Q. I have dull pain and discomfort in the upper right abdomen with chronic gallstone problem. Kindly help.

Answered by
Dr. Nagaraj Patil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Nov 07, 2020

Hello doctor,

I am a 28-year-old male with 185 cm tall and 75 kg weight. I have a constant feeling of discomfort (sometimes dull pain) in the stomach's right top quarter for around a month. I have gallstones for 14 years now (size up to 6 mm), and the doctor told me this is the root cause. But from what I know, the pain from gallstones should be more severe and not last so long.

I have also checked my liver (via blood tests) and the ultrasound diagnostic of gastro organs. They seem to be fine, and the gallbladder does not have any infection or gallstones block. Also, there are no signs of gastro problems via EGD. What else could cause the pain in this area? Maybe some kinds of parasites? Or could it be a problem with the back? I have not found any connection with the food, only that the discomfort is worse at night time. Also, sometimes I feel itching in the area where I have pain. Can you suggest some further diagnostic measures? I want to be 100% sure that this is caused by gallstones to agree on gallbladder removal surgery.



Welcome to

Many of the times, gallstones do not produce any symptoms unless they are big enough to obstruct the bile duct when they can cause sharp pain in the right upper part of the abdomen, especially after meals. They even do not cause any change in liver function tests, hence your normal reports.

Other causes of pain in this area could be kidney stones, infections of the kidney, liver conditions like abscess in liver, trauma to the ribs, ulcers in the stomach, etc. Some time pancreas related problems can cause pain in this area. In addition to food, gallstones related pain exacerbate during night time when maximum cholesterol synthesis happens. This stimulates the gallbladder to secrete more bile, which results in pain.

Unfortunately, no medications can cause the dissolution of gallstones. For mild discomfort, you can take pain killers. If the pain is unbearable and the gallbladder is infected, then the only option is to remove the gallbladder. In your case, you can opt for surgery only for severe pain, or it gets infected, which I do not think are the case with you.

I hope this helps.

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