Sharp Abdominal Pain? Why Gallstones Hurt & Medical Next Steps

Sharp abdominal pain can be alarming—especially when it comes on suddenly and feels intense. One common cause of this type of pain is gallstones. While many people with gallstones never have symptoms, others experience severe discomfort that can't be ignored.

Understanding why gallstones hurt, what symptoms to watch for, and what to do next can help you respond quickly and appropriately.

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What Are Gallstones?

Gallstones are hardened deposits that form inside the gallbladder, a small organ located under the liver on the right side of your abdomen. The gallbladder stores bile, a digestive fluid that helps break down fats.

Gallstones can form when:

• There is too much cholesterol in the bile
• There is too much bilirubin (a waste product from red blood cells)
• The gallbladder doesn't empty properly

Gallstones can range in size from a grain of sand to a golf ball. Some people have just one. Others may have several.

Importantly, many people with gallstones never experience symptoms. These are called "silent gallstones." Problems start when a stone blocks a bile duct.

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Why Do Gallstones Cause Sharp Pain?

Pain from gallstones happens when a stone blocks the normal flow of bile. This blockage causes pressure to build up in the gallbladder, leading to inflammation and intense discomfort.

The most common painful condition related to gallstones is called biliary colic.

Biliary Colic Pain Often:

• Appears suddenly
• Occurs in the upper right abdomen
• May radiate to the right shoulder or back
• Lasts from 30 minutes to several hours
• Often starts after eating a fatty meal

The pain can be sharp, cramping, or steady and severe. It may be strong enough to interfere with normal activities.

If the blockage persists, more serious conditions can develop.

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When Gallstones Become More Serious

Gallstones don't always stop at causing temporary pain. In some cases, complications can develop, including:

1. Acute Cholecystitis (Gallbladder Inflammation)

This occurs when a stone remains lodged in the gallbladder outlet.

Symptoms may include:

• Persistent abdominal pain (longer than 6 hours)
• Fever
• Nausea or vomiting
• Tenderness when pressing on the abdomen

This condition requires medical attention.

2. Choledocholithiasis (Blocked Bile Duct)

If a gallstone moves into the main bile duct, it can block bile flow from the liver.

Signs may include:

• Yellowing of the skin or eyes (jaundice)
• Dark urine
• Pale stools
• Persistent abdominal pain

3. Pancreatitis

A gallstone can block the pancreatic duct, leading to inflammation of the pancreas.

Symptoms may include:

• Severe upper abdominal pain
• Pain that spreads to the back
• Fever
• Rapid pulse

Pancreatitis can be serious and requires immediate medical care.

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What Does Gallstone Pain Feel Like?

People describe gallstone pain in different ways, but common descriptions include:

• A sharp, stabbing pain
• A squeezing or gripping sensation
• Intense pressure under the ribs
• Pain that makes it hard to sit still

Unlike indigestion, gallstone pain does not usually improve with antacids or a bowel movement. It often peaks quickly and can be severe.

If you're experiencing sharp upper abdominal discomfort and want to better understand what might be causing it, you can use a free abdominal pain symptom checker to explore possible causes and determine whether you should seek medical care right away.

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Who Is at Higher Risk for Gallstones?

Gallstones are common. Certain factors increase the risk:

• Female sex
• Age over 40
• Family history of gallstones
• Obesity
• Rapid weight loss
• Pregnancy
• High-fat or high-cholesterol diet
• Diabetes
• Liver disease

That said, anyone can develop gallstones—even without clear risk factors.

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How Are Gallstones Diagnosed?

If your doctor suspects gallstones, they will:

1. Ask about your symptoms and medical history
2. Perform a physical exam
3. Order imaging tests

The most common test is an abdominal ultrasound. It is painless and highly effective at detecting gallstones.

In some cases, additional imaging such as CT scans or MRIs may be used.

Blood tests may also be ordered to check for infection, inflammation, or bile duct blockage.

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Treatment Options for Gallstones

Treatment depends on whether your gallstones are causing symptoms.

If Gallstones Are Silent

No treatment may be needed. Many people live their entire lives without symptoms.

If Gallstones Are Causing Pain

Treatment typically involves:

1. Gallbladder Removal Surgery (Cholecystectomy)

This is the most common and effective treatment.

• Usually performed laparoscopically (minimally invasive)
• Most patients go home the same day or next day
• Recovery typically takes 1–2 weeks
• You can live normally without a gallbladder

Once the gallbladder is removed, gallstones cannot recur.

2. Medications (Less Common)

In rare cases, medications may be used to dissolve cholesterol gallstones. However:

• It can take months or years
• Stones may return
• It is not suitable for most patients

3. ERCP Procedure

If a gallstone is stuck in a bile duct, a procedure called ERCP may be used to remove it without surgery.

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When Should You Seek Immediate Medical Care?

You should seek urgent medical attention if you experience:

• Severe abdominal pain lasting more than a few hours
• Fever with abdominal pain
• Yellowing of the skin or eyes
• Persistent vomiting
• Chest pain (to rule out heart problems)

These could signal serious complications that require prompt treatment.

Do not ignore intense or worsening pain.

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Can Gallstones Be Prevented?

You cannot completely eliminate the risk of gallstones, but you can lower it by:

• Maintaining a healthy weight
• Avoiding rapid weight loss
• Eating a balanced diet with fiber
• Limiting highly processed and high-fat foods
• Staying physically active

Small, sustainable lifestyle changes are more protective than extreme dieting.

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Is Sharp Abdominal Pain Always Gallstones?

No. Many conditions can cause sharp abdominal pain, including:

• Appendicitis
• Kidney stones
• Peptic ulcers
• Acid reflux
• Irritable bowel syndrome
• Liver conditions
• Pancreatitis
• Even heart problems

Because abdominal pain has many possible causes, getting a proper medical evaluation is essential.

If you are unsure what your symptoms mean, starting with a structured assessment like a symptom check for Abdominal pain can provide guidance—but it should not replace professional medical care.

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The Bottom Line

Gallstones are common, and many people never know they have them. But when gallstones block bile flow, they can cause sharp, intense abdominal pain that should not be ignored.

Most cases are treatable, and gallbladder removal is a safe and widely performed procedure. Serious complications are possible—but they are manageable when treated promptly.

If you experience:

• Severe abdominal pain
• Fever
• Jaundice
• Persistent nausea or vomiting

You should speak to a doctor immediately.

Even if symptoms are mild, it's wise to schedule a medical evaluation to confirm the cause. Abdominal pain can sometimes signal life-threatening conditions, and early diagnosis makes a difference.

When in doubt, listen to your body—and speak to a doctor about anything that could be serious or life threatening.