A gallstone attack, also known as biliary colic, can cause sudden, severe pain in the upper right abdomen. This pain occurs when a gallstone blocks the cystic duct, obstructing the flow of bile from the gallbladder. While medication and surgery are often used to treat gallstones, making dietary changes during an attack can help minimize symptoms. Being aware of which foods to avoid and which to emphasize is key to managing pain and preventing complications.
What are gallstones?
Gallstones form when bile contains too much cholesterol or bilirubin. Most stones are made up of hardened cholesterol. Gallstones range in size and shape, and some resemble pebbles while others can be as large as golf balls. The gallbladder stores and concentrates bile, a fluid made in the liver that helps digest fats. Gallstones form within the gallbladder and can cause problems when they obstruct bile ducts, leading to a buildup of bile that can cause inflammation and pain.
What are the symptoms of a gallstone attack?
A gallstone attack occurs when a stone blocks the cystic duct. This duct drains bile from the gallbladder. When it’s blocked, a gallstone attack can cause:
- Severe pain in the upper right or middle abdomen
- Pain that may radiate to the right shoulder or back
- Pain after eating a fatty meal
- Nausea and vomiting
- Fever
- Chills
- Jaundice (yellowing of skin and eyes)
Attacks often last from 1 to 4 hours. Symptoms typically peak within the first hour and then gradually get better.
What triggers a gallstone attack?
Gallstone attacks may be triggered by:
- Eating foods high in fat, such as fried or fatty foods
- Rapid weight loss
- Fasting
- Dehydration
- Pregnancy
- Certain medications including birth control pills
Eating seems to be one of the main triggers. High fat foods cause the gallbladder to contract more forcefully, which may cause a stone to become lodged in the cystic duct.
How are gallstones diagnosed?
To diagnose gallstones, a doctor will typically:
- Take a medical history and ask about symptoms
- Conduct a physical exam to check for pain in the abdomen
- Order blood tests to look for signs of infection or inflammation
- Perform imaging tests such as an abdominal ultrasound, CT scan, or MRI
These tests allow doctors to check for stones in the gallbladder and ducts. Blood tests also help rule out other potential causes of abdominal pain.
What foods should I avoid during a gallstone attack?
During a gallstone attack, stick to a low-fat diet to help minimize symptoms. Avoid:
- Fatty and fried foods
- High-fat dairy like cheese, whole milk, and ice cream
- Fatty cuts of meat
- Poultry skin
- High-fat bakery items like muffins and pastries
- Rich sauces and gravies
- Oils
- Butter and margarine
- Eggs
- Pizza
- Chips
- Avocados
- Coconuts
- Nuts and seeds
Stick to low-fat proteins like fish, skinless chicken breast, beans, and lean cuts of beef or pork. Avoid using added fats when cooking. Steaming, grilling, baking, and broiling are healthier low-fat cooking methods.
Are there any foods I should emphasize during an attack?
Focus on eating foods that are easy to digest and low in fat. Good options include:
- Fruits like applesauce, berries, melons, citrus fruits, and bananas
- Cooked vegetables such as carrots, spinach, asparagus, squash, and green beans
- Whole grains like oatmeal, bran cereals, whole wheat bread or pasta
- Skinless chicken breast or lean cuts of beef or pork
- Fish like salmon, tuna, herring, and cod
- Eggs whites or egg substitutes
- Tofu and soy products
- Beans, peas, and legumes
- Low-fat dairy products like skim or low-fat milk, yogurt, and cheese
- Broths and miso
When cooking, opt for healthy fats like olive oil or avocado in moderation. Also drink plenty of fluids like water, unsweetened tea, and broths. Staying hydrated can help thin out bile and prevent stone formation.
What should I eat after a gallstone attack?
After an attack has passed, it’s important to continue eating a low-fat diet to prevent repeat episodes. Gradually reintroduce higher fat foods in moderation while paying attention to how foods affect your symptoms. Foods to emphasize include:
- Non-citrus fruits
- Non-fat or low-fat dairy products
- Vegetables
- Whole grains
- Lean proteins like fish, poultry, soy, beans
- Legumes
- Healthy fats like olive oil, nuts, seeds, avocado
- Spices, herbs, vinegars for flavoring
Avoid fried and fatty foods, eggs, pizza, chips, pastries, and rich creamy sauces or dressings. Stick to water and limit soda, juices, alcohol, and sugary drinks. Eating smaller, more frequent meals may also help prevent attacks. Losing weight if overweight and exercising can also lower risk.
Are gallbladder removal and gallstone surgery an option?
If gallstones continue causing symptoms, surgery to remove the gallbladder (cholecystectomy) may be necessary. This is one of the most common surgeries performed. It removes the gallbladder so stones can’t block ducts and cause pain.
There are two main types of this surgery:
- Laparoscopic – Minimally invasive surgery with small incisions and use of a camera. This has a shorter recovery time.
- Open surgery – Involves one large abdominal incision. This has a longer recovery time.
Surgery provides permanent relief in 80-95% of people with gallbladder issues. However, it can pose risks including bleeding, infection, injury to other organs, and post-surgery diarrhea. Alternative surgeries like lithotripsy use sound waves to break up stones but are not as common.
When should I seek emergency care for gallstones?
Seek emergency care if you experience:
- Severe pain that persists for over 5 hours
- Fever over 100.4°F (38°C)
- Shaking chills
- Vomiting that prevents keeping liquids down
- Signs of jaundice like yellowed skin
- Clay-colored stool
These may be signs of complications like pancreatitis, infection, or gallbladder inflammation needing urgent treatment. Otherwise, make a prompt appointment with your healthcare provider for evaluation if attacks persist.
What medications can help relieve gallstone pain?
Medications may provide relief during an attack:
- Pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol)
- Antispasmodic drugs to reduce gallbladder contractions
- Antibiotics if infection is present
- Medications to improve bile flow like ursodeoxycholic acid
For severe cases, hospitalization and intravenous medications may be required. Seek emergency care if over-the-counter medications don’t reduce pain. Stopping an attack quickly can prevent complications.
How can diet help manage and prevent gallstones?
Dietary changes can help reduce the risk of gallstones forming and lower complications. Tips include:
- Eating frequent small meals instead of large ones
- Limiting fatty, sugary, and processed foods
- Increasing high-fiber foods like fruits, veggies and whole grains
- Drinking plenty of fluids like water and herbal tea
- Limiting alcohol intake
- Achieving or maintaining a healthy weight if overweight
Losing weight quickly can increase gallstone risk so aim for 1-2 lbs per week. Consult a dietitian and your doctor for help creating a gallbladder-friendly eating plan.
What supplements may help prevent gallstones?
Some supplements may help lower risk of developing gallstones:
- Vitamin C – Potent antioxidant that helps prevent cholesterol crystallization in bile
- Magnesium – Helps bind cholesterol to bile acids so stones are less likely to form
- Turmeric – Anti-inflammatory properties may help prevent gallbladder inflammation
- Milk Thistle – Helps improve bile flow and gallbladder function
- Chanca piedra – Herb used traditionally to dissolve gallstones
Always consult your healthcare provider before starting supplements, especially if you have any medical conditions or take medications. Supplements should complement, not replace, medical treatments.
What lifestyle changes can help prevent gallstone attacks?
Making certain lifestyle adjustments may help reduce your risk of recurrent gallstone pain and complications:
- Lose weight gradually if overweight
- Follow a low-fat diet emphasizing fruits, vegetables, lean proteins, whole grains and legumes
- Exercise most days of the week for at least 30 minutes
- Drink alcohol moderately or avoid completely
- Quit smoking and avoid secondhand smoke
- Drink plenty of fluids like water, herbal tea, broth
- Avoid skipping meals or crash diets
- Reduce stress through yoga, meditation, counseling, or other methods
Making these changes provides overall health benefits while also keeping gallstones in check. But be sure to get medical care if attacks persist or worsen.
Conclusion
Gallstone attacks can cause severe abdominal pain, nausea, vomiting, and other distressing symptoms. While attacks often resolve in a few hours, making dietary changes can help ease discomfort. Emphasize low-fat foods and avoid fatty, sugary, and heavily processed items. Surgery or medications may be necessary for recurring gallstones. Staying hydrated, losing weight if overweight, and exercising can also lower gallstone risk. Promptly seek medical care for any concerning symptoms or persistent attacks. With the right prevention and treatment, it’s possible to manage gallstones and maintain a healthy, varied diet.
