Gall Bladder Pain During Pregnancy: Causes, Risks, And Treatment

Gall Bladder Pain During PregnancyCauses, Risks And Treatment

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Did you know? Women in the age group of 20-60 years are more likely to suffer from gallstones than men (1). And the gall bladder problem is the second most common condition after appendicitis during pregnancy that requires a surgery. Two to four percent of pregnant women are found to develop gallstones, which are detected in ultrasound scanning.

But what work does a gallbladder do, and how does a pregnancy affect its functioning? MomJunction answers these questions and tells you about the care you need to take to keep the problem away.

What Is A Gallbladder?

A gallbladder is a small organ located beneath the liver. It stores the extra bile produced by the liver that helps in digesting the fats. As the food moves from your stomach, the gallbladder releases the bile juice into the small intestine to digest the fats.

If you suffer from any severe problems of the gallbladder, your healthcare provider might remove the organ surgically. As it is not a vital organ, your body will get adjusted to the lack of the gallbladder.

Pregnancy is a time when the gall bladder is vulnerable to various conditions. There is a lot to deal with the gall bladder pain during pregnancy.

[ Read: Treatments For Obstetric Cholestasis ]

Gallbladder Problems During Pregnancy:

The gallbladder problems can result from its infection, inflammation, and blockage:

1. Gallstones:

If there are not enough bile salts or there is extra cholesterol, or if the gallbladder does not empty out its content properly, they lead to the formation of hard stones or gallstones. Gallstones are usually composed of calcium bilirubinate, cholesterol and calcium carbonate (2).

The progesterone hormone produced during pregnancy causes the body’s muscular tissue to relax (3). Therefore, the bile slows down, leading to the development of gallstones and other infections such as inflammation of the gallbladder (cholecystitis).

Symptoms of gallstones:

If you have gallstones during pregnancy, you can have these symptoms after a high-fat meal, and last for almost an hour.

  • Nausea
  • Yellowing skin (jaundice)
  • Severe pain in the upper right or middle part of the abdomen. It can be aching, cramping, sharp or dull)

If the pain persists, it could indicate a major problem in the gallbladder.

2. Cholestasis:

You are at a greater risk of this condition as your body makes more quantities of estrogen during pregnancy. The increasing estrogen levels can raise the cholesterol concentrations in the bile, and reduce gallbladder contractions. The slowing down of the contractions is known as cholestasis (reduced flow of bile). It is sometimes referred to as extrahepatic cholestasis (that occurs outside the liver) and intrahepatic cholestasis or obstetric cholestasis (that occurs inside the liver).

This condition leads to complications such as meconium in the amniotic fluid (meaning the baby has passed the stool before its birth), stillbirth and premature birth (4).

Symptoms of cholestasis:

  • Cholestasis has symptoms such as:
  • Intense itching
  • Dark colored urine
  • Yellowing skin and eyes (jaundice)
  • Fatigue
  • Depression
  • Loss of appetite

Cholestasis is hard to recognize as the symptoms are quite common during pregnancy.

3. Biliary colic:

Biliary colic occurs due to the blockage of the gall ducts. If the bile is not able to exit the gallbladder due to stones, it can cause inflammation or infection inside the gall bladder. Non-release of bile means the failure of fats to digest in the small intestine. This causes a shooting pain in the upper abdomen and back, which may last for a few minutes to several hours. You may even have nausea and vomiting (5).

4. Gallbladder sludge / Biliary sludge:

It mostly happens when the gallbladder is filled with excess cholesterol and not enough bile. Bile is like a soap, which emulsifies fats so that they can be absorbed into the digestive tract. If there is not enough bile, the remaining fat turns into sludgy goo, referred to as gallbladder sludge.

In some cases, sludge thickens and forms into gallstones. And in some, it just fades away. But if it remains persistent, the doctor may prescribe medications or go for the surgical removal of the gallbladder.

[ Read: Overweight During Pregnancy ]

When To See A Doctor?

In some conditions, you will develop gallstones without even knowing about it. They are considered ‘silent gallstones’, as they do not affect the functioning of the gallbladder. But if they remain for a longer time, they block the ducts and cause a ‘gallbladder attack’.

This attack can cause the following symptoms which require immediate medical attention.

  • A low-grade fever or chills
  • Dark-colored urine
  • Light-colored stools
  • Yellowing of skin
  • Pain in the upper abdomen lasting for about five hours
  • Pain beneath the right shoulder
  • Pain at the backside in between the shoulder blades
  • Nausea and vomiting
  • Bloated feeling
  • Intolerance to fatty foods
  • Belching and indigestion
  • Worsening pain during deep inhalation

Keep a watch on the above gallbladder symptoms during pregnancy. Report the symptoms to your doctor right away. Most times, these symptoms are common in your third trimester and after delivery. But if you are at a greater risk of the gallbladder diseases, the symptoms develop much earlier in pregnancy.

Risk Factors For Gallbladder Problems During Pregnancy:

You are at a high risk of developing gallstones, biliary colic and other gallbladder related conditions due to:

  • A family history of gallbladder diseases
  • Any pre-pregnancy gallbladder conditions
  • Overweight
  • Having high cholesterol or high-fat diet
  • Diabetes
  • Your origin (Native Americans and Mexican Americans are at a higher risk than others) (6)

[ Read: Diabetes During Pregnancy ]

Diagnosis For Gallbladder Problems:

  1. You may mistake the gallbladder disease symptoms as morning sickness that happens in the first trimester. But, if symptoms remain beyond the first trimester, your doctor may perform an ultrasound to test for gallbladder problems.
  1. She would examine the bile ducts for gallstones through magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP) and hepatobiliary iminodiacetic acid (HIDA) scans.
  1. Blood tests are performed to check the signs of inflammation, infection of bile ducts, pancreatitis and other complications.
  1. Most of the tests, such as oral cholecystogram (gallbladder X-ray), nuclear scan and computed tomography (CT) scan, are not safe during pregnancy.

Depending on the symptoms and risk factors, your doctor may go ahead with the treatment management.

Treatment For Gallbladder Issues During Pregnancy:

Gallbladder problems require immediate treatment as severe complications can put both you and your baby at risk.

[ Read: Upper Respiratory Tract Infection During Pregnancy ]

Non-surgical treatment:

  • Gallbladder problems need a treatment only when you start seeing the symptoms.
  • If you show signs of infections such as a low-grade fever, nausea, dark-colored urine and more, your doctor might prescribe antibiotics.
  • If you have itching because of cholestasis, medications are given to lessen the itch, and the fetus is closely monitored until your delivery.
  • The biliary colic condition may require hospitalization with intravenous fluid replacement to manage pain and dehydration.

Surgical treatment:

Your doctor may have to go ahead and remove your gallbladder in severe cases of infection and pain.

1. Laparoscopic cholecystectomy:

Gallstones, which keep the bladder from emptying completely and develop an infection, require surgery. Though gall bladder surgery is not a recommended treatment during pregnancy, it is possible for a woman to have a safe gallbladder removal. This procedure is known as cholecystectomy, which involves removal of the gallbladder with the use of unique instruments by making tiny incisions in the abdomen. This is a safe surgical procedure to perform in any trimester as per the guidelines shared by the SAGES (Society of American Gastrointestinal and Endoscopic Surgeons) (7).

Another procedure, open cholecystectomy, done in the third trimester, requires a wide abdominal incision for the easy removal of the gallbladder without damaging the uterus.

2. Endoscopic treatment:

Choledocholithiasis is the presence of gallstones in the common bile duct. These gallstones can be removed by ERCP (endoscopic retrograde cholangiopancreatography), a procedure in which a thin and flexible tube is run through your mouth to the opening of the common bile duct. It injects a dye and possesses a small camera at the end of the tube to have a better view of the stones. The stones are then removed through the tube.

The abdomen is covered during this procedure so that the radiations will not harm the fetus (8).

Measures That Help Prevent Gallbladder Problems:

Gallbladder pain could be unbearable. It is better to prevent the problem than look for a treatment later. You may take these preventive measures:

1. Weight management:

Managing weight prevents many complications, including that of the gall bladder.

  • Make sure you eat right and not more.
  • Binge eating will not yield any benefits.

2. Fitness:

Having a healthy routine is a must.

  • Have a good workout in the form of exercises and Yoga.
  • Keep your body fit and flexible to avoid health complications.

3. Manage diabetes:

If you have diabetes and possess high levels of triglycerides, there would be a greater risk of gallstones. Therefore, you should keep your diabetic levels under check.

[ Read: Benefits Of Fiber During Pregnancy ]

Gallbladder Diet During Pregnancy:

Diet can play a major role in reducing the severity of gallbladder problems if you are already experiencing conditions such as gallstones.

1. Limit your fat consumption:

Fat foods trigger a reaction in the gallbladder, and the pain turns accurate if you have large gallstones. Therefore, limiting your dietary fat will alleviate gallstone symptoms. For instance, choose light meat and skinless poultry in place of red meat, and low-fat yogurt in place of cooking oils. These modifications in diet will lower the risk of a gallbladder attack and help you maintain a healthy weight.

2. Consume more fiber:

Eat whole grains, fruits, and vegetables. They assist in the digestion process and decrease the gallbladder infection.

  • Eat four to five cups of fruits or veggies everyday
  • Use vitamin-rich veggies such as tomato and baby spinach in the sandwich, instead of mayonnaise or cheese
  • Add a handful of dried apricots to a cup of oatmeal
  • Berries, broccoli, kale and all dark-colored fruits and veggies are good options

3. Hydrate yourself:

Drink plenty of water. Keeping yourself hydrated helps flush away toxins and unwanted residues from the body. It also improves digestion. However, avoid sweetened beverages and sodas as they contain extra calories. Instead, choose plain water with a twist of lemon.

4. Eat whole foods:

Fresh and whole foods are healthy alternatives to processed and refined foods.

  • Eliminate highly processed foods containing trans fats, preservatives, and other additives
  • Avoid packaged items such as crackers, chips and cakes
  • Try making your snacks such as fruit or vegetable slices, sandwich, and sprouts

Frequently Asked Questions

Gallbladder problems leave with several questions. Here we answer some commonly asked questions:

1. Can gallstones harm my unborn baby?

According to the US National Institute of Diabetes and Digestive and Kidney Diseases, gallbladder problems could cause serious complications during pregnancy. Though gallstones and deposits do not directly affect the baby, the consequences of the disease could do.

If you experience pain in the gall bladder for more than five hours, or severe symptoms of inflammation, infection, nausea and vomiting, they will restrict you from having nutritious food, thus hampering the baby’s growth.

2. What can happen if gallstones are not treated?

Gallstones may cause spells of severe gallbladder pain if not treated on time. They also lead to inflammation of the gallbladder, the condition known as cholecystitis. In rare cases, it can cause an abscess.

If the gallstones block the bile duct, resisting bile flow from the liver, it can lead to jaundice. They may also affect the release of pancreatic juices causing pancreatitis (inflammation of the pancreas).

3. Do gallbladder problems recur after pregnancy?

Gallbladder problems will not appear for two to four months post delivery. It is due to the changing pregnancy hormone levels. But sometimes, a few conditions can cause gallbladder diseases even after pregnancy.

  • Changing levels of pregnancy hormones post delivery.
  • Rapid weight loss. When you lose fat quickly, the excess cholesterol remains in the bile causing gallstones.

4. Is pregnancy possible after gallbladder removal?

Yes, you can get pregnant after the surgical removal of the gallbladder. There are no complications if you conceive. However, you should take enough rest, and abstain from physical works while recovering. Also, keenly observe the healing process and stay hydrated.

[ Read: Healthy Drinks To Take During Pregnancy ]

A Quick Summary:

  • Your risk for gallstones increases with your age and the number of pregnancies
  • Elevation in the levels of liver enzymes can change the bile flow (9)
  • Ultrasound is the only safe method for diagnosing gallbladder conditions
  • Surgical and gastrointestinal consultation should be the next step after diagnosis
  • Surgical intervention for gallstone diseases does not lead to fetal mortality, stillbirth or preterm labor.

If you had suffered any gallbladder disease during pregnancy, but did not require a surgery, then you need to have a regular follow-up. Symptoms can sometimes develop later in life.

You need not worry about gallbladder conditions, as the chances of their occurrence are few and also, there is a cure for the problem.

Have something to share about gallbladder issues? Feel free to share your thoughts in the below comment section.

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Rebecca Malachi

"I believe words have power. They are a powerful tool for a creative soul. Being a 'word addict', I express my thoughts and contribute articles on health, wellness and beauty. Apart from writing, I love listening to gospel music and enjoy observing nature in silence."
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