Cholelithiasis with acute cholecystitis: what to know

The gallbladder stores bile and releases it after meals. A stone lodged near its outlet can trap bile, irritate the gallbladder wall and produce steady pain, often under the right ribs or in the upper abdomen. Fever, nausea or vomiting may accompany the inflammation. This is different from a brief episode of gallstone pain because the discomfort may persist and the gallbladder can become infected.

A diagnosis is usually considered after an examination, blood tests and an ultrasound or other imaging. Gallstones do not always cause symptoms, and abdominal pain alone does not establish this diagnosis.

Arrange prompt medical assessment if this diagnosis is suspected. A clinician may recommend observation in hospital, fluids, pain relief, medicine for nausea and antibiotics when infection is suspected. The timing of gallbladder removal depends on your symptoms, scan findings and overall health. Until assessed, follow the advice given about eating and drinking, and avoid taking someone else’s medicine.

Keep a record of when pain starts, what you ate, vomiting, fever and any yellowing of the skin or eyes. Learn more about [Gallstones](/conditions/gallstones/) and arrange a [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) for follow-up.

Seek urgent medical help for severe or persistent upper-abdominal pain, fever or chills, repeated vomiting, yellow skin or eyes, confusion, faintness, or pain with marked weakness. These signs can indicate worsening inflammation, infection or a problem involving the bile ducts or pancreas. Do not wait for a routine appointment if symptoms are escalating.

Sudden severe abdominal pain with vomiting can also need urgent assessment because gallstone disease may affect the pancreas. Read about [Abdominal Pain](/symptoms/abdominal-pain/) and [Vomiting](/symptoms/vomiting/) while arranging care.

Ask what the scan showed, whether the gallbladder is infected, which pain medicines are suitable, whether antibiotics are needed, and when a surgical review should happen. Ask which symptoms mean you should return immediately and whether your usual medicines or food and drink need temporary changes.