Nearly half of the population suffers from upper abdominal pain once in their life, but they ignore its seriousness, which later on leads to potential complications. 

Approximately 40% of adults around the world experience upper abdominal pain once in their lifetime. 

One of the most common causes is surprisingly Gall bladder stones, which are undiagnosed, affecting around 45% of the global population. 10% of people also experience peptic ulcers at some point in their lifetime, with upper abdominal pain being a prominent symptom and 5 - 7 % heart diseases and 3-4% muscular pain.

TABLE OF CONTENTS

• Upper Abdominal Pain
• A Key Warning Sign of Gallbladder Stones
• The Risk of Bile Duct Obstruction
• Large stones causing cancer in the gall bladder
• What Causes Gallstones?
• Some Other Causes of Upper Right Abdominal Pain at Night
• Diagnostic Methods
• What Treatment is Necessary?
• Conclusion

Upper Abdominal Pain:

Upper abdominal pain just under the right rib cage or seemingly in the midline where both the rib cages meet is an uncomfortable condition. Almost everyone experiences such abdominal pain at some point, and most of the cases are not serious, but if a pain is persistent and especially during the night, precisely between 11 pm and 5 am, this requires further evaluation immediately. 

Do you know there are numerous causes of upper abdominal pain that are difficult to understand from a Google search?

Seeking professional guidance to understand the cause of your discomfort. Some of the known causes are 

• Gastritis
• Gall stones
• Peptic or Duodenal ulcer
• Pancreatitis
• Hepatitis
• Acid reflux or GERD
• Muscle sprain

All these conditions showcase upper abdominal pain with associative symptoms as well.

But if upper right abdomen pain occurs at night specifically between 11pm to 5am and  is consistent which prevents you from sleeping soundly, it requires immediate medical attention. The most common cause maybe gallbladder stones, which can be diagnosed by an ultrasound scan of the abdomen. This is a condition that can lead to further complications if left untreated and ignored. 

So, Let’s understand the Warning Signs of Gallbladder Stones

Upper right abdominal pain at night is a noticeable symptom of gall bladder stones, which most patients experience. This pain can last anywhere from 30 minutes to 8 hours and usually starts between 11 PM and 5 AM, a major sign that there may be a gallbladder issue. The pain may radiate to the back or shoulder, which is accompanied by nausea and vomiting.

If your gallstone is larger than 10 mm, there is a probability of it getting stuck in the neck of the gallbladder which is quite painful. This type of pain from gallstones indicates immediate surgical removal of the gallbladder. Furthermore, if the pain is associated with jaundice (a condition of yellowing of the skin and eyes) and fever, it might suggest serious biliary obstruction due to stone slippage in CBD, which requires a consultation with a surgeon and immediate hospitalization.

Other Red flag symptoms: Don’t overlook

• Pain is so intense that it interrupts your daily life activities.
• Pain associated with vomiting or inability to tolerate liquid or solid diet
• Pain associated with having fried foods and party foods causes severe acid reflux in the night while sleeping.
• Having persistent nausea and fullness of the stomach, bloating after short meals
• Having low-grade fever, especially during the day, causing severe lethargy

What are the causes of gallstones?

• High cholesterol levels (above 240 mg/dl); excess cholesterol contributes to gallstone formation and is one of the leading causes. It’s necessary to check on your Lipid profile.
• Overeating or binge eating are the major contributors in recent years, also in children.
• Following Social media ambiguous crash dieting programs.
• Fast food and junk food as your primary source of calories
• Obesity is one of the major contributing factors for gallbladder stones
• Genetic factor, family tree plays an important role. If your mother, father, or grandparents experienced gallstones once in their lifetime, there is a high chance you can also be diagnosed with the same diseases.
• Sudden weight loss due to the peer pressure of a lean body, the liver releases more cholesterol into bile, and this leads to its conversion into crystallite stone
• Smoking impacts the gallbladder's ability to contract and empty bile effectively; this leads to the accumulation of bile in the gallbladder, which increases the size of gallstones. Cigarettes contain harmful chemicals that damage the tissues inside the gallbladder.
• Chronic alcohol abuse creates oxidative stress on the wall lining of the gallbladder, which is another factor for gallstone formation. Alcohol can lead to higher cholesterol secretion and be conducive to gallstone formation.
• Medications: Taking birth control pills or taking medicine to lower cholesterol increases the risk.
• Gallstones are common during pregnancy due to hormonal changes. 

The Risk of Bile Duct Obstruction

Gallstones of any size, whether small or large (10mm, 12mm, or 14mm), can lead to serious complications if left untreated. The most serious risk with smaller stones is that they can slip into the common bile duct (CBD), which can result in Choledocholithiasis or CBD stones. This condition is potentially fatal or life-threatening, as it may lead to severe pancreatitis and other severe complications. The most common symptom of this is jaundice with severe abdominal pain nausea and persistent vomiting, which, if left untreated, leads to life-threatening complications or even ICU admission

Large stones causing cancer in the gall bladder

Gallstones, when large, especially starting from 10 mm and growing in sizes up to 40 mm, if left untreated, have a severe risk of turning the gall bladder cancerous.

The larger stone erodes the inner wall of the gall bladder causing the bile acids to react with the innermost lining of the gall blader to form cancer cells. Most gall bladder cancers are unfortunately diagnosed very late, after the surgery is completed and the biopsy report confirms the same. Another potentially life-threatening condition occurs when a large stone impacts the neck of the gall bladder, causing a white, thick viscous liquid called mucocele or frank pus called empyema. In both cases, if the gall bladder wall ruptures with this condition, it is a disaster, as this toxic fluid spills in the abdomen, causing sepsis. This needs immediate admission and surgery 

Diagnostic Methods:

Determining the cause of upper abdominal pain usually requires a complete evaluation, which includes a review of medical history, a physical exam, and diagnostic testing. Below are some suggestions of tests used in this process:

• Ultrasound: This is the first scan for detecting gallstones. It is still considered the gold standard for diagnosing gallbladder stones.
• MRCP: A MRCP scan is magnetic resonance cholangiopancreatography, a type of MRI scan that produces images of the liver, gallbladder, pancreas, and bile ducts. It is a non-invasive procedure that uses magnets, radio waves, and a computer to create detailed images.  

What Treatment is Necessary?

Immediate attention is always required, whether gallbladder stones are symptomatic or asymptomatic. If left untreated, gallstones can lead to severe complications, as mentioned above. With the advent of advanced 3D laparoscopic cholecystectomy, treatment for gallstones has become more efficient and accessible than ever before. 

Benefits of this advanced procedure include:

• Short duration of surgery
• Short duration of anesthesia.
• Early oral intake within 4 hours.
• Faster recovery times.
• Less pain and early mobilization.
• Minimal scarring.
• Day care surgery (non-insurance cases)
• Faster return to normal activities.

This modern approach has revolutionized gallstone treatment, offering faster, more effective care with long-lasting results.

Conclusion

The 3D laparoscopic cholecystectomy procedure, only available at MASSH Hospital, is a super-advanced, minimally invasive method for treating gallstones, offering exceptional benefits. You can opt for this procedure to get the best outcomes and a safer procedure with a 24-hour discharge facility. This procedure is so advanced it reduces the operative time from the standard 2-hour procedure to 25–30 minutes, hence the anesthesia recovery time is much faster. 

The 3D view reduces the complication and risk of surgery to potentially minimal,  no infection and no stitches; the techniques reduce scarring and promote faster recovery. The 3D technology precision provides a clearer 100X zoom and depth vision for the surgeon, ensuring an enhanced, safer and more efficient gallbladder removal. 

As a result, patients experience less pain and can start walking within 5 hours. The patient can resume a normal diet the very next day, with no specific restrictions. The usage of advanced fibro glue, we don’t apply stitches any more, and the patient can also have a bath the next day with no specific dressing. Patients can  be discharged the same day, avoiding the prolonged hospital stays, specifically in non-insurance cases

This procedure not only alleviates the discomfort but also significantly improves the quality of life. 

Disclaimer

The information provided here is for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. 

Please seek the advice of our physician or surgeons with any questions you may have regarding a medical condition.