What are the causes of gallbladder pain?

Question

Hello, doctor,

I hope you are well. I am writing to share a persistent health concern I have been experiencing. Over the previous five years, I have had three episodes that resembled gallbladder attacks, even though ultrasound scans revealed no gallstones. Given that I have a fatty liver (without fibrosis), I am curious if gallbladder attacks can occur without the presence of gallstones. Most recently, after eating a large amount of fried food at a barbecue, I experienced severe symptoms such as vomiting, diarrhea, and fever. My cousin, who is a doctor, gave me IV therapy at home, which included anti-nausea medication and a pain reliever, and my symptoms improved substantially within a few hours. However, while my gallbladder looks to be free of stones, I have decided to consult a gastroenterologist to find out what is causing these gallbladder-like episodes. Over the last five years, the recurrence of these occurrences has been a cause of anxiety for me. My blood work is normally normal, except for high ALT levels due to my fatty liver. Could you please suggest possible causes or more testing that could help me understand my condition? I understand the necessity of a lower-fat diet, but I am wondering if there are any further actions I should take. Thank you for your time and guidance.

Kindly help

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I have reviewed your case history in detail. The current episode of vomiting, diarrhea, and fever is not typical for gallbladder issues. This can be food poisoning or acute gastroenteritis, which may result from eating outside food, an unusual meal, or even meals at home. It can happen to anyone at any time. Symptoms of gallbladder stone disease are more typically associated with right-sided upper abdominal pain, severe nausea, vomiting (not diarrhea), and the onset of fever. However, such a fever does not resolve quickly and usually requires either a longer course of antibiotics or surgery.

Jaundice can also occur in gallbladder stone disease. If you still want to confirm the diagnosis, you can go for magnetic resonance cholangiopancreatography (MRCP), which is a special MRI test used to visualize the gallbladder as well as the biliary ducts and channels. I agree that small stones or sludge can be missed on a simple ultrasound report. Elevated alanine aminotransferase (ALT) is not normal, and you should be focusing on your fatty liver and dietary habits. Rarely, there is a condition known as non-calculus biliary colic, where a patient can experience symptoms similar to gallstones despite there being no stones. However, this is very rare and more common in certain populations.

I hope this helps.

Thank you.