Acute Cholecystitis Quiz
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Stomachache
Localized abdominal pain
Loss of appetite
Cannot take a deep breath because of stomach pain
Yellow eyes
Pain in the middle of the upper stomach
Stomach tenses when pressed lightly
Not seeing your symptoms? No worries!
What is Acute Cholecystitis?
A condition in which the gallbladder (organ that stores bile from the liver) becomes infected or blocked by a stone, causing bile to build up and the gallbladder to swell.
Typical Symptoms of Acute Cholecystitis
- Stomach or abdominal pain that prevents deep breathing
- Stomach or abdominal pain with the abdomen becoming hard when gently pressed
- Stomach or abdominal pain
- High white blood cell counts on blood test within last 1 week
- Stomach or abdominal pain after eating oily foods
- History of gallstones or gallbladder inflamamtion
- Pain in the upper right abdomen
- Pain in the upper abdomen
Diagnostic Questions for Acute Cholecystitis
Your doctor may ask these questions to check for this disease:
- Are you experiencing stomach or abdominal pain that prevents you from taking deep breaths?
- Do you have stomach or abdominal pain with your abdomen becoming hard when gently pressed?
- Do you have any stomach or abdominal pain?
- Were you diagnosed with high white blood cell count recently?
- Do you experience stomach or abdominal pain after eating oily foods?
Treatment of Acute Cholecystitis
Treatment includes antibiotics and pain medications. Patients may be asked to fast and receive fluids through a needle in the vein to help rest the gallbladder. Some patients may need a procedure to remove a stone or surgery to remove the gallbladder.
Reviewed By:
Maxwell J. Nanes, DO (Emergency Medicine)
Dr Nanes received a doctorate from the Chicago College of Osteopathic Medicine and went on to complete a residency in emergency medicine at the Medical College of Wisconsin. There he trained at Froedtert Hospital and Children's Hospital of Wisconsin in the practice of adult and pediatric emergency medicine. He was a chief resident and received numerous awards for teaching excellence during his time there. | | After residency he took a job at a community hospital where he and his colleagues worked through the toughest days of the COVID-19 pandemic. |
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Dec 5, 2025
Following the Medical Content Editorial Policy
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See full list
Symptoms Related to Acute Cholecystitis
Diseases Related to Acute Cholecystitis
FAQs
Q.
Right Shoulder Pain and Nausea: Could It Be Your Gallbladder? (Action Plan)
A.
There are several factors to consider; see below for important details that could change your next steps. Right shoulder blade pain with nausea can be referred pain from gallbladder inflammation or gallstones, especially if it follows fatty meals or includes upper right abdominal tenderness; avoid fatty foods, watch for red flags like fever, jaundice, or pain lasting hours, and seek prompt medical evaluation. Other causes like muscle strain, reflux, liver or pancreas problems, and even the heart are also possible.
References:
* Memon N, Farooq U, Memon G, Ali U. Referred pain from the gallbladder and bile ducts: a systematic review. J Pak Med Assoc. 2023 Sep;73(9):1992-1996. doi: 10.47391/JPMA.6453. PMID: 37703891.
* Yokoe M, Takada T, Hwang TL, Akazawa K, Brittenden J, Chen MF, et al. Acute cholecystitis: current concepts in diagnosis and treatment. J Hepatobiliary Pancreat Sci. 2021 Nov;28(11):1037-1049. doi: 10.1002/jhbp.922. Epub 2021 Oct 23. PMID: 34680879; PMCID: PMC8725141.
* Afzali M, Kim G, Ma J, Reardon PR. Gallbladder pain and referred pain. Ann Transl Med. 2017 May;5(9):209. doi: 10.21037/atm.2017.03.73. PMID: 28575005; PMCID: PMC5440026.
* Portincasa P, Di Ciaula A, Palmieri VO, Garruti G, Wang DQ, Moschetta A. Diagnosis and Management of Gallstone Disease. J Clin Med. 2020 May 29;9(6):1806. doi: 10.3390/jcm9061806. PMID: 32474936; PMCID: PMC7356611.
* Anand S, Sinha A. Biliary Colic. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542186/ PMID: 32491566.
Q.
Sharp Pain After Eating? Why Your Gallbladder is Flaring and Medically Approved Next Steps
A.
Sharp pain after eating, especially fatty foods, is often a gallbladder flare from gallstones blocking bile flow, with upper right abdominal pain that may spread to the back, nausea, and bloating; red flags like fever, jaundice, or pain lasting hours need urgent care. There are several factors to consider, and because other conditions can mimic gallbladder pain, medically approved next steps range from short term diet changes and prompt evaluation with ultrasound to surgery for recurrent attacks; see the complete guidance and important details below to choose the right next step for you.
References:
* Guttmann J, et al. Acute cholecystitis: current concepts in diagnosis and treatment. Minerva Gastroenterol Dietol. 2019 Jun;65(2):107-115. PMID: 30421712.
* Yokoe M, et al. Tokyo Guidelines 2018: Diagnostic criteria and severity grading of acute cholecystitis (TG18). J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):17-30. PMID: 29043438.
* Rogy MA, et al. Medical versus surgical management of gallstones: a systematic review and meta-analysis. J Am Coll Surg. 2019 Oct;229(4):393-400.e1. PMID: 31252199.
* Indar AA, et al. Gallstone disease: a review of the epidemiology, pathogenesis, and clinical management. World J Gastroenterol. 2016 Apr 7;22(13):3455-67. PMID: 27076822.
* Sgouros SN, et al. Functional gallbladder disorder: a reappraisal of the Rome IV diagnostic criteria for biliary pain. World J Gastroenterol. 2018 Oct 7;24(37):4236-4245. PMID: 30338908.
Q.
Severe Pain? Why Your Gallbladder Is Failing & Cholecystectomy Next Steps
A.
Severe upper right abdominal pain that is intense, persistent, or recurs after meals is often due to gallstones and may mean your gallbladder is failing; cholecystectomy is the routine, very safe fix with typically quick recovery, and you should seek urgent care for fever, jaundice, vomiting, or pain lasting hours. Delaying evaluation can lead to complications such as acute cholecystitis, pancreatitis, or infection. There are several factors to consider about diagnosis, imaging, timing and type of surgery, recovery, diet changes, and risks that could affect your next steps; see the complete guidance below.
References:
* pubmed.ncbi.nlm.nih.gov/32677894/
* pubmed.ncbi.nlm.nih.gov/30588448/
* pubmed.ncbi.nlm.nih.gov/32266004/
* pubmed.ncbi.nlm.nih.gov/34109156/
* pubmed.ncbi.nlm.nih.gov/36965682/
Q.
Sharp Rip Under Your Ribs? Why It’s Your Gallbladder & Medical Next Steps
A.
Sharp pain under the right ribs that worsens after eating is often from the gallbladder, usually gallstones causing biliary colic; if pain is constant or comes with fever, chills, vomiting, or yellowing of the skin or eyes, it may be acute cholecystitis that needs urgent care. Doctors confirm with an exam, blood tests, and ultrasound, and treatment ranges from pain control and a low-fat diet to antibiotics and gallbladder removal; there are several factors to consider for your next steps, so see the complete details below.
References:
* Pavan, S., Piana, D., Di Leo, M., & Vescovi, P. (2018). Cholelithiasis: Clinical Presentation and Pathogenesis. *Digestive Diseases, 36*(2), 99–112. (PMID: 29424888)
* Kim, H. J., Kim, J. S., & Lee, M. S. (2020). Acute cholecystitis: current concepts in diagnosis, treatment, and long-term prognosis. *Annals of Translational Medicine, 8*(13), 856. (PMID: 32662282)
* Wang, H., & Tan, Y. M. (2020). Management of acute cholecystitis: From diagnosis to treatment. *World Journal of Gastrointestinal Surgery, 12*(9), 241–251. (PMID: 32906806)
* Zakko, L. A., & Sandlin, A. (2021). Biliary Colic: A Review of Diagnosis and Management. *Gastroenterology & Hepatology, 17*(3), 119–125. (PMID: 33719003)
* Guerra, A., Shrestha, R., & Lopez, R. (2022). Gallbladder disease: A review. *Journal of Digestive Diseases, 23*(2), 101–108. (PMID: 35147551)
Q.
Can eating fatty or heavy foods trigger right-sided pain under the ribs?
A.
Eating fatty or heavy foods may cause right-sided pain under the ribs, especially if there are gallstones involved.
References:
Berhane T, Vetrhus M, Hausken T, Olafsson S, & Søndenaa K. (2006). Pain attacks in non-complicated and complicated gallstone .... Scandinavian journal of gastroenterology, 16373282.
Q.
Could right rib pain be caused by gallbladder problems like gallstones?
A.
Yes, right rib pain can be due to gallbladder issues like gallstones, which often cause pain in the upper right part of the belly.
References:
Berhane T, Vetrhus M, Hausken T, Olafsson S, & Søndenaa K. (2006). Pain attacks in non-complicated and complicated gallstone .... Scandinavian journal of gastroenterology, 16373282.
https://pubmed.ncbi.nlm.nih.gov/16373282/
Khan U, Aarebrot A, Mo S, Landa S, Rösler C, Sodha OK, et al. (2024). Epstein-Barr in a Patient Presenting with Right Upper .... The Journal of emergency medicine, 38423863.
https://pubmed.ncbi.nlm.nih.gov/38423863/
Revzin MV, Scoutt LM, Garner JG, & Moore CL. (2017). Right Upper Quadrant Pain: Ultrasound First!. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 28586152.
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Halpin V. Acute cholecystitis. BMJ Clin Evid. 2014 Aug 20;2014:0411. PMID: 25144428; PMCID: PMC4140413.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140413/Bagla P, Sarria JC, Riall TS. Management of acute cholecystitis. Curr Opin Infect Dis. 2016 Oct;29(5):508-13. doi: 10.1097/QCO.0000000000000297. PMID: 27429137.
https://journals.lww.com/co-infectiousdiseases/Abstract/2016/10000/Management_of_acute_cholecystitis.13.aspxGallaher JR, Charles A. Acute Cholecystitis: A Review. JAMA. 2022 Mar 8;327(10):965-975. doi: 10.1001/jama.2022.2350. PMID: 35258527.
https://jamanetwork.com/journals/jama/article-abstract/2789654