It is believed that gallstone pain results from the blockage of the duct (cystic duct) that allows bile to exit the gallbladder. This typically happens from a stone or sludgy material that plugs up the cystic duct and as a result, the gallbladder can become quite inflamed. This inflammation and possible infection is referred to as cholecystitis. Patients who have gallbladder problems that reach this stage typically need to be in the hospital, often on intravenous antibiotics, analgesics and typically will require surgery. There are some patients who have classic symptoms of gallbladder disease and gallstones without any evidence of gallstones or sludge in the gallbladder. There is a subgroup of people that apparently have a problem with how the gallbladder functions and empties and this particular problem is referred to as biliary dyskinesia.
Other complications of gallstone disease can occur if a stone escapes out of the gallbladder and falls into the common bile duct, which is the path that bile ultimately has to pass through to enter the small intestine. When this happens, an infection can occur in the bile duct referred to as cholangitis. The bile duct can become blocked causing jaundice or the stone can pass through the bile duct and cause inflammation of the pancreas referred to as biliary pancreatitis. These are all serious complications of gallstone disease and need to be diagnosed and dealt with promptly.