Gallstone Symptoms: What a Gallbladder Attack Feels Like

What a gallbladder attack feels like

The gallbladder stores bile and squeezes it into the bowel when you eat, especially after fatty food. If a stone blocks the gallbladder outlet, the gallbladder contracts against it, causing biliary colic. Despite the name, the pain is usually steady rather than coming in waves.

Typical features:

• severe, constant ache or pressure under the right ribs or in the upper middle belly (epigastrium)
• builds over 15 to 60 minutes and plateaus
• spreads to the right shoulder blade or between the shoulder blades
• nausea, sometimes vomiting
• restlessness: you cannot find a comfortable position
• eases on its own within a few hours as the stone falls back

Between attacks you usually feel completely well. Attacks can be weeks or months apart. Our biliary colic page explains this pattern in more detail.

Gallbladder pain location

Signs that gallstones have caused a complication

These need hospital assessment.

Gallstones or something else?

Gallstone pain is often mistaken for other conditions:

• Heartburn and reflux: burning behind the breastbone, eased by antacids. See GERD.
• Peptic ulcer: gnawing upper belly pain, often relieved or worsened by eating.
• Heart attack: pressure in the chest or upper belly, especially with breathlessness, sweating or arm pain.
• Kidney stones: pain in the flank spreading to the groin.
• Indigestion and bloating: vague fullness, burping and gas after fatty meals are common but are not reliable signs of gallstones and often persist after gallbladder removal.

Who is likely to have gallstones

Gallstones are more common in women, people over 40, pregnant people, people with obesity, after rapid weight loss or weight-loss surgery, and in some families and ethnic groups, such as Indigenous peoples of the Americas. The gallstones condition page covers causes, tests and surgery in detail.

What to do during a gallstone attack

1. Stop eating and sip only water.
2. Take a pain reliever: acetaminophen (paracetamol) or an NSAID such as ibuprofen, if safe for you. Follow the label dose. NSAIDs work well for biliary pain but avoid them if you have kidney problems, stomach ulcers or take blood thinners.
3. Use a heating pad on the area for comfort.
4. Watch the clock. Pain that lasts more than 6 hours, or comes with fever or yellowing, needs emergency care.
5. Book a doctor's appointment even if the attack settles. An ultrasound can confirm gallstones, and attacks tend to recur.

Reducing attacks while you wait for treatment

• eat smaller, regular meals instead of skipping meals and then eating a large one
• cut back on fried and very fatty foods, which trigger strong gallbladder contraction
• avoid crash diets. Lose weight gradually, about 1 to 2 lb (0.5 to 1 kg) a week
• be aware that no diet dissolves gallstones. Once you have had typical attacks, surgery is the definitive treatment

Frequently asked questions

What are the first signs of gallstones?

The first sign is usually a sudden attack of steady, severe pain in the upper right or middle belly, often after a fatty meal or at night, lasting 30 minutes to a few hours. Nausea and pain spreading to the right shoulder blade are common. Many people never have symptoms.

How long does a gallbladder attack last?

A typical attack lasts from 30 minutes to a few hours and then fades. Pain lasting more than 6 hours suggests the gallbladder has become inflamed (cholecystitis) or that another complication has developed, and you should go to an ER.

Where is gallbladder pain felt?

It is felt under the right ribs or in the upper middle of the belly, and often spreads to the right shoulder blade, between the shoulder blades or into the back. Some people feel it mainly in the center of the upper belly, which is why it is mistaken for heartburn.

Can gallstones cause back pain?

Yes. Gallbladder pain commonly spreads to the right upper back or right shoulder blade. Severe pain that bores straight through to the middle of the back with vomiting can mean gallstone pancreatitis, which is an emergency.

Do gallstones cause bloating and gas?

Bloating, burping and gas are common in people with gallstones, but studies show they are just as common in people without gallstones and often continue after the gallbladder is removed. The symptom that reliably points to gallstones is the typical attack of steady upper belly pain.