A gallbladder attack usually causes steady, severe pain in the upper right or upper middle of your belly that builds quickly and lasts from about 30 minutes to several hours, sometimes spreading to your right shoulder or back. Indigestion is usually milder: a burning, full or bloated feeling that comes and goes and often eases with antacids.
Steady, intense pain, not a mild discomfort that eases when you burp or pass wind. Most often under the right ribs or in the upper middle of the belly.
More of a burning, bloating or early fullness feeling, and often responds to antacids.
Both can follow a heavy or oily meal, so the type, strength and length of the pain matter more than the trigger.
Fever, chills, yellowing of the skin or eyes, or pain that will not settle are warning signs that need prompt medical attention.
A gallbladder attack is sudden pain caused when a gallstone blocks the outflow of bile from the gallbladder. The gallbladder is a small pouch under the liver that stores bile, a digestive juice that helps break down fat.
When you eat, especially a fatty meal, the gallbladder squeezes to release bile. If a stone is lodged at its outlet, the gallbladder squeezes against the blockage and pain builds. Doctors call this “biliary colic”. When the stone moves back, the pain eases, which is why attacks come in episodes. Our page about gallstones explains how stones form and who is more likely to get them.
Indigestion, also called dyspepsia, is discomfort in the upper belly linked to eating. It usually feels like burning, gnawing, bloating or an uncomfortable fullness, often with burping or mild nausea.
Common triggers include large meals, eating quickly, rich or spicy food, alcohol, coffee, smoking, stress and some painkillers. Indigestion can also come from acid reflux, gastritis (inflammation of the stomach lining) or a stomach ulcer. If heartburn is part of the picture, KYM Surgery’s reflux site explains whether heartburn and acid reflux are the same thing.
The clearest clues are the type of pain, how strong it is, and how long it lasts. Gallbladder pain is steady and severe and does not ease with burping or antacids, while indigestion is usually a milder burning or fullness that settles more easily.
| Feature | Gallbladder attack (biliary colic) | Indigestion (dyspepsia) |
|---|---|---|
| Where you feel it | Upper right belly under the ribs, or upper middle | Upper middle belly, sometimes behind the breastbone |
| What it feels like | Steady, intense, gripping or aching | Burning, bloating, full or gnawing |
| How strong | Often severe; hard to sit still or get comfortable | Usually mild to moderate |
| How long | Builds over minutes, lasts about 30 minutes to several hours | Comes and goes; may linger on and off after meals |
| Spreads to | Right shoulder blade or back | Rarely spreads |
| Timing | Often after a fatty meal, and often in the evening or at night | During or soon after eating |
| Eased by antacids, burping or passing wind? | Usually not | Often yes |
| Other symptoms | Nausea, vomiting, sweating | Burping, bloating, sour taste, mild nausea |
These patterns are a guide, not a diagnosis. The two can overlap, and some people with gallstones also have indigestion, so a doctor may need tests to tell them apart.
Pain from the gallbladder can be felt away from the organ itself because nerves from the upper belly share pathways with nerves from the shoulder and back. This is called referred pain.
Many people feel it between the shoulder blades or under the right shoulder blade, and some first assume it is a muscle strain. Our article on back pain and gallbladder problems looks at this in more detail.
A gallbladder attack becomes more serious when the blockage does not clear or infection sets in. Go to the emergency department, or call 995, if you have any of the following:
These can point to complications such as gallbladder inflammation or infection (cholecystitis), a stone blocking the bile duct, or inflammation of the pancreas. Read how a gallbladder infection can affect your whole body.
Upper belly pain can also come from the heart. If you have chest pressure or tightness, pain spreading to the arm or jaw, breathlessness or cold sweats, call 995 straight away.
The usual first test. It can show gallstones, signs of gallbladder inflammation or a widened bile duct from a blocking stone. Quick, non-invasive and no radiation.
To check liver function, infection markers and pancreatic enzymes. MRCP (an MRI of the bile ducts) or a CT scan may follow.
If indigestion seems more likely, a thin camera passed through the mouth into the stomach may be suggested instead.
If gallstones are causing repeated attacks, your surgeon may discuss laparoscopic gallbladder surgery. Gallstones found by chance that cause no symptoms often do not need surgery, so treatment is guided by your symptoms and scan findings.
See a doctor if you have had even one episode of severe upper belly pain lasting 30 minutes or more, or if you have indigestion that keeps returning. Your GP or a polyclinic can assess you first and arrange an ultrasound or referral.
Also get checked if indigestion comes with difficulty swallowing, unplanned weight loss, vomiting, black stools or new symptoms after the age of about 50, as these need further investigation. If you have already been told you have gallstones and your attacks are becoming more frequent, you can contact KYM Surgery to arrange a consultation.
Common questions about telling gallbladder pain apart from indigestion.
Yes. Many people in Singapore first call it “gastric” because the pain is in the upper belly and often comes after a meal. The difference is that gallbladder pain is usually stronger, steadier and longer lasting, and does not ease much with antacids.
It can. Some people have occasional attacks months apart, while others have them more often. Each attack carries a chance of complications, so repeated episodes are worth discussing with a doctor.
Not always. Attacks often follow a large or oily meal, but they can also start at night or without an obvious trigger.
Yes. Gallstones are common, and so is indigestion from other causes such as reflux or gastritis. This is why doctors look at the full pattern of symptoms and tests before deciding whether the gallbladder is the cause.
Stop eating, rest, and note when the pain started. If it lasts more than a few hours, or you develop fever, yellow skin or repeated vomiting, go to the emergency department.
Dr Kan Yuk Man, senior consultant surgeon, sees patients with gallstones and gallbladder pain at Mount Elizabeth Orchard and Farrer Park Hospital.
Disclaimer: This article is for general information only and is not a substitute for medical advice. Please consult a qualified doctor for advice specific to your situation.
