What does gallbladder pain (biliary colic, attack) feel like?

Published: March 31, 2015
Last reviewed: February 14, 2017

Gallbladder is a small sac (about 3.5 x 1.2 inch or 9 x 3 cm) that lies in the upper right abdomen underneath the lower edge of the liver (33) and is completely covered by the ribs.

Gallbladder location image

Diagram 1. Gallbladder is located below the right rib cage.
(free image use)

Medical terms and definitions:

  • Biliary system refers to the gallbladder and the ducts that carry the bile from the liver to gallbladder and from the gallbladder to small intestine.
  • Biliary colic refers to sudden pain in the gallbladder or common bile duct.
  • Cholecystitis is an inflammation of the gallbladder.
  • MRI is magnetic resonance imaging.

Where is gallbladder pain felt?

Gallbladder pain occurs in the upper right abdomen below the lowest ribs, or in the upper central abdomen, below the breastbone.

Gallbladder Referred Pain

The pain can radiate to the lower right chest, flank or back, toward the right shoulder blade area or shoulder tip or the right side of the neck. This is called gallbladder referred pain (Diagram 2).

Gallbladder pain location picture

Diagram 2. Gallbladder pain and referred pain location
(free image use)

Can gallbladder pain be felt on the left side?

Gallbladder pain can extend from the right over the middle toward the left side of the abdomen, but the pain on the left side alone is not typical for gallbladder problems. In very rare cases, in which the liver and gallbladder are located on the left side, the pain from gallbladder would be on the left side, of course.

What does gallbladder pain feel like?

  • Sudden mild pain that–within 15-60 minutes–develops to moderate to severe dull and constant pain, which can last from several minutes to few days. The pain is steady, not wavy.
  • Pain can be worse during deep breathing but is usually not triggered by the body movements.
  • It can flare up within few hours after large–not only fatty–meals or at any time, commonly at night.
  • It is not relieved by antacids, vomiting, passing gas, a bowel movement or by changing body position.
  • It is recurrent; it occur every few days, months or years.
  • References: (1,2,3,4)

How long does gallbladder pain last?

  • In gallstones without gallbladder inflammation: several minutes to few hours
  • In gallbladder inflammation (cholecystitis): from 6 hours to few days
  • In gallbladder or biliary dyskinesia: at least 30 minutes
  • In gallbladder cancer: chronic, daily discomfort or dull pain

Other Symptoms and Signs of a Gallbladder Disease

  • Nausea or vomiting that occur only when pain occurs (1)
  • Occasional symptoms: fever, jaundice, itchy skin, dark urine and pale stools
  • Occasional signs: tenderness to touch or a palpable lump in the right upper abdominal quadrant

Indigestion, dyspepsia after fatty meals, abdominal bloating, excessive belching, heartburn, constipation or diarrhea are not specific for a gallbladder disease – they can also occur in other abdominal disorders (1,2,4). Gallbladder issues do not seem to be directly connected with headache, but some people believe they can trigger migraine.

Gallstones in the Gallbladder (Cholelithiasis)

Gallstones can develop when the gallbladder empties slowly or when the bile contains too much cholesterol (cholesterol gallstones) or bilirubin (pigment gallstones) (3).

Risk factors for gallstones include female sex, obesity, rapid weight loss (>3 pounds/week), bariatric surgery, prolonged fasting, starvation, pregnancy, oral contraceptives, medications (fibrates, estrogen replacement therapy), diabetes type 2, increased breakdown of red blood cells (hemolysis), old age and family history of gallstones (1,2,3). There is no clear connection between the type of diet and gallstones.

Gallstones can be present in the gallbladder for years without causing pain; the pain occurs when the stones block the duct that goes out from the gallbladder (the cystic duct), which results in gallbladder distension.

Pain characteristics:

  • Sudden, constant pain in the upper right abdominal quadrant, which typically lasts 1-6 hours (range: 30 minutes to more than 12 hours) (1,4)
  • No or only mild tenderness in the upper right abdominal quadrant (1,4)
  • No pain or other symptoms between the attacks (1)

Other symptoms include nausea or vomiting. Gallstones without inflammation usually cause no fever.

Diagnosis is by ultrasonography. Treatment is by painkillers and, in recurrent attacks, by gallbladder removal.

Gallstones During Pregnancy

During pregnancy, gallbladder is more relaxed and empties slower, which increases the risk of developing gallstones and gallbladder inflammation, especially in women who had gallbladder disease before pregnancy. When surgery is required, it should be optimally performed in the second trimester; both open and endoscopic surgery are considered safe (27).

Gallstones in Children

Gallstones in children are rare; risk factors include hemolytic anemia (breakdown of red blood cells), for example in sickle cell disease, obesity, Crohn’s disease, surgical removal of the last part of the intestine (ileum) and prolonged fasting or artificial (intravenous) feeding. Symptoms, diagnosis and treatment are the same as in adults.

Biliary Sludge

Biliary sludge refers to small (1-3 mm) clumps of the concentrated bile that may either dissolve spontaneously or develop into gallstones (2). Biliary sludge can, sometimes, cause pain similar to pain from gallstones, or complications, such as cholecystitis, cholangitis or acute pancreatitis (12).

Diagnosis is by MRI or MRCP. When the gallbladder function–evaluated by HIDA scan–is poor, the recommended treatment is gallbladder removal.

Gallbladder Inflammation (Cholecystitis)

Gallbladder inflammation (cholecystitis) is usually caused by gallstones but can also occur in a gallbladder without gallstones.

Pain characteristics:

  • Sudden, constant pain in the right upper abdomen that may last from 6 hours to few days
  • Tenderness to touch in the gallbladder area
  • Pain during breathing in when a doctor presses upon the gallbladder (Murphy’s sign)

Other symptoms and signs: nausea, vomiting, a palpable lump in the painful area and, sometimes, low-grade fever, excessive sweating or jaundice (2). NOTE: high fever (>101 °F or 38.3 °C) may indicate an infection or other complication which can be a medical emergency.

Recurrent episodes of acute cholecystitis can result in chronic cholecystitis with shrunken gallbladder; it is not clear if chronic cholecystitis causes any symptoms (14).

Diagnosis of cholecystitis is by ultrasound and blood tests. Treatment is by painkillers, antibiotics and surgical gallbladder removal within 78 hours of the attack onset (2).

Gallstones in the Biliary Duct (Choledocholithiasis)

When gallstones move from the cystic duct to the common bile duct (Picture 1), they block the passage of the bile and can cause:

  • Pain similar to gallbladder pain lasting from several hours to days
  • Jaundice
  • Dark urine and pale stools
  • In case of infection (acute cholangitis): fever and chills
  • Reference: (1,4,15,16,18) 

Diagnosis and treatment is by ERCP.

Biliary Pain Without Gallstones

Acute Acalculous Cholecystitis

Acute acalculous cholecystitis refers to an acute gallbladder inflammation without gallstones or gallstones that are too small to be detected by ultrasound (biliary sludge).

Risk factors include prolonged fasting, diabetes and infections (hepatitis, infectious mononucleosis, Dengue fever, HIV/AIDS) (2,10).

Gallbladder Dyskinesia

Gallbladder dyskinesia refers to a motility disorder of the gallbladder that is not related to bile stones or other organic abnormalities.

Sphincter of Oddi Dysfunction (SOD)

A spasm in the sphincter of Oddi at the end of the common bile duct can block the normal bile flow and cause dull pain after eating, nausea or vomiting (24). The condition is more common in women who have had their gallbladders removed (22). The pain in SOD can be triggered by stress.

Gallbladder Polyps

Gallbladder polyps are abnormal growths in the gallbladder wall, which, rarely, cause right upper abdominal pain, nausea or vomiting (8). Large polyps (>1.5 cm) may develop into cancers (8).

Chronic Biliary Pain

Primary Sclerosing Cholangitis

Primary sclerosing cholangitis is a rare chronic autoimmune disease of the bile ducts, usually in young adults but also in children. It is strongly associated with inflammatory bowel disease (ulcerative colitis or Crohn’s disease) (19).

Symptoms include chronic pain and a lump (enlarged liver) in right upper abdomen, fatigue, loose, pale and greasy stools, jaundice, itchy skin and weight loss. The disease can lead to cirrhosis, liver failure or cancer of the bile duct (cholangiocarcinoma) (19). The only effective treatment is liver transplantation (19).

Cancer in the Gallbladder or Bile Duct

Gallbladder cancer and cancer of the bile duct (cholangiocarcinoma) are rare. Gallbladder cancer usually develops as a complication of a chronic gallbladder inflammation (cholecystitis) in older people (5). Symptoms include chronic pain in the upper abdominal quadrant, a palpable lump below the right rib cage, lumps (enlarged lymph nodes) around the belly button and above the left clavicle, nausea, vomiting and fever, anorexia and weight loss and, especially in bile duct cancer, jaundice, dark urine and pale (grey, white or yellow) stools (5,6,7).

Diagnosis of gallbladder cancer is by ultrasound, CT or MRI and of bile duct cancer by MRCP or ERCP. Treatment may involve surgical removal of the gallbladder or bile, chemotherapy or radiation therapy (25,37). Except in early stages, prognosis is poor (5).

Pain After Gallbladder Removal

Pain that persist despite gallbladder removal can be caused by bile reflux, gallstones trapped in the bile ducts, bile leakage due to accidental bile duct injury, sphincter of Oddi dysfunction or internal scars (adhesions).

Complications of a Gallbladder and Bile Duct Disease

Acute Pancreatitis

Pancreatitis is inflammation of the pancreas. Causes include obstruction of the lower part of the common bile duct by stones, inflammation or cancer resulting in the obstruction of the pancreatic duct.

Symptoms include sudden, severe, dull, constant pain in the upper (right, central or left) abdomen that may wrap around the side of your body and involve the back; the pain is worse during lying and can last for few days; it be relieved by leaning forward; other symptoms: nausea, vomiting (38).

Life Threatening Complications

High fever (>101 °F or 38 °C), abdominal distension, dizziness or impaired consciousness can speak for one of the medical emergencies:

  • Gallbladder rupture
  • Peritonitis–inflammation of the peritoneal membrane that covers abdominal organs (39,41)
  • A collection of pus in the liver (liver abscess) or in the gallbladder (empyema) (1)
  • Sepsis or septic shock–infection with invasion of bacteria into the blood (42)


Abdominal ultrasound can detect:

  • Gallbladder stones as small as 2 mm in 95% cases and, sometimes, stones in the common bile duct
  • Acute or chronic cholecystitis, gallbladder polyps and cancer (2)

Endoscopic ultrasound–via the tube inserted through mouth into the duodenum–can reveal stones in the common bile duct and biliary sludge (44).

Magnetic resonance imaging (MRI) can show biliary sludge, gallbladder polyps and cancers.

Magnetic resonance cholangiopancreatography (MRCP) provides a detailed image of the gallbladder and bile ducts. A doctor injects a contrast substance into a vein and after some time, when the contrast collects in the gallbladder and bile ducts, a MRI scan is done. MRCP can show stones, tumors and inflammation in the common bile duct (1,2,31).

Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic and therapeutic procedure that involves passing a tube with a camera on its end through the mouth into the duodenum and injecting the contrast substance into the bile duct, followed by an X-ray. ERCP can reveal stones in the common bile duct and enables removal of stones, drainage of the infected duct and cutting the sphincter of Oddi.

X-ray shows gallstones in only up to 20% cases and CT scan in up to 80% cases (43).

Hepatobiliary scintigraphy (HIDA scan) is used to evaluate the gallbladder emptying; poor emptying (ejection fraction <40%) is an indication for the gallbladder removal.

Blood tests can, sometimes, show:

  • Increased white blood cells (WBC): in cholecystitis and cholangitis
  • Increased liver enzymes or bilirubin: in bile duct obstruction

Pain Relief and Treatment

Analgesics for Severe Pain

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): diclofenac injection into the muscle or as a suppository, indomethacin, ketorolac
  • Narcotic analgesics: morphine or pethidine injection into the muscle
  • Antispasmodics: dicyclomine
  • References: (2,11,30)

Analgesics for Mild to Moderate Pain

  • Antispasmodics: butylscopolamine (hyoscine butylbromide) tablets
  • Opiates: codeine
  • NSAIDs: ibuprofen tablets
  • Paracetamol
  • Reference: (30)

During pregnancy, NSAIDs (diclofenac, ibuprofen, indomethacin, ketorolac, naproxen) should be avoided in the third trimester because they may cause birth defects, but aspirin, paracetamol and opiates (codeine, fentanyl, morphine, pethidine) appear to be safe (20,23).


Do not eat during a gallbladder attack and drink only plain water to prevent gallbladder contractions (29).


To prevent nausea and vomiting, a doctor can prescribe antiemetics, such as metoclopramide, ondansetron or prochlorperazine (2,30).


In inflammation (cholecystitis, cholangitis), a doctor should give you intravenous antibiotics (not by mouth) (11,17).

Surgical Gallbladder Removal (Cholecystectomy)

Endoscopic cholecystectomy is a surgical procedure that involves a small incision in the abdominal wall and removing the gallbladder using an endoscope.

Classical open surgery is performed when endoscopic removal is not available or possible.

Other Treatment Options for Gallbladder Gallstones

  • Oral gallstone dissolution. When surgery might be risky and when gallstones are small (<5 mm), dissolving stones by ursodeoxycholic acid by mouth for at least 6-12 months can be tried; stone recurrence after this treatment is about 50% (2).
  • Extracorporeal shock-wave lithotripsy can be used to break stones smaller than 2 cm; recurrent rate is up to 30% within 5 years (2).

Home Remedies

Few things that may help relieve gallbladder pain, according to anecdotal reports:

  • Heating pad or castor oil compress
  • Hot bath

Gallbladder Flush

There is no reliable scientific evidence that gallbladder flush or cleanse using the following herbs or beverages helps to ease gallbladder pain or prevent gallstones (28,35): alfalfa, apple cider vinegar, apple juice, a mixture of beet, carrot and cucumber juice, barberry bark, calendula, catnip, chamomile tea, chicory, dandelion, Epsom salt, fenel seed, garlic, ginger, goldenseal, honey with turmeric, lemonade, milk thistle, nettle, olive oil, peppermint tea, psyllium, quebra pedra, rosemary, salt water, St. John’s Wort, wild yam root, yellow dock and yellow root.

Diet to Prevent Gallstones

The main dietary approach that can help prevent gallstones is avoiding obesity or, if already obese, to lose weight slowly (1-2 lbs/week).

There is insufficient evidence about the preventative effects of the following diet approaches on gallstone formation:

  • Low saturated fat, low sugar and high dietary fiber intake
  • Vegetarian diet
  • Vitamin C supplements
  • Caffeine (coffee, green tea)
  • Moderate alcohol drinking
  • Drinking plenty of water
  • References: (32,34,35,36)

If you already have gallstones, it may help you prevent painful attacks if you avoid big meals and fat-rich meals.

Differential Diagnosis

Other causes of pain after eating: irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), gastritis or gastric ulcer, food allergy, staph food poisoning

Other causes of sudden side pain: appendicitis, pleurisy, urinary tract infection (UTI), kidney stones, rib fracture, shingles, adhesions (scar tissue in the abdominal cavity after surgery)

Other causes of sudden right upper abdominal pain: inflammatory bowel disease (IBD), inflammation of the liver (viral hepatitis), small bowel obstruction, aneurysm of the abdominal aorta, eclampsia (increase of blood pressure during pregnancy)

22 thoughts on “What does gallbladder pain (biliary colic, attack) feel like?”

  1. Maria says:

    Hi, I am a 34 year old female. Four months ago I started with nausea which I ended up in the ER. No pain what’s so ever. They did ultrasound and found gallstones. Two and half months ago I had the surgery to remove my gallbladder and that’s when everything started. I been having the nausea pretty much everyday, upper middle abdominal pain radiating to my back which last from 3-5 min. I have loose stool some days and then constipated other days. my appetite is nothin how it was before which I’ve lost 10 pounds. I’ve gone to ER for this pain but blood work Was done on enzymes and all came normal. I have no fevers, no vomiting, no blood on stools.

    And all this started after I had my gallbladder remove which I never had this symptoms before the surgery other than the nausea. I woke up last night with the pain on my upper abdominal lasted like 2 min or so going to my back and it went away with some tingling down my arms.
    Need help!

    1. Jan Modric says:

      Nausea without pain is not typical for gallstones; not saying it’s not possible, but it really is not typical. So, it could be possible that the nausea did not come from your gallbladder even when you had stones.

      When the gallbladder is removed, the bile flows constantly from the liver directly to the bowel and can irritate it. It’s a common issue. You can search for a diet after gallbladder removal on some reliable medical website. Next, sphincter of Oddi dysfunction (SOD) could be a possible cause of pain. It is typically treated with an endoscopic surgery, but results are often not satisfactory.

      Pancreatitis and gastritis could also cause nausea and upper abd. pain. I recommend you to write a really detailed list of your symptoms and eventual their triggers (eating, lying down…) in a chronological order and speak with a gastroenterologist.

      Tingling down the arms, nausea and upper abdominal pain can also occur in heart disease. At 34, a typical heart pain–angina pectoris–is less likely, but there may be some other cause.

    2. Susan says:

      Possibly bile reflux. Check with gastroenterologist. That happened to me 8 months after having my gallbladder removed. Bile backs up into stomach. I had constant nausea, no appetite, lost 20 pounds, pain under right ribs. I was sick for 3 1/2 months before they finally diagnosed it. Hope you are better now.

  2. Rosa!is finamore says:

    Going through the same issues,last week a had a endscopy seen mild gastritis some inflammation also took a biopsy.back gi MD 12-23-15…it will take a few office visits..he went to one of the top medical school in the country.my upper bel!y discomfort.I will keep you posted..

  3. bill augustin says:

    A cup of milk helps morning pain disappear for me and a few ibuprofen a day gets rid of the 3+ times a day diharrea, I only get the real pain if I drink hard liquor or malt beverage drinks, I havent had an attack for a few years now,except on some mornings I found if I drink a little bit of milk the pain instantly dissapears but if I drink anything else OMG the pain starts and won’t stop till I take oxycodone ,so I’ve learned to live with it just by drinking milk and taking ibuprofen 800 mg a day…

  4. Vicki Scimeca says:

    Have had persistent diarrhea since 11/15. Am now experiencing pain in my gallbladder area, fast throbbing pain that comes and goes since 2/23/16. Have a history of hemagionomas (had a mass removed in 2014, 9 hemagionomas), polyp on gallbladder and cyst on liver. Not sure exactly if it’s the gallbladder or liver….

    1. Jan Modric says:

      Vicki, your symptoms sound serious enough to see a doctor. It does not matter is it liver or gallbladder issue; either can block the bile flow and cause diarrhea. You can try to eat less fatty foods and see if it helps for diarrhea, but go and see a doctor.

    2. sandra dee says:

      my sister is going through the exact same thing right now except she never had a hemangioma.

  5. luv39 says:

    Hi I’m Rose I had my gallbladder removed after my son in 1991 was born and I’ve always had the phantom pains every do often always a numb type feeling along when it does anyone else have both. Please let,me know if anyone else has this same thing

    1. Jan Modric says:

      luv39, it is possible that pain arise from the bile duct or the sphincter of Oddi at the end of the duct. You may discuss with a gastroenterologist about the related conditions called “biliary dyskinesia” or “sphincter of Oddi dysfunction.”

  6. millicent says:

    i had my gallbladder removed in January this year, soon after the surgery i couldn’t seem to stomach anything because o would vomit and felt bloated and then the itching started. It was horrible i would scratch all over the itching wouldn’t stop, my eyes were yellow, my urine was dark orange like, then i went to the doctors but they couldn’t give me anything that would stop all this until i meet an old friend who referred me to a natural herbalist. I went there and she recommended natural activated charcoal which i diluted a teaspoonful in a glass of water twice a day and everything stopped now im fine. No more itching, no more jaundice my urine is ok

    1. Jan Modric says:

      Millicent, symptoms you have described usually arise from a blockage of the bile ducts outside or inside of the liver (extrahepatic or intrahepatic cholestasis). It is a good idea to ask a doctor to find the exact cause; in your case it could be a small stone lodged in the bile duct.

  7. Kitty Wertz says:

    I have right epigastric pain with nausea,diarrhea ,radiating to back for the last month. I had my gallbladder removed over 15 years ago. I had an ERCP x 3 for a stone after surgery a year later. Now the pain is starting again.

    1. Jan Modric says:

      Kitty, after gallbladder removal, the pain can still arise from the bile ducts, either due to stones or “sphincter of Oddi dysfunction,” for example. You may want to get this checked again.

  8. Karl says:

    I have itching skin since 6 week mild right uper abdomen pain
    I am taking antihistamine but no result I have no rash
    No irritation
    I have consult my dermatolog he could not give me diagnosise
    The gallbladder can cause this itching

    1. Jan Modric says:

      Karl, the itch caused by a gallstone or liver disease typically goes with jaundice (yellow skin) and possibly white, floating stools. You may want t ask a gastroenterologist.

  9. Tracy says:

    Hi. I am 33 years old. I thought I had the flu, but no fever. Due to fairly constant stomach cramping for three days I thought maybe it was gallbladder? Diarrhea went along with it and I could not keep food down for 24 hours. A few months ago mine was inflamed but not serious enough for surgery. I didn’t make an appointment with my Dr this week because the pain went away today (day 4). Tonight my left side keeps spasming. Should I still be concerned?

    1. Jan Modric says:

      A mild food poisoning is probably a more common cause of diarrhea and cramping on the left side than an inflammation of the gallbladder. gallbladder pain is typically on the left. I can’t exclude anything, though.

  10. James mckernon says:

    Recently I had a very painful attack of gallstones which lasted several hours and i had to go to hospital.The doctor told me I had inflammation and put me on antibiotics for a week,he also said he would remove my gallbladder,but when he asked me my age (72) he changed his mind,and told me I had a one in five chance of another attack.My general health is very good and if I get a cut it heals very quickly.What do other people think? Ps personally I would prefer to have my gallbladder removed.

    1. Jan Modric says:

      Every surgery has its risks and consequences. After gallbladder removal, some people have diarrhea lasting for several weeks or months, for example. It’s totally your decision. It seems that doctors are a bit reserved about a surgery after a single attack.

  11. Mary Edwards says:

    help does it only hurt in your back?? thats where mine is and it won’t stop! tried the apple cider vinegar thing it helped but its back!!! When do you give up and go to ER??

    1. Jan Modric says:

      Having recurring attacks is enough of the reason you go to the doctor. It could be possible to have gallbladder pain only in the back.

Leave a Reply

Your email address will not be published. Required fields are marked *