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The first step in relieving the pain of an inflamed gallbladder, cholecystitis, is making sure the pain is really from your gallbladder.

  • Gallbladder pain originates on the right side of your body, under your rib cage.
  • Pain from gallstones, gall "gravel," and gallbladder inflammation radiates up toward your shoulder, or sometimes down toward your right knee.
  • At first gallbladder pain is "colicky." It comes in a wave and passes. As your gallbladder remains inflamed, however, the pain gradually becomes constant.
  • Gallbladder pain is usually worst after a meal, not before eating.
  • Gallbladder attacks can be unusually severe when you go off a low-fat diet, because the gallbladder has stored a lot of bile it hasn't had to release.
  • Gallbladder problems usually but don't always cause nausea and vomiting.
  • Gallbladder problems often cause tachycardia (accelerated heartbeat) and fever.
  • In older people and in diabetics, the pain of gallstones and other gallbladder issues may be vague, hard to locate. 
  • Children, especially children who have sickle cell anemia or who are on parenteral (intravenous) nutrition may experience no pain at all.
  • It's not the norm to be able to feel a swollen gallbladder just to by touching the skin, although this happens in 30 to 40 percent of cases.
  • Jaundice, yellowing of the skin and/or eyes, occurs in about 15 percent of cases. If the underlying problem isn't treated, the yellow tends to turn to green. That's usually a sign someone needs to have gone to the emergency room yesterday and definitely should go right away.

 

If you aren't having surgery soon, then the primary tool you have for managing the pain is diet.

 

It helps to remember what you gallbladder does to make the right choices. After you eat a fatty meal, your lower digestive tract releases a yellowish-green unpleasant substance called bile to emulsify the fat. That's necessary because fat floats. If you have fat floating inside that long, turning tube known as your intestines, you will have a variety of problems getting food to keep traveling downward for absorption and waste matter flowing downward for elimination. Usually the pressure builds up until you just have to "go."

Your liver makes the bile and sends it down the biliary duct for storage in the gallbladder so your digestive tract will have all the bile it needs in a single "dump" after you eat a meal. When those digested fat reach your small intestine, fat-sensing cells release a hormone called cholecystikinin into your bloodstream, and the muscles around your gallbladder attempt to squeeze out the bile. If you have gallstones or gallbladder gravel, the result is a lot of pain and very little bile release. So what do you do?

  • First of all, don't stop eating altogether. If you still have a gallbladder, it will continue to accumulate bile and swell when you don't eat.
  • But don't eat a lot of fatty foods at one meal, either. The more fat your gut senses, the more cholecystikinin is released into your bloodstream, and the more the muscles around your gallbladder will squeeze, squeeze, and sqeeeze some more.
  • Laxatives speed up the passage of food through your intestines so there is less opportunity for fat to get "stuck." They don't treat the underlying disease. They just help you cope with the symptoms.
  • Use a product that draws water into your stool, like magnesium (MOM or Epsom salts), not a stimulant laxative that forces you to "go." You can become dependent on stimulant laxatives to that when you don't take them, you become profoundly constipated but also have gallstone attacks.
  • If you have a specific food that works for you, eat it. However, be aware that not everyone will have the same helpful food. Usually it's something that you uniquely allergic or sensitive to that gives you diarrhea under normal circumstances but helps you cope with gallbladder disease.

But cure is always better than treatment. Many of these problems will go away after gallbladder surgery, but it takes about six weeks to get back to normal.

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