What Causes a Gallbladder Attack?

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  • Written By: Eliza Kay
  • Edited By: A. Joseph
  • Last Modified Date: 10 October 2019
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A gallbladder attack occurs when gallstones form in the gallbladder. Gallstones are hard deposits of digestive fluid that range from the size of a grain of sand to the size of a small tangerine. There are three main causes of gallbladder attacks: excess cholesterol in the digestive bile, excess bilirubin in the digestive bile or the inadequate emptying of the gallbladder into the small intestine.

Bile is a fluid that is produced by the liver and that aids in the digestion of fats. One cause of a gallbladder attack occurs when there is too much cholesterol in the bile. Cholesterol usually is dissolved by bile, but if there is too much, then the cholesterol might crystallize and turn into gallstones, possibly causing a gallbladder attack. This is the most common cause of gallbladder attacks. Some evidence suggests that individuals who eat diets that are high in carbohydrates and fat might have a greater incidence of gallbladder attacks.

Another cause occurs when there is too much bilirubin in the bile. During the natural breakdown of red blood cells, a chemical called bilirubin is produced. It can be created in excess by the liver during certain health conditions, such as cirrhosis of the liver, blood disorders and infections of the bile ducts. When the gallstone is created by too much bilirubin in the bile, it is called a pigment stone because of its darker color.


A third cause of gallstone attacks occurs when the gallbladder does not adequately empty itself into the small intestine. When this happens, the bile can build up in the ducts and become very concentrated. This high concentration of bile then clumps together into gallstones.

In addition to these three causes of gallbladder attacks, a large list of risk factors are known to increase one's likelihood of having an attack. These risk factors include being female, being more than 60 years old, being of American Indian or Hispanic descent, being pregnant or having a family history of gallstones. Eating a high-fat or high-cholesterol diet, eating a low-fiber diet, undergoing hormone replacement therapy, losing weight rapidly or receiving intravenous feeding also can increase the risk of gallbladder attacks. Certain health disorders increase the risk as well, including diabetes, anemia, obesity. Having had a bone marrow or organ transplant also increases one's risk.

The symptoms of a gallbladder attack include sudden and rapidly intensifying pain in the middle and upper right portion of the abdomen, as well as in the right shoulder or between he shoulder blades. The pain can last for as long as a few hours. In addition, an individual who is suffering from gallstones might experience abdominal fullness, clay-colored stools, nausea, fever or yellowing of the skin and eyes. Some individuals, however, might not experience any symptoms even when gallstones are present.

Gallbladder attacks are very common, so treatments are readily available for those who suffer from gallstones. The treatment options include medication that dissolves cholesterol gallstones. Other patients might require gallbladder removal surgery or a procedure called electrohydraulic shockwave lithotripsy, for those who cannot undergo surgery.


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