Gallbladder Pain: When to seek medical attention and what can happen if you ignore symptoms

How my gallbladder ruined an Italian feast

For the last few weeks, Dinner Table Doctor and I have been having some in-depth discussions about gallbladder pain. I was recently hospitalized twice – all because of my gallbladder. I am embarrassed to admit that prior to these events, I only had a vague idea of the purpose of my gallbladder. I knew gallbladder function had something to do with digestion and bile, but beyond that, why on earth should I care? I do now. Which is ironic because I no longer have my gallbladder. I feel the need to share my newfound knowledge, in the hopes that none of my readers will deal with such a painful lesson. Know your body!

My Experience with Gallbladder Pain

Over a month ago, I had severe stomach pains which began around 10 PM and lasted a few hours, then went away after I was violently ill. As I lay writhing on the sofa, I cursed myself, because I truly believed my pain stemmed from partaking in a lovely Italian feast to celebrate my father’s birthday. (No, this is not the feast my gallbladder ruined. That comes later.) You may remember that I am lactose intolerant, but I rarely avoid dairy products. DTD has given me many a speech about doing so, but I just love cheese. Instead of avoiding it, I take handfuls of lactase enzymes with each serving of cheese and just deal with my stomach discomfort and multiple trips to the bathroom for the next few days. My father’s birthday feast included a delicious lasagna, filled with ooey, gooey, cheesy delight. I had two giant pieces. I also had a ton of clam dip as an appetizer. My dad makes this simple mixture of cream cheese and chopped clams, and it’s so yummy I simply can’t resist it. Although I was smart enough not to have the ice cream with the birthday cake, I obviously overindulged in dairy products.

Had I confided in DTD that evening, he probably would have deduced that my problem was my gallbladder. But the next morning I just told him I had a rough night from too much dairy and that was that. I swore I would never eat lasagna again – even my mom’s which is the best lasagna there is. Sadly, DTD is never surprised when I say something like this, and I didn’t explain that I was much more ill than when I normally gorge on dairy products. I’m the gal who cries “Wolf!” and DTD has learned to ignore me on certain occasions, rightfully so. After all, he’s my husband and not my doctor. He knows me too well.

Fast forward two days and the pain came back. Again, it was around 10 PM, but this time it lasted several hours. I hesitated to wake my husband whose work day begins at 4:15 AM. I figured the pain would eventually go away like it did before. As the intensity of the pain grew and was going on 4 hours, I finally woke him. After listening to my description of symptoms, he suspected it was my gallbladder and took me to the emergency room.

Gallbladder Function

While I was writhing in the emergency room awaiting treatment, DTD tried to take my mind off the pain by explaining exactly what the gallbladder does. I don’t remember much, but the condensed version is that the gallbladder is a small organ tucked under your liver. It is there to store bile, a substance the liver makes to help your body break down fat. If you eat a meal with fat in it, your gallbladder will empty some bile into the bile duct, a tube that sends the bile into your small intestine to aid with digestion. There was a time when human beings didn’t eat frequent meals and rarely indulged in high fat meals, so the gallbladder would store bile and release it when necessary. Nowadays, many humans have fatty meals frequently, so our gallbladders work overtime and can become irritated and inflamed. The higher the content of fat in a meal, the stronger the stimulus for the gallbladder to squeeze. This doesn’t happen while you’re eating, but later, when the food is making its way through your digestive tract.

Gallbladder Symptoms

Both nights I had progressing pain in my entire abdomen, most severe in the middle of my chest and right below my right rib cage. It started as a sour stomach or bad case of indigestion. I took some Tums and Pepto Bismol. The first night, the pain went away after I vomited. The second night, nothing made the pain go away and it kept intensifying until I was really scared. That’s when I woke up my personal physician, AKA husband.

Typically gallbladder pain is epigastric, or where your ribs come together. Sometimes the pain is worse in the right upper quadrant and often it radiates to the right shoulder blade. The pain is crampy in nature and makes most people want to bend over and writhe. It usually happens hours after eating a meal or late at night. Often the pain is sudden and severe, then goes away as quickly.

Gallstones

DTD explained that certain gallbladder conditions will cause pain or a gallbladder attack. Most commonly, gallstones form inside the gallbladder and cause inflammation and pain as well as nausea and vomiting. While the symptoms can come and go, they generally get worse over time, which is obviously what happened to me. I suffered from acute cholecystitis, which is a syndrome of right upper quadrant pain and fever caused by gallbladder inflammation most commonly brought on by gallstones.

Gallstones are not typically a big issue, but they can cause pain when they get stuck in a bile duct. Many people with stones experience biliary cholic, or pain from a stone that is stuck and then resolves itself. Even if the problem corrects itself, it probably will continue to get worse with more frequent episodes and can lead to serious problems, such as:

• Jaundice, which is a condition that turns your eyes or skin yellow
• Inflammation of the pancreas, which is an organ of the digestive system that plays an essential role in converting food into fuel (a relatively common and potentially deadly condition)
• Infection of the gallbladder
• A tear in the gallbladder, which can also lead to death

Gallbladder Removal (Cholecystectomy)

Surgeons used a laparoscope, which is a long and thin tube that has a light and itty-bitty camera, to remove my gallbladder. This is the most common method of removing a gallbladder. Normally the procedure is pretty easy and goes off without a hitch. There are four small incisions for the insertion of the scope and other tools. Most people are home within 24 hours, and I was no exception. Apparently my gallbladder was a mess and full of stones, so it was a good thing I had it removed. Little did I know, my saga wasn’t over yet.

The Missed Feast

After my procedure, I felt pretty good for a few days. I was happily gearing up to celebrate my birthday. I felt lucky to be out of the hospital and on the mend so that I could truly live it up, which is exactly what I want to do on my birthday. Ever since I was diagnosed with leukemia 13 years ago, I am grateful for every birthday and I celebrate accordingly.

My sweet mother, who had just created an Italian feast for my father’s birthday, offered to throw another one for me. She really outdid herself this time, probably because she felt bad that I was just in the hospital. She made homemade pasta and meatballs along with braciole, which is thinly sliced beef wrapped around hard boiled eggs and cheese and simmered in sauce. It is a treat! She also made a fantastic chocolate birthday cake. It was a feast fit for a spoiled daughter who is loved beyond measure!

Unfortunately, as my daughter and I headed across the street to my parents’ house, I didn’t even make it down the driveway. I once again experienced severe stomach pain. Since I no longer had a gallbladder, I was more than a little surprised. This time the pain was far worse. By the time we got to the emergency room I was screaming and writhing in pain reminiscent of childbirth.

One little gallstone decided to hide out in a duct and was left behind. Eventually it got stuck and that’s what was causing my pain. I was in the hospital for 3 more days and missed my birthday feast, although there were a few leftovers when I finally returned home.

Lesson Learned

In retrospect, I was having gallbladder pain for several months. My frequent stomach discomfort was always a little worse in my upper right abdomen, just under my rib cage. I was so used to having stomach issues that I ignored the pain since it wasn’t constant. How I wish I would have tried staying away from dairy to see if it made a difference. I also should have communicated with DTD more clearly. What’s the use of having my own resident doctor if I don’t tell him all of my symptoms? Why did I wait for the pain to be excruciating before I mentioned it?

As you can see from the above possible complications, you should never ignore gallbladder pain, even if it goes away. Visit your doctor and discuss your options. Once you have gallbladder pain, your risk of injury increases, so you need to take charge of your health.

I also learned that DTD is an excellent caretaker as well as a great doctor. He really went above and beyond in making sure I was OK and to this day he pampers me, which makes the many dinner table speeches about a healthy, high fiber diet and exercise well worth it.

Avoiding Gallbladder Issues

How do you keep yourself from getting gallstones? If you have experienced gallbladder pain which has corrected itself and you want to avoid future surgery or complications, you can absolutely take control.

• Maintain a healthy weight. People who are overweight are more likely to get gallstones.
• Eat a well-balanced diet and avoid fatty meals.
• Exercise regularly.
• Reduce sugar and carbohydrates.

I never want to go through that pain again and I hope you learn from my mistake. Don’t ignore pain. Go see a doctor and explain your symptoms clearly. Get help before it turns into an emergency situation and you miss your birthday feast!

Irene’s Recipe for Braciole

Sorry that I don’t have any pictures of my wonderful birthday feast, because I MISSED IT!! But my mom is kind enough to share the recipe and I included some generic photos so you have an idea of what it looks like before and after cooking. Like a lot of experienced home cooks, my mom doesn’t always give exact amounts or measurements, so use your best judgement.

If you really want specific amounts, just Google braciole. You’ll see there are several different recipes. Depending on what part of Italy the recipe originated, the ingredients vary greatly. This is how my mom makes it:

• Several long pieces of thinly sliced steak. You can buy special thin beef labeled braciole at some grocery stores, or you can buy some thinly sliced flank steak.
• Several peeled hard boiled eggs
• Good quality grated parmesan cheese
• Parsley and dried Italian seasoning
• Bread crumbs

Salt and pepper the steak. You are going to roll up an egg or two (depending on how wide the steak is) very tightly in the beef slice. If the slices are too small to roll the whole eggs, you can also chop the eggs and spread them on the meat. Add grated parmesan cheese, salt, pepper, and a little bread crumbs, then tightly roll up the meat. Tie securely with a few pieces of butcher twine so it won’t come apart while cooking. Brown each roll on all sides in some olive oil.

In a big pot, lightly brown some garlic in oil and then add 2 or 3 cans of tomato sauce with a little water. Put the meat in the sauce with basil, salt and pepper to taste and simmer for several hours. Serve with pasta.

Enjoy! If you happen to experience pain in your upper right abdominal area hours after the meal, go see a doctor.

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