It often radiates to the tip of the right shoulderblade. Sometimes, but not always, there is vomiting. Attacks may or may not be triggered by fatty meals, and often return unpredictably. Sludging of the bile, or spasms in the bile drainage duct can cause identical pains. Peptic ulcers or a spastic bowel and pains from the heart or the aorta can give similar symptoms.
Gallbladder attacks can mimic heart pains of angina or a heart attack.
When gallstone or biliary problems are suspected, an ultrasound test of the gallbladder is usually ordered, along with some blood tests. The ultrasound test is quite reliable, but not entirely foolproof. When inconclusive, a nuclear medicine scan may be obtained. Even though nonsurgical treatments for gallstone problems are available, as long as there is a gallbladder, the same process which originally formed the stones will likely continue to happen. How it is done, depends on the number and size of the stones, and what other medical problems are present.