Understanding Phantom Gallbladder Pain : Definition, Symptoms & Causes

Phantom gallbladder pain is the pain experienced post cholecystectomy. It occurs as the symptoms around the gallbladder resemble cholecystitis pain but the root cause is different.

Gallbladder is a small pear-shaped hollow organ that is a part of the biliary system along with the liver and pancreas. It leads into the small intestine.⁽¹⁾

It stores bile, a fluid made in the liver that facilitates the digestion of fat and the excretion of cholesterol. Bile is also known to possess antimicrobial properties.

Gallbladder also maintains the concentration of bile in the digestive system by absorbing excess water and electrolytes from the bile and making it more effective at breaking down. Water and electrolytes may concentrate the bile.

Gallbladder is considered an essential organ for digestion. It is possible to live a healthy life post removal of this organ but people after gallbladder surgery, a person may experience diarrhea and bloating.

There are several reasons for understanding phantom gallbladder pain which includes:

• Mostly phantom gallbladder pain is mistaken for other conditions such as gastroesophageal reflux disease or irritable bowel syndrome. Understanding phantom gallbladder pain can be helpful for doctors to develop an effective treatment plan for it, which include pain management techniques, acupuncture, and massage.
• Chronic pain hampers the quality of life of a person. Proper management techniques can be helpful in improving the overall well-being of an individual.
• Phantom gallbladder pain can be prevented by the knowledge of reducing the risk of complications post gallbladder removal, which may include following a low-fat diet, exercising regularly, and avoiding medications that may irritate the digestive system.

Knowledge about phantom gallbladder pain can be helpful in making an accurate diagnosis and finding an accurate treatment that may help improve the quality of life and prevent further complications.

Phantom pain refers to the pain in the part of the body that is no longer present or removed. For example, a person whose limb has been amputated would feel pain as if that absent body part is still there.

Phantom gallbladder pain occurs as a part of the post-cholecystectomy syndrome and refers to the group of symptoms that may mimic the ones occurring before a cholecystectomy or gallbladder removal surgery.

The person may experience pain and discomfort after the surgical removal of the gallbladder. This might happen as the bile is still being produced but there is no gallbladder to store and release it. This is called post-cholecystectomy syndrome.

Research shows that 10-15% of people who undergo cholecystectomy surgery experience post-cholecystectomy syndrome.⁽²⁾

Symptoms of phantom gallbladder pain may vary from person to person, but commonly ongoing abdominal pain and discomfort are experienced. Along with it, the other symptoms include:⁽³⁾

• Nausea
• Vomiting
• Loss of appetite
• Fatigue
• Jaundice
• Diarrhea and loose stool
• Bloating and gas
• Pain in the upper right and middle region of the abdomen
• Worsening of pain post meals

It is important to speak with a healthcare professional if any of these symptoms are experienced. The doctor can help in determining the symptoms and developing an appropriate treatment plan which can further improve the quality of life.

• Phantom gallbladder pain and actual gallbladder pain are quite different from one another.
• Actual gallbladder pain is caused due to specific conditions or issues related to the gallbladder while in phantom gallbladder pain, there is ongoing pain and discomfort after gallbladder removal.
• The gall bladder pain may be caused by a variety of conditions, which include:
• Gallstones form in the gallbladder and can cause pain and other symptoms.
• Cholecystitis, a condition in which the gallbladder gets inflamed and swollen due to blockage in the bile duct.
• Biliary colic, pain occurring due to the gallstones blocking the bile duct.

On the other hand, phantom gallbladder pain is a vague or nonspecific discomfort that occurs in the upper right or middle part of the abdomen and is accompanied by nausea, bloating, or diarrhea. It does not occur due to any specific conditions or issue with the gallbladder.

Actual gallbladder pain may occur due to specific conditions or issues with the gallbladder, while phantom pain is the discomfort experienced after the gallbladder is removed and does not have any specific issue or cause linked.

There are different factors that can result in phantom gallbladder pain:

• Removal of Gall Bladder: Mostly phantom gallbladder pain in experienced post cholecystectomy and is taken as a temporary conclusion until other causes are revealed.⁽²⁾ Gallbladder plays an important role in the digestive process. After cholecystectomy, the bile is directly released from the liver to the intestine which may cause discomfort and pain. Also, surgery may cause damage to the surrounding tissues and nerves, which may be another cause of pain after the procedure.
• Nerve Damage: Damage to the nerves around the gallbladder during the process of gallbladder removal can result in persistent pain even after the surgery healing has taken place leading to persistent pain.⁽⁴⁾ The most commonly affected case of phantom gallbladder pain is the intercostal nerves located between the ribs.
• Psychological Factors: A person experiencing phantom gallbladder pain cannot solely depend on physical factors. There can also be an influence of emotional and psychological factors as well. Studies show people with cholecystectomy continue to experience pain more likely due to anxiety, depression, and other psychological conditions.⁽⁵⁾ These factors are more likely to exacerbate the pain symptoms.
• Other Potential Causes: Other causes of the experience of phantom gallbladder pain may include bile reflux, damage to the sphincter of Oddi, residual gallstones in the bile duct, and surgical complications.

Diagnosing phantom gallbladder pain can be challenging as the symptoms are similar to those of other gastrointestinal conditions. The doctor needs to take the medical history, do a thorough physical examination, and order imaging tests to identify the cause of the persistent pain.

The diagnostic tests include:

• Ultrasound to check for the presence of residual gallstones and other abnormalities.
• Endoscopic retrograde cholangiopancreatography combines x-ray with the use of endoscope to examine the bile duct and the pancreatic ducts. This can be helpful in identifying abnormalities or strictures in the bile duct.
• Magnetic resonance cholangiopancreatography uses magnetic resonance imaging to produce detailed images of the bile duct and pancreatic duct that can be helpful in identifying issues with the flow of the bile.
• CT scan to evaluate the abdominal organs and any abnormalities or structural issues.

Along with all of these, the doctor may order blood tests to check for the signs of inflammation and based on all of these may be able to come over to a diagnosis and treatment plan.

The treatment for phantom gallbladder pain may include medication that may include the causes of the symptoms:

• For irritable bowel syndrome sedatives and antispasmodics are given.
• For diarrhea, cholestyramine is given which is a type of bile acid binder.
• For gastroesophageal reflux disease antacids, proton pump inhibitors, or histamines are used.

There are also surgical procedures including endoscopic retrograde cholangiopancreatography, endoscopic stone extraction, and removal of the remaining cystic duct.

There are a few lifestyle changes that can be helpful in managing phantom gallbladder pain, which include:

• Avoiding spicy or fatty foods, acidic food, or other gas-producing foods.
• Exercising regularly and maintaining a healthy body weight that can be helpful in preventing the development of additional health problems.
• Drinking plenty of water to helps flush out toxins that increase the development of complications related to digestive health.
• Chronic pain can lead to anxiety and stress that can further exacerbate the symptoms. Practicing meditation, yoga, and breathing exercises can help in managing stress.

Over-the-counter medications can help in relieving phantom gallbladder pain. However, it is important to consult a doctor before starting any medication for phantom gallbladder pain.

It is important to seek medical attention for anyone experiencing phantom gallbladder pain. The symptoms may sometimes indicate an underlying medical condition that may require proper diagnosis and treatment. This can be helpful in preventing unwanted complications and also help in improving the quality of life of an individual.

There are a few tips that can be helpful in managing phantom gallbladder pain. These include:

• Managing Diet: Certain foods can trigger phantom gallbladder pain. Avoiding fried and fatty foods along with avoiding caffeine, alcohol, and gas-producing foods including cabbage, beans, and broccoli can be helpful.
• Drinking Plenty Of Water: This can be helpful in flushing out toxins and reducing the risk of developing complications related to digestive health.
• Exercising Regularly: This helps in maintaining body weight and preventing the development of additional health problems which may exacerbate phantom gallbladder pain.
• Practicing Stress Management: Stress may exacerbate the symptoms of phantom gallbladder pain. Practicing stress management techniques can be effective in reducing pain.

• Joining support groups can be helpful as it provides emotional support and a sense of community for people with phantom gallbladder pain. The problems can be shared with people experiencing similar problems and coping strategies can be shared.
• There are also many online resources that provide information on phantom gallbladder pain and provide coping strategies.
• Seeking help from a mental health professional can help manage its impact on emotional health.

• Self-care is important for managing any type of health condition including phantom gallbladder pain. It can be helpful in feeling empowered and in control of health.
• Everyone experiences phantom gallbladder pain differently. Practicing self-care and self-advocacy can be helpful in working out with the healthcare professional in finding out a personalized care plan and meeting individual needs.
• It can also be helpful in improving the knowledge of the condition and thereby improve the quality of life of an individual.

Phantom gallbladder pain can occur post cholecystectomy. The symptoms may occur due to the underlying condition due to gallbladder removal.

Healthcare professionals determine the treatment plan depending on the underlying condition. It is therefore important to speak with a healthcare professional.

A doctor should be consulted for any unexplained symptoms following a cholecystectomy procedure to reduce post-surgical complications.