Question

I had my gallbladder taken out five years ago and I still get pain on my right side under my ribs. I have had all kinds of tests done and they can't find anything. If I eat fatty foods, chocolate, sauces and so on, I get the pain about twenty minutes later.

Answer

Unfortunately, you have developed a fairly common problem after gallbladder removal - that of recurrent right-sided abdominal pain. This is known as the Post-Cholecystectomy Syndrome. Patients with this problem tend to have a recurrence of their original pain, or a variation of it, after the gallbladder has been removed surgically. There are many theories to explain why this occurs. The most likely reason is that the original pain had nothing to do with the gallbladder in the first place. Often patients see a physician for right-sided upper abdominal pain and the diagnosis of gallbladder disease is made just on the basis of seeing stones on an ultrasound. The problem with this approach is that many people can have gallstones without symptoms, and not all right-sided pain relates to the gallbladder. Before attributing such pain to gallstones, a proper history must be obtained and this must correlate with the results of studies done that support the gallbladder as the cause of the symptoms.

Another cause of recurrent pain is a different problem in the bile ducts. The gallbladder is just one component of the bile duct system that drains the liver. Stones can also occur, or pass into the other bile ducts, and the sphincter (valve) that regulates bile flow into the intestinal tract can also be too tight. Any of these problems can cause pain that is indistinguishable from gallbladder pain. Finally, there are other diseases that can occur after gallbladder surgery that are unrelated to the surgery and that can lead to right-sided pain. These include rib or chest wall inflammation, peptic ulcer disease, irritable bowel syndrome, and others.

You should visit a gastroenterologist to get a full evaluation, to determine what is causing your pain. Additional tests (such as blood tests, a CT scan, ultrasound, or even endoscopy) may be needed to make the correct diagnosis - then the proper therapy can be prescribed.

If you are concerned about gallstones and gallbladder removal, you might want to check these articles!

Gallstones after gallbladder removal
Coffee reduces gallstone risk
Abdominal obesity doubles risk of gall bladder surgery

You can read more about all this in the Health Center: Bladder Problems.