A gallbladder attack can cause sudden and severe pain. If you’ve been diagnosed with gallstones, you might worry about this happening to you. But finding a gallstone on an ultrasound or CT scan doesn’t mean you need treatment.

“Gallstones are fairly common in Western countries because our diets have more processed and fatty foods,” says David Efron, M.D., chief of acute care surgery at The Johns Hopkins Hospital. “Many of us are walking around with gallstones and don’t know it. But that alone isn’t an indication that you’ll have a gallbladder attack or need it removed. Gallstones usually aren’t a problem until they cause symptoms.”

What does the gallbladder do?

The gallbladder is a storage pouch for bile, a liquid that aids digestion. The liver continually makes bile, which is stored in the gallbladder until you eat. When you consume food, the stomach releases a hormone that causes the muscles around the gallbladder to contract and release the bile.

Bile helps break down fat during digestion. It’s made up of several substances, including cholesterol, bile salts and water. Some of those substances, such as cholesterol, can pack together and form gallstones ranging in size from that of a grain of sand to a golf ball. Up to 15% of people have gallstones, but most never become problematic.

Gallbladder Attack Symptoms

When gallstones get stuck while traveling through the duct (tube) to the stomach, they block the outflow of bile, which causes the gallbladder to spasm. This usually leads to sharp pain, like being cut by a knife, under the rib cage in the upper right side or center of the abdomen. The pain can be so severe that it takes your breath away. You might mistake it for a heart attack, says Efron. 

Other common symptoms of a gallbladder attack include:

• Pain that lasts several hours
• Abdominal pain after eating
• Nausea or vomiting
• Fever or chills
• Light-colored stool
• Brownish-colored urine
• Yellowing of skin or whites of eyes

Seek immediate medical care if you are having some of these symptoms.

How long does a gallbladder attack last?

The attacks usually last several hours. Nothing can be done to stop an attack while it’s happening. The pain typically subsides once the gallstone has passed.

“Gallbladder attacks are often so painful that people end up in the emergency room,” says Efron. “That’s a good thing because it’s important to get evaluated when you have severe pain. Several serious conditions, like heart attacks, ulcer perforations and appendicitis, have similar symptoms to gallstones and need to be ruled out. Also, sometimes gallstones don’t pass on their own and can lead to complications like infection in the gallbladder or pancreas inflammation.”

How can gallbladder problems be prevented?

Gallstones are more likely to form if there’s an overabundance of cholesterol in the bile. So, the best way to prevent an accumulation of gallstones is to reduce your fatty food intake. Diets recommended for lowering high cholesterol levels, such as the Mediterranean diet, are helpful if you have gallbladder problems.

What treatment is available for gallbladder stones?

Medication can ease the pain of a passing gallstone. Your doctor may also prescribe antibiotics if your gallbladder or surrounding organs are infected (cholecystitis). 

If gallbladder attacks are a reoccurring problem, the best approach is to remove the gallbladder. “We don’t remove individual stones because new ones just reform,” says Efron. “If your gallbladder is chronically obstructed with stones, it’s not functioning as a healthy part of the digestive system anyway — it’s just causing problems.”

Gallbladder removal surgery (cholecystectomy) is frequently performed laparoscopically. During this minimally invasive procedure, a tiny camera is inserted into one of several keyhole-size incisions to guide the surgeon in the removal process. The benefits of laparoscopic surgery include less need for pain medication and a quicker recovery.

Can you digest food without a gallbladder?

You can still digest food, including fat, after your gallbladder is removed. Your liver will continue to produce bile. Instead of being stored in the gallbladder until you eat a meal, the bile is released directly into the intestines as it’s made. You don’t have to worry about following a strict diet — just eat healthy. 

“Some people will have a little bit of diarrhea in the postoperative period,” reports Efron. “But that usually settles down after about a month. The body adjusts and you can function just fine.”

Learn more about gallstone disease treatment.