Gallbladder Pain (cont.)

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What are other diseases to consider?

Whenever biliary colic is suspected, the possibility of heart pain (angina or heart attack, due to ischemia (reduced blood flow of the heart) should also be considered and vice-versa. The heart pain and biliary pain, although caused by two very different processes, share some common characteristics; they may be confused with one another because sometimes heart pain can be felt in the mid-upper abdomen, and sometimes biliary colic can be felt in the chest. Heart pain also may be associated with nausea and vomiting. Therefore, any patient with pain typical of biliary colic should have an electrocardiogram done, preferably during the pain and/or blood tests to exclude the possibility of heart ischemia.

What is cholecystitis?

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Cholecystitis may occur as a complication of prolonged obstruction of the ducts. It occurs when inflammation develops, usually as a result of bacterial infection. If it results as a complication of sudden obstruction of the ducts, it may begin as biliary colic. Less commonly, it may begin de novo, that is, without the pain that is typical of biliary colic, particularly in situations in which the underlying cause is not gallstones (for example, acalculous cholecystitis, vasculitis, etc.).

The pain of cholecystitis is different from biliary colic. It is located in the same area and is constant, but since the cause of the pain is inflammation and not ductal distention, jarring motion, for example, jumping up and down, makes the pain worse. Individuals tend to lie still rather than move about looking for a position of comfort. Other signs of inflammation are tenderness in the right upper abdomen (although this may occur to a lesser degree with distension of the gallbladder without inflammation) and fever.

Medically reviewed by Martin E Zipser, MD; American board of Surgery

REFERENCE: MedscapeReference. Cholelithiasis.

Medically Reviewed by a Doctor on 4/28/2014

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