Is Your Stomach Pain a Sign of Gallbladder Issues? - Gastroenterology and Hepatology

Q: Is Your Stomach Pain a Sign of Gallbladder Issues?

The symptoms of gastric ulcers are as follows： (1) Pain below the sternum due to gastric acid irritating the ulcer, which patients may experience as a persistent, recurrent pain two hours after meals or when fasting. <br>(2) Relief of pain after meals： Patients often feel a reduc

Is this symptom gastric pain or cholecystitis?

Hello Doctor: I have been experiencing stomach pain for the past ten years.
I have undergone an endoscopy, which only showed redness in the gastric mucosa.
However, my stomach pain has not improved, and medication has not alleviated the pain.
Recently, friends and my father went to the hospital for stomach pain and were diagnosed with gallstones.
After reading many articles online, I am increasingly confused about whether my issue is related to my stomach or my gallbladder.
Therefore, I would like to consult you about my symptoms as follows:
1.
I experience episodes almost every month, lasting 2 to 3 days each time.
2.
The pain usually starts in the afternoon and intensifies in the evening, especially 30 minutes to 1 hour after eating.
3.
The pain is located beneath the right rib cage; it hurts when pressed, and deep breathing causes pain.
Sometimes the pain is severe enough to make me break out in a cold sweat, and I can be awakened by the pain at night.
4.
Occasionally, I feel nauseous and sometimes experience belching.
5.
There was one instance (only once) when the pain was so severe that it felt like it was radiating to other areas, but I was in too much pain to pinpoint where it was coming from.
Ten years ago, I experienced pain so intense that I couldn't get up and was rolling on the floor, and I asked my mother to buy me stomach medication, which was the only time it worked; other medications have not helped.
I am really afraid of undergoing another endoscopy.
I have seen a doctor and hinted that I suspect a gallbladder issue, but he insisted it was a stomach problem.
Shouldn't doctors conduct thorough examinations? Many cases of stomach pain are actually related to gallbladder issues.
My father suffered from stomach pain for decades, and only recently, when his eyes turned yellow, did the doctor say it was a gallbladder problem.
I just don't want to delay seeking treatment.
Why won't the doctor even help me with an examination? Please, could you review my situation and advise me on what I should do? Thank you.

CANDY, 20~29 year old female. Ask Date: 2006/09/27

Dr. Cai Yaozhou reply Gastroenterology and Hepatology

The symptoms of gastric ulcers are as follows: (1) Pain below the sternum due to gastric acid irritating the ulcer, which patients may experience as a persistent, recurrent pain two hours after meals or when fasting.
(2) Relief of pain after meals: Patients often feel a reduction in pain after eating, as the presence of food in the stomach decreases gastric acid, thereby alleviating discomfort.
Taking antacids can have a similar effect.
(3) Nighttime pain: Gastric acid secretion is most active around 2 AM, so if a patient wakes from sleep due to stomach pain, it is likely they have a gastric ulcer.
By around 6 AM, gastric acid secretion is at its lowest, so pain may also be relatively reduced at that time.
Gastric ulcers occur due to the formation of holes or cracks in the stomach lining, typically affecting the esophagus (the tube between the throat and stomach) or the duodenum (the upper part of the small intestine).
Experts previously attributed gastric ulcers to stress, but it is now suspected that they are caused by a bacterium known as Helicobacter pylori.
Overuse of pain relievers, such as aspirin or ibuprofen, can also lead to gastric ulcers.
Other contributing factors may include stress, smoking, excessive alcohol consumption, excessive gastric acid, and insufficient mucus in the stomach lining to protect it.
Gastric ulcers are generally easy to treat.
If caused by bacteria, antibiotics (sometimes in combination with other medications) can be effective.
The bacteria that cause gastric ulcers can also lead to gastritis, with some patients experiencing nausea, vomiting, and upper abdominal pain similar to indigestion.
Although the symptoms of gastritis are almost identical to those caused by overeating or consuming greasy foods, gastritis is not caused by these habits.
Doctors may prescribe antacids to treat mild gastritis, and antibiotics if it is bacterial.
If gastritis is not properly treated, it can lead to serious consequences.
What can you do? Avoid taking aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs.
Drink plenty of water or fluids, but avoid milk, as it can lead to increased gastric acid.
Take antacids.
Eat smaller, more frequent meals.
Stay away from foods that trigger stomach pain.
Avoid alcohol or limit alcohol consumption.
Do not smoke and avoid secondhand smoke.
Engage in relaxing exercises.
When to see a doctor immediately: If you vomit blood or anything resembling coffee grounds, this may indicate gastric bleeding.
If you feel cold sweats and are about to faint, seek medical attention promptly.
See a doctor if you have symptoms of a gastric ulcer and experience severe back pain, as this may indicate a perforated ulcer.
If you have a gastric ulcer and feel weak or pale, you may be anemic due to the ulcer.
If your stool is deep red or black, or contains blood, this may indicate internal bleeding.
Seek medical advice if you have severe stomach pain or if symptoms of gastric ulcers or gastritis persist for more than two weeks.
Prevention strategies include reducing the use of aspirin and ibuprofen, eating less irritating foods, managing stress, and following your doctor's instructions for medication to prevent recurrence of gastric ulcers.

Reply Date: 2006/09/27

More Info

Your symptoms certainly raise concerns that warrant further investigation, especially considering your history of stomach pain and the recent experiences of those close to you with gallbladder issues. Based on the details you've provided, it seems that your pain is localized to the right upper quadrant of your abdomen, which is a common area for gallbladder-related pain, particularly if gallstones are present.

Gallbladder issues, such as gallstones or cholecystitis (inflammation of the gallbladder), can manifest with symptoms similar to what you are describing. The pain you experience, especially after meals, is characteristic of gallbladder problems, as the gallbladder releases bile to aid in digestion, and if there are stones blocking the bile ducts, it can lead to significant pain. The fact that your pain intensifies in the evening and after eating further supports this possibility.

Here are some key points to consider regarding your symptoms:
1. Pain Characteristics: The nature of your pain—intensifying after meals, located under the right rib cage, and associated with nausea—aligns with gallbladder issues. Gallbladder pain can often be sharp and may radiate to the back or shoulder.

2. Duration and Frequency: The episodic nature of your pain, occurring monthly and lasting for several days, is also consistent with gallbladder attacks. These attacks can be triggered by fatty meals, which cause the gallbladder to contract more vigorously.

3. Accompanying Symptoms: Nausea and the sensation of fullness or bloating can accompany gallbladder issues. The fact that you have experienced severe pain in the past, to the point of being unable to move, is concerning and suggests that you may have had significant gallbladder-related issues previously.

4. Previous Investigations: While you have undergone endoscopy, it is important to note that this procedure primarily examines the stomach and the upper part of the small intestine. It does not visualize the gallbladder or bile ducts. Therefore, if your doctor has not yet performed an ultrasound or other imaging studies specifically targeting the gallbladder, it may be prudent to request these tests.

5. Consultation with a Specialist: If your current physician is not addressing your concerns about gallbladder issues, consider seeking a second opinion from a gastroenterologist or a surgeon who specializes in biliary diseases. They can provide a more thorough evaluation and may recommend imaging studies such as an abdominal ultrasound or a HIDA scan to assess gallbladder function and check for stones.

6. Potential for Complications: Delaying diagnosis and treatment of gallbladder issues can lead to complications, such as acute cholecystitis or pancreatitis, especially if a stone blocks the pancreatic duct. Symptoms like jaundice (yellowing of the skin and eyes) can indicate that a stone is obstructing the bile duct, which requires immediate medical attention.

In summary, your symptoms suggest that there could be an underlying gallbladder issue that has not yet been diagnosed. It is essential to advocate for yourself in the healthcare system, and if necessary, seek out additional opinions or tests to ensure that you receive the appropriate care. Keeping a detailed record of your symptoms, including when they occur and their severity, can also be helpful when discussing your case with a healthcare provider.

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