When your gallbladder starts acting up, the first thing to do is stop eating, especially anything fatty, and pay close attention to your symptoms. Most gallbladder attacks are caused by gallstones temporarily blocking the duct that drains bile, triggering intense pain in the upper right abdomen. What you do next depends on how severe the pain is, how long it lasts, and whether you develop a fever or other warning signs.
What a Gallbladder Attack Actually Feels Like
The classic gallbladder attack hits after a meal, particularly one high in fat. You’ll feel a steady, squeezing pain in the upper right side of your abdomen, sometimes radiating to your right shoulder blade or back. This isn’t a sharp, stabbing pain that comes and goes in waves. It builds over 15 to 60 minutes, then stays constant. Many people also feel nauseous or vomit.
A straightforward gallstone episode (sometimes called biliary colic) typically lasts anywhere from 30 minutes to a few hours and then fades on its own as the stone shifts. There’s usually no fever. If the pain lasts six hours or longer, intensifies rather than fading, and comes with a fever or chills, the gallbladder itself is likely inflamed. That’s a more serious situation called acute cholecystitis, and it won’t resolve on its own.
What to Do During an Active Attack
Stop eating immediately. The pain is triggered by your gallbladder contracting, and eating, particularly fat and protein, makes it contract harder. When food enters your small intestine, your gut releases a hormone that signals the gallbladder to squeeze out bile. Fat is the strongest trigger for this hormone release, protein is close behind, and carbohydrates barely stimulate it at all. So the single most effective thing you can do in the moment is stop giving your body reasons to squeeze that gallbladder.
Sip water if you can keep it down. Some people find that applying a heating pad to the upper right abdomen helps with the pain, though this won’t change what’s happening inside. Over-the-counter pain relievers can take the edge off, but they won’t stop the attack. If you can, lie on your left side or sit upright rather than lying flat, as some people find this more comfortable.
Most importantly, watch the clock. If the pain eases within a few hours and you feel relatively normal afterward, you’ve likely had a biliary colic episode. It’s not an emergency, but it is a signal that something is going on and you should see a doctor soon.
Red Flags That Need Immediate Attention
Certain symptoms during or after an attack signal a potentially serious complication. Get medical help right away if you notice any of these:
- Abdominal pain lasting several hours that isn’t improving or is getting worse
- Fever or chills, even a low-grade fever
- Yellowing of your skin or the whites of your eyes (jaundice)
- Dark, tea-colored urine or pale, clay-colored stools
- Persistent vomiting where you can’t keep anything down
These can indicate an infected gallbladder, a stone lodged in the common bile duct, or inflammation spreading to the liver or pancreas. None of these situations resolve at home.
Eating After the Pain Passes
Once an attack subsides, don’t celebrate with a cheeseburger. For the next several days, keep your diet extremely low in fat. A practical guideline: check nutrition labels and stick to foods with 3 grams of fat or less per 100 grams. That means plain rice, toast, lean chicken breast, fruits, vegetables, and broth-based soups. Avoid fried food, butter, cream sauces, cheese, pastries, and fatty cuts of meat.
This isn’t a cure. It’s damage control. Eating low-fat meals reduces how forcefully your gallbladder contracts, which lowers the chance of another stone getting wedged in the duct. Many people find their attacks follow a clear pattern tied to rich, heavy meals, and adjusting their diet buys them time until they can see a doctor and figure out next steps.
How Your Doctor Figures Out What’s Wrong
The first test is almost always an abdominal ultrasound. It’s painless, quick, and good at spotting gallstones. However, ultrasound is better at confirming stones exist than at diagnosing active inflammation. If your doctor suspects your gallbladder is inflamed but the ultrasound isn’t conclusive, a HIDA scan may be the next step. This imaging test tracks how bile moves through your system and is considered more reliable for diagnosing acute cholecystitis.
Sometimes the ultrasound shows “sludge” rather than solid stones. Biliary sludge is a thick, muddy mixture of bile components that hasn’t fully crystallized into stones. If you have sludge but no symptoms, it typically doesn’t need treatment. If it’s causing attacks, the approach is the same as for gallstones.
Surgery: What It Looks Like and How Fast You Recover
If you’re having repeated gallbladder attacks, your doctor will likely recommend removing the gallbladder entirely. This is one of the most common surgeries performed, and it’s done laparoscopically in most cases, through a few small incisions. You can often go home the same day.
Recovery from laparoscopic surgery is faster than most people expect. Full recovery takes about a week, and many people return to work within one to two weeks. You’ll be cleared to go home once you can eat and drink without pain and walk without help. If the surgery needs to be done through a larger incision (open cholecystectomy), which is less common, expect two to three days in the hospital and four to six weeks for a full recovery.
You don’t need your gallbladder to live a normal life. Without it, bile flows directly from your liver into your small intestine rather than being stored and concentrated first. Your body adapts, though the transition isn’t always seamless.
Life After Gallbladder Removal
Roughly 10 to 15% of people who have their gallbladder removed experience ongoing digestive symptoms afterward, sometimes called postcholecystectomy syndrome. This can include fatty food intolerance, bloating, diarrhea, indigestion, and intermittent abdominal pain similar to what you had before surgery. For most people in this group, symptoms are manageable and improve over time as the body adjusts to continuous bile flow. A smaller number have persistent issues that need further investigation.
Some estimates put the number as high as 30% experiencing at least some digestive changes, though many of these are mild and temporary. Diarrhea is one of the more common complaints, affecting about 35% of postcholecystectomy patients to some degree, because bile now drips steadily into the intestine rather than being released in controlled bursts.
Nonsurgical Options for Gallstones
If surgery isn’t an option due to other health conditions, there is a medication that can slowly dissolve certain types of gallstones. It works only on cholesterol-based stones that aren’t calcified, and it requires at least 12 months of daily treatment. Even then, about 40% of patients achieve complete stone dissolution. Stones also frequently come back after the medication is stopped. For these reasons, surgery remains the standard recommendation for gallstones causing symptoms.
For elderly patients or those who can’t safely undergo surgery, a procedure to widen the opening where the bile duct meets the intestine can help prevent stones from getting stuck and causing complications like pancreatitis. This is done endoscopically and doesn’t require general anesthesia in the traditional sense.