Hey orris, i got gallbladder stone attack for the seventh time(i had c section 2 months back so i am stalling for time), this time it started in evening and by nighttime i was only vomiting bile, it continued well into morning and i felt faint, i had only eaten wet rice and khichdi in small amount.today its second day but i still feel pain in my stomach.yesterday i thought it was because vomiting caused strain on my stomach but today i am not sure...
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gallstone attack persistent abdominal pain day after attack post cesarean section management
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I have solid clinical information now. Let me put this together for you.
What's likely happening - and why the second-day pain matters
First, let me be direct: persistent abdominal pain on day 2 after a gallstone attack is a red flag that goes beyond simple biliary colic. Here's why, and what to watch for.
What happened during the attack
A typical biliary colic attack occurs when a stone lodges in the cystic duct (the exit of the gallbladder). The gallbladder contracts against that blockage, causing intense pain. If the stone dislodges and falls back into the gallbladder or passes through, the pain resolves - usually within a few hours, almost always within 6 hours. Vomiting bile (green/yellow) during the night is consistent with that kind of prolonged, severe obstruction.
Why day-2 pain changes the picture
According to Tintinalli's Emergency Medicine (one of the most authoritative EM textbooks):
"Biliary colic typically lasts a few hours or less. If pain persists longer, gallstone complications of greater severity, such as acute cholecystitis or cholangitis, must be considered."
- Tintinalli's Emergency Medicine
Pain that lingers into day 2 suggests the stone may not have dislodged and that your gallbladder has become inflamed - this is acute cholecystitis. Once obstruction persists, the gallbladder wall becomes distended, ischemic, and inflamed. Bacteria can then infect the stagnant bile (E. coli, Klebsiella are common culprits).
The post-C-section layer
Two months post-cesarean is an important context:
- Pregnancy and the postpartum period are known risk factors for gallstone formation and attacks - estrogen and progesterone increase bile cholesterol saturation and slow gallbladder emptying
- Having had 7 attacks total (and now one severe enough to cause vomiting bile and near-fainting) means your gallbladder disease is progressing
- Being 2 months post-surgery creates a surgical timing dilemma - your doctors are understandably cautious. However, laparoscopic cholecystectomy is generally considered safe from 6 weeks postpartum onwards, and the window is becoming relevant for you
Warning signs - seek urgent care TODAY if you have any of these
Based on textbook criteria and clinical guidelines, go to the emergency department without delay if you develop:
| Warning Sign | What It Suggests |
|---|---|
| Fever (>38°C / 100.4°F) with chills | Infected gallbladder (cholecystitis) or cholangitis |
| Pain that is now constant and worsening (not coming in waves) | Acute cholecystitis or perforation |
| Yellowing of skin or eyes (jaundice) | Stone in the common bile duct (choledocholithiasis) |
| Dark urine, pale stools | Common bile duct obstruction |
| Rapid heartbeat, low blood pressure, confusion | Sepsis / cholangitis (life-threatening) |
| Abdominal rigidity / board-like belly | Perforation / peritonitis |
| Pain that now radiates to your back with vomiting | May also involve pancreatitis |
Even without these signs, lingering pain on day 2 warrants an ultrasound and blood tests (CBC, liver enzymes, lipase, bilirubin) today. Acute cholecystitis can look deceptively stable and then deteriorate rapidly.
Why you're still in pain today (most likely explanations, in order)
- Early/mild acute cholecystitis - the stone didn't fully dislodge; gallbladder is inflamed and tender. This is the most likely cause of ongoing dull pain.
- Muscular strain from vomiting - hours of retching genuinely strains the abdominal wall and can cause lingering soreness. This is possible but should be improving, not static or worsening.
- Gallstone pancreatitis - if a stone passed into or near the common bile duct / pancreatic duct, it can trigger pancreatitis. This usually causes pain that radiates to the back and is worse lying flat.
- Choledocholithiasis (stone stuck in the common bile duct) - this causes persistent pain and may not show on basic ultrasound.
What you should do right now
- Get an ultrasound today - to check for gallbladder wall thickening, pericholecystic fluid, or common duct dilation (signs of acute cholecystitis or choledocholithiasis)
- Get blood tests - CBC (white cell count), CRP, liver function tests (ALT, AST, bilirubin, ALP), and lipase/amylase to rule out pancreatitis and infection
- Don't eat fatty or heavy food until this is evaluated - stick to clear liquids or plain bland foods
- Tell your doctor about all 7 attacks - with the frequency increasing and attacks becoming more severe (vomiting bile, near-syncope), the risk-benefit calculation for cholecystectomy has almost certainly shifted in favor of surgery even at 2 months post-C-section
- If the pain worsens at any point overnight - don't wait for morning; go to emergency
The bigger picture - timing of surgery
Surgeons often recommend waiting 4-6 weeks after C-section before laparoscopic cholecystectomy to allow healing. You are now 2 months out, which is within the acceptable window for most surgical teams. Cleveland Clinic guidance is that frequent, severe attacks shift the risk-benefit toward earlier rather than later intervention. Having a 7th severe attack with persistent pain is a strong clinical argument for not delaying further.
Bottom line: You are right to be unsure it's just strain. Persistent pain on day 2 after a gallstone attack needs to be evaluated today - not because it is definitely serious, but because the conditions it could represent (acute cholecystitis, pancreatitis, choledocholithiasis) are all treatable if caught early and dangerous if missed. Please don't wait this one out at home.
I can feel this pain in my abdomen ,2 inch above my c-section scar
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pain 2 inches above c-section scar after gallstone attack second day causes
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This location detail is actually very helpful clinically. Here is what it means:
Pain 2 inches above the C-section scar - what this tells us
Your C-section scar is at the very bottom of your abdomen (bikini line / suprapubic area). Two inches above that puts the pain roughly in the lower central abdomen / lower umbilical region - which is anatomically quite far from where the gallbladder lives.
The gallbladder sits in the upper right abdomen, under the ribcage. Gallstone pain typically shows up in the right upper quadrant or epigastrium (upper-center). Pain sitting low - near the C-section scar area - is not a typical location for a gallstone or cholecystitis.
This means you likely have two separate things going on right now:
What is causing the low abdominal pain (near C-section scar)
Given that you are 2 months post-C-section, there are several causes that fit this location much better than gallstones:
1. Uterine/surgical healing pain
The uterine incision is still healing internally at 2 months. The intense abdominal muscle strain from hours of severe vomiting the previous night is very real - retching violently repeatedly can pull on the internal fascial layers right above the uterine scar. This is probably the most likely explanation for this specific location.
2. Internal adhesions forming
C-sections cause adhesions (internal scar tissue bands) as the body heals. These can cause pulling, aching, or cramping pain in the lower abdomen, especially when the bowel is stressed (and vomiting/GI illness definitely stresses the bowel). At 2 months, adhesion formation is actively happening.
3. Bowel/gas pain
After prolonged vomiting and eating only wet rice and khichdi, your gut is under-fed, stressed, and possibly gassy. Gas pain and intestinal cramping commonly settle in the lower central abdomen right where you're describing.
4. Referred pain from the gallbladder attack
Less likely in this location, but visceral pain can sometimes spread and refer to unusual areas, and the whole abdomen may feel sensitized after a severe attack.
5. Less likely but worth ruling out: wound complications
At 2 months, true wound breakdown is unlikely, but if you have any redness, firmness, swelling, or discharge at or near the scar itself, it needs to be checked.
The key question - where is your pain RIGHT NOW?
| Pain location | Most likely cause |
|---|---|
| Upper right abdomen / under right ribcage | Gallbladder - cholecystitis, needs urgent evaluation |
| Upper center (epigastric) | Gallbladder / pancreatitis |
| Lower center, 2" above scar | Post-C-section healing, adhesions, bowel/gas, vomiting strain |
| Both areas simultaneously | Could be both issues acting together |
What this means for you practically
- The lower abdominal pain is less alarming than if it were upper-right. It is more consistent with post-surgical recovery + vomiting strain. Monitor it - it should gradually improve over the next day or two if it's strain/adhesion-related.
- However, do not ignore any upper abdominal pain (especially right side under ribs). That is where gallbladder complications show up, and that still needs to be evaluated after what you described yesterday.
- If the lower pain is crampy and coming in waves, it could also be your bowel recovering from the vomiting episode - this is normal.
- If it is constant, hard, or getting worse, or if you develop a fever, it needs to be seen today.
One important thing to check right now
Press gently on the area 2 inches above the scar:
- Is the pain surface-level / muscular (hurts more when you press or tense your abs)? - More likely strain from vomiting
- Is the pain deep inside, unchanged when you press the skin? - More likely internal (bowel, adhesion, or referred)
- Is the area hard, rigid, or board-like? - Go to emergency immediately
Your body has just been through a lot in a short time - a C-section 2 months ago, a new baby, and now a severe 7th gallstone attack with overnight vomiting. It would be surprising if your abdomen felt completely fine. But the pattern you're describing (lower location, day 2, no fever mentioned) leans more toward post-attack recovery plus C-section-related pain than an acute surgical emergency - as long as you don't develop the red flags listed previously (fever, jaundice, worsening/constant pain, rigidity).
Still strongly recommend getting that ultrasound and bloodwork today.
No now you are saying i realise it is in upper abdomen only,near naval
Pain near the navel (periumbilical) is actually a clinically significant location. Let me be direct with you.
Periumbilical (around the navel) pain - this matters
Pain centered around or near the navel, persisting into day 2 after a severe gallstone attack with overnight vomiting, points to a few specific possibilities:
Most important concern: Pancreatitis
This is the one I want you to take seriously. When a gallstone passes from the gallbladder into the common bile duct, it can block the opening of the pancreatic duct. This triggers gallstone pancreatitis - inflammation of the pancreas.
Periumbilical pain that radiates to the back is the classic presentation of pancreatitis. Key features that fit your situation:
- Severe vomiting (often the dominant symptom)
- Vomiting bile specifically
- Pain that persists and doesn't fully resolve after the gallstone attack
- Pain centered around the navel/upper-central abdomen
- Feeling faint (from dehydration and pain)
- You've had 7 attacks - repeated stone movement through the bile duct increases pancreatitis risk each time
Pancreatitis is not something to wait out at home. It can range from mild (managed with fluids and rest) to severe (life-threatening). It is diagnosed with a simple blood test - lipase/amylase - which will be markedly elevated.
Second possibility: Referred gallbladder pain
The gallbladder's nerve supply overlaps with the periumbilical region. During or after a severe attack, the pain can feel centered around the navel rather than strictly in the upper right. This is visceral referred pain - your brain can't precisely locate where the signal is coming from inside the abdomen.
Third possibility: Bowel ileus / gut stress
After prolonged vomiting and minimal food intake, the intestines can slow down (ileus). This causes a dull, generalized periumbilical ache. Less urgent, but contributes to the discomfort.
What you need to do - and I mean today, not later
Given:
- Periumbilical pain on day 2
- Overnight vomiting of bile
- Near-fainting
- 7th gallstone attack
- Only 2 months post-C-section
You need blood tests and an ultrasound today. Specifically ask for:
- Serum lipase and amylase (pancreatitis screen)
- Liver function tests - ALT, AST, bilirubin, ALP (bile duct obstruction)
- CBC (white cell count for infection)
- Abdominal ultrasound
If lipase comes back elevated, you will likely need IV fluids and hospital admission regardless of your C-section history. Pancreatitis after a gallstone attack is one of the cleaner reasons surgeons will also prioritize getting the gallbladder out sooner rather than later.
Please don't wait on this one. The location you're now describing - periumbilical, persisting for 2 days, after severe vomiting - is a stronger signal than lower abdominal pain would have been. Get seen today.
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