As stated previously, the major gallbladder problems that produce gallbladder pain are biliary colic, cholecystitis, gallstones, pancreatitis, and ascending cholangitis. There are two major causes of pain that either originate from the gallbladder or involve the gallbladder directly. They are due to 1) intermittent or complete blockage of any of the ducts by gallstones; or 2) gallstone sludge and/or inflammation that may accompany irritation or infection of the surrounding tissues, when partial or complete obstruction of ducts causes pressure and ischemia (inadequate blood supply due to a blockage of blood vessels in the area) to develop in the adjacent tissues.
Gallstones usually form in the gallbladder, but may form in any of the ducts. When the gallbladder is compressed (squeezed by musculature), bile usually goes out through the ducts into the GI tract; however, if gallstones or gallstone sludge is present, there can be partial or complete blockage of the ducts with pressure on the surrounding tissue, sometimes enough to cause local ischemia. Other processes such as trauma can cause gallbladder pain. Infection of the biliary ducts and the gallbladder, usually occurring after gallstone obstruction also can cause pain.
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