AIBU to ask what a gallbladder attack is?

[typicalvalues]

Having had extensive investigations done recently and two gallstones found (1 of 0.5cm and 1 of 0.6cm), the medical team and surgical team have said to me that the only time gallstones cause pain is when the gallbladder is infected (which would have inflammatory markers in bloods - I don't) or when they get into bile duct (which doesn't appear to be the case for me at the moment). So they have ruled out gallstones as a possible cause for pain radiating from under rhs ribs to chest and abdomen. So when you guys say a 'gallbladder attack', what do you mean exactly, or how have your doctors explained it to you? Have you had infection/inflammatory markers in bloods?

Or is it the abdominal pain equivalent to 'it's a virus' diagnosis when they can't find a cause?

They have suggested 'biliary colic' but I think a CT and ultrasound may have ruled that working diagnosis out?

Happy to hear from fellow sufferers and clinicians.

I had the pain you describe accompanied by vomiting. A couple of times I had flue like symptoms alongside the vomiting and pain - hot/cold/shivering. After 48 hours of pain and sickness I saw the GP who prescribed pain killers and referred me for a scan. The scan showed several stones and "gravel" so I was referred to have it removed. There were no blood tests to check for infection.

You can definitely have pain from gallstones without infection, it’s called biliary colic. Cholecystitis is when the gallbladder is infected. Biliary colic would usually be diagnosed when a patient has acute RUQ pain and an USS confirms gallstones but bloods are normal.

Biliary colic is when the gallbladder is contracting around stones, causing pain. It comes and goes, and is worse after eating fatty foods, as that’s what stimulates the gallbladder to contract.

Sorry but that’s completed incorrect. A cursory google will explain what happens during a gallbladder attack. In short, when fat (of any kind, good, bad, even tiny amounts) is eaten, the gallbladder contracts to release bile that breaks down the fat you’ve eaten. If you have gallstones, that contracting squeezes the stones = agony. Worse than childbirth.
Had mine out and it’s wondrous
I cannot understand any hcp telling you the above - it’s literally not rocket science how gallstones cause pain?

I thought 'biliary colic' WAS a gallstone attack?

I had two symptoms (for years). One was a mild but annoying dull ache in my right back shoulder area, usually worse in evenings, occasionally bad enough to make me feel sick. I assumed this was from mouse use at work/bad posture - but haven't experienced it in the years since I had my gallbladder out.

2 - by far the most scary - what felt like a heart attack or even like labour, building up in minutes from an ache - all around the top half of my abdomen, and generally worse on the right hand side. Doubling over in pain, usually lasted about 30-60 mins, I would take painkillers and get in the bath if I could but they only mildly helped. Lying down made it worse, peeing made it slightly better. But they just had to subside on its own.
The pain would move around the body, so from shoulder blades, to ribs etc.

IIRC I only had 'sludge' not stones but clearly bad enough to remove the gallbladder. It was misdiagnosed for quite a while until I went on internet forums...

The way it was explained to me was that when I ate too much fatty food (my trigger), the gallbladder goes into overdrive to produce enough bile to digest the fatty food (fatty food needs more bile to be digested). The gallbladder is trying to pump out the bile which then sort of agitates the stones and they start moving around inside the gallbladder which causes the discomfort and pain as your body is essentially trying to get them out. Pain becomes very bad if the stones start to make their way to the bile duct and worse if they get stuck in there (can be very serious). So that "contraction" like feeling that you suffer during an attack is your body trying to expel the stones. Then as the food starts to get digested through the system, bile production slows down, the stones stop moving so much and everything starts to calm down.

I never had any bloodwork done during investigations, my attacks (one trip to A&E and a home doctor visit for the worst ones) and an ultrasound to confirm presence of stones was enough to get me surgery to remove my gallbladder. Gallbladder infection was never mentioned.

Anyone else thinking the medical team have confused gall stones with kidney stones?

All the posters prior to me have been correct and it matches my DHs experience excepting instead of gravel/small stones, he had one very large gallstone and he would have an attack when it rolled over in his gallbladder and blocked the bile duct.

I'm after completely lying on my own thread (brain fog). They've said that the only time it can cause CONSTANT pain is when it's infected. Ignore me. I've just remembered. Jesus but I'm an idiot. Sorry to annoy you all!

@MindGrapes

I thought 'biliary colic' WAS a gallstone attack?

I had two symptoms (for years). One was a mild but annoying dull ache in my right back shoulder area, usually worse in evenings, occasionally bad enough to make me feel sick. I assumed this was from mouse use at work/bad posture - but haven't experienced it in the years since I had my gallbladder out.

2 - by far the most scary - what felt like a heart attack or even like labour, building up in minutes from an ache - all around the top half of my abdomen, and generally worse on the right hand side. Doubling over in pain, usually lasted about 30-60 mins, I would take painkillers and get in the bath if I could but they only mildly helped. Lying down made it worse, peeing made it slightly better. But they just had to subside on its own.
The pain would move around the body, so from shoulder blades, to ribs etc.

IIRC I only had 'sludge' not stones but clearly bad enough to remove the gallbladder. It was misdiagnosed for quite a while until I went on internet forums...

How you've described your pain, is EXACTLY what I have!

The pain from gallbladder flare ups can last for many hours... depends each time. The pain from that is beyond horrendous!

The markers are if it is pancreatitis which is yet another form of hell!

The gallbladder flare ups were enough to put me into hospital several times for morphine injections and the lovely anti sickness jag in the bottom!

Pancreatitis had me in for about a week and the flare ups two days at the most.

Gallbladders are evil!!!

Scenario 2 of your post @MindGrapes is precisely the pain I have. I've had surgeons interrogate me on where the pain is, bowel movements, nausea, vomiting 'How many times have you vomited? How many times have you had a bowel movement? Is it worse when you eat and drink?' and I just shouted at him (all the while the other bloody surgeon is pressing on my stomach) and I just shouted 'STOP - YOU'RE CONFUSING ME' and started to cry and asked them to leave me alone. Me and pain don't get along. How can you be expected to answer questions when you're dosed with morphine, in pain, one surgeon is pressing on you and the other surgeon is bombarding you with questions!

It's like they gleefully came in, all willing to bloody dissect me lol and then it didn't prove to be gallbladder at all.

I'm sorry, I had forgotten what they had explained. It was specifically about constant pain.

I've read your updates but the pain you described in opening post can be gallbladder flare ups.

I always had mine top right by ribs and went down into stomach so was extremely sore when pressed down on when examined also.

I couldn't do anything with the extreme flare ups and was literally on the couch in agony while throwing up in a bag as couldn't make it to the toilet as pain so bad.

Please don't let them fob you off!

Other flare ups can be horrendous even if for a shorter time.

With everything going on I have been told by several people they will only remove if the person is admitted to hospital with pancreatitis shown by markers in the blood. Otherwise it is a long wait for it as an outpatient. I would be attending with the bad flare ups so it builds a record and you receive the proper pain relief and hopefully someone will take pity and stick you on the inpatient op list!

I've had cholecystitis so believe me I know the pain.

@DinosaurDigestive

I've read your updates but the pain you described in opening post can be gallbladder flare ups.

I always had mine top right by ribs and went down into stomach so was extremely sore when pressed down on when examined also.

I couldn't do anything with the extreme flare ups and was literally on the couch in agony while throwing up in a bag as couldn't make it to the toilet as pain so bad.

Please don't let them fob you off!

Other flare ups can be horrendous even if for a shorter time.

With everything going on I have been told by several people they will only remove if the person is admitted to hospital with pancreatitis shown by markers in the blood. Otherwise it is a long wait for it as an outpatient. I would be attending with the bad flare ups so it builds a record and you receive the proper pain relief and hopefully someone will take pity and stick you on the inpatient op list!

Haha - see - this is where I get interested. Because I strongly expect that they have tried to worm their way out of surgery to the point of blaming it on an electrolyte imbalance (discharge summary showed all electrolytes to have been normal on admission - admittedly, potassium did drop during admission, but on admission, with agonising pain, they were normal).
I'm just trying to make sense of it as the pain persists.

*strongly suspect

I completely agree with you.

They did the same with me many times as they were restricting the op lists.

It is beyond disgusting to leave someone with diagnosed gallstones who is having an attack. They were there on the scan and they will obviously still be there!

I honestly would be going back to A&E or contacting NHS24 due to the time and explaining to them about the pain - they will more than likely refer you to hospital anyway as usual but you won't have just rocked up without being told to so calling them can be useful.

I ended up petrified of eating as even random foods were causing attacks and I ended up with technically an eating disorder and being on food supplement drinks due to them messing me about nonstop.

I literally thanked them so many times and nearly hugged them when I was finally told I was on the list for the following day when I was in hospital!

You should not be getting left in pain especially severe pain so if it is bad especially with vomiting I would definitely go back again.

Yes, three weeks of vomiting now. No diarrhoea (but the joy of constipation due to codeine!). My stomach has literally just blown up like a fucking balloon in the past hour. I've eaten nothing as I can't, yet up she goes! Hootie and the blowfish, here I am. I should present myself at the maternity blooming ward at this stage.

You need to get seen. They should have at least had the decency to prescribe anti sickness meds!!

Prochloraperazine melts work wonders compared to some others. Melts slowly side of top gum and gets rid of the horrible nausea feeling too. But it isn't enough for severe only the lovely needle in the bum for that!

Fact you are unable to eat means they should be whipping it out. Can almost guarantee they will try and blame the pain on constipation though! That has been one line I've heard the most even when obvious the cause is something else! Anything to not do things properly!

I'm on ondanzepran and cyclizine. One prescribed by GP and one prescribed by hospital on discharge. The ondanzepran one seems to work better. Cyclizine, bizarrely, stays in my system, then I throw up about an hour later (why?) and then I'm fine for a few hours.

*Note, I may not have spelled either of those correctly and too in pain to go look at the boxes for correct spellings

I had regular gallbladder attacks until the bloody thing was recently removed. The attacks for me were characterised by:

Sudden onset of very severe pain which was continuous and horrendous until it suddenly passed - each attack lasting 1-3 hours each time

Nausea and occasional vomiting

Chills and sweats

In between attacks I felt absolutely fine. My understanding is that attacks occur when a stone gets stuck in a duct, causing pressure to build until the stone is dislodged. I had no other symptoms and blood tests etc were fine.

It’s shocking that you have stones and they aren’t planning surgery! The pain is the worst I’ve ever had - would rather have gone through labour again. The relief I feel having it out is huge. They are being ridiculous and fobbing you off!

The way it was explained to me was that when I ate too much fatty food (my trigger), the gallbladder goes into overdrive to produce enough bile to digest the fatty food .... except that the gallbladder doesn’t produce bile, it merely collects the bile that has been produced. That’s why you can have it removed and still have a normal life.

Bile is being produced continuously, the gall bladder acts as a reservoir until it is needed. So when you eat fatty food, which is what the bile is needed for, the gall bladder squeezes out the bile to help digest it.

If you have no gall bladder, bile is still produced in a steady stream, but if you eat a lot of fat, there isn’t the reservoir of bile to throw at it, and you may have pain.

This happily coincides with an admission on Monday morning, so easier to follow. In hospital (7 days), they had me on dihydrocodeine or something for the first 5 days. Also on oramorph, but difficult to get the night staff to administer in particular - the nursing staff during the day were on the ball. I begged the doctor to take me off it Friday night as I thought it was the painkillers making me sick. Vomiting and in horrendous pain throughout. Doctor did so. Saturday morning they had switched me to oxycodon (spelling again?) administered every 12 hours. Begging for painkillers during that time as it had no effect on pain whatsoever. Again asked for painkillers to be changed to just codeine and was taken off oramorph and put on a more long term pain relief. This worked and I was discharged the Monday. Except the pain still persists. And the nausea and vomiting.