How are Acid Reflux and the Gallbladder Related?
There is no relationship between acid reflux and gallbladder disease, other than the fact that the diseases can give similar symptoms and therefore can be difficult to distinguish from on another.
While classic acid reflux disease will cause heartburn, at times it may only cause upper abdominal pain. When it does, the pain is usually located in the upper epigastric area, the region just below the breastbone in the center of the body. Classic gallbladder pain is present in the right upper quadrant, below the ribs on the right side. At times it can radiate to the back or around the right side, and if the gallbladder is infected, may be associated with fever. If there is involvement of the bile duct, there may be jaundice or elevation of liver enzymes. In around fifty percent of patients with gallbladder disease, the pain can be in the epigastric area instead of the right upper quadrant. If there is no fever or liver enzyme abnormalities, this might be difficult to distinguish from acid reflux disease. While an ultrasound of the gallbladder can confirm gallstones, that does not mean that the symptoms are from gallstones.
Many times patients will undergo surgical removal of the gallbladder and continue to have upper abdominal pain. Ultimately, it may be found that the symptoms are related to acid reflux disease. It therefore is important to try to rule out acid reflux disease prior to gallbladder removal, especially if there is no fever, jaundice or liver blood test abnormalities that would essentially rule out acid reflux disease. Most patients, in the absence of such findings, should undergo upper gastrointestinal endoscopy as well as treatment with a trial of acid-reducing agents such as proton pump inhibitors prior to gallbladder removal. Dietary treatment can be beneficial in both conditions, with a low fat diet most appropriate for gallbladder disease, and a caffeine-free diet, with avoidance of lying flat after meals the best for acid reflux disease.