under a general anaesthetic, so you are asleep for the procedure. Through a few small cuts, I use a camera and fine instruments to remove the gallbladder.
The operation is to remove the gallbladder itself, not just take out the stones. This is because if the gallbladder is left behind, new stones can form and the same problem can come back and it is more risky to go back in again.
The time in hospital can vary. Some people go home the same day, while others may need to stay overnight, especially if the gallbladder is inflamed, infected, or the operation is more complex than expected.
Gallbladder surgery is common, but no operation is risk-free. Possible risks include bleeding, infection, blood clots, bile leak, hernia, injury to nearby structures such as the bile duct, bowel or blood vessels, and risks linked to anaesthetic.
Some people also notice temporary bowel changes after surgery, especially with fatty foods. Before gallbladder surgery, I will talk through the risks that apply to you, not just a generic list, so you know what to expect.
Gallstones can become more common after significant or rapid weight loss, including after weight loss surgery. At Perth Obesity Solutions, this is something I keep in mind when assessing abdominal pain after gastric sleeve or gastric bypass.
If you have had any of these bariatric procedures and you start getting new pain high in your abdomen, especially after eating, please get it checked. It may be nothing serious, but it is not something I would want you to brush off as “just recovery” or a diet issue.
If gallstones have shown up on a scan, or you keep noticing pain after meals, it is worth sitting down with a surgeon and working out whether the gallbladder really fits the picture.
At Perth Obesity Solutions, I take a practical and patient-centred approach. I will review your symptoms, examine you, look at your scans and blood tests, and talk you through your options in plain English.
Gallbladder disease can be painful and disruptive, but once the cause is clear, we can talk through the treatment options and what may be appropriate for you.