Gastroesophageal reflux disease (GERD) and gallbladder disease are common conditions that can cause nausea and pain in the upper abdomen. However, it is unclear whether the two conditions have a direct link.

Aside from a few shared symptoms, these conditions also feel different. The most common symptoms of GERD are heartburn and acid reflux, while in gallbladder disease, the pain is typically on the right side and may radiate to the shoulder.

This article looks at GERD and gallbladder disease, including their similarities and differences, whether the conditions are linked, and whether one can cause the other.

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Gallbladder disease and GERD are two different medical conditions. In GERD, the contents of the stomach travel back up the esophagus, or food pipe, causing a burning sensation. This is known as heartburn or acid reflux.

The gallbladder is further down the digestive tract. It stores bile, which is similar to stomach acid in that it is a liquid that aids digestion. However, where stomach acid is strongly acidic, bile is alkaline.

Gallbladder disease occurs when the gallbladder becomes infected, inflamed, or develops gallstones, which are hardened deposits of bile. This results in pain and swelling.

Scientists are still learning whether there is a connection between GERD and gallbladder disease.

Can GERD cause gallbladder problems?

The association between GERD and gallbladder problems is unclear.

In an older 2015 study, researchers found that among 604 people with GERD, over 13% of them had gallstones, which is higher than the rates in the general population. Among people without GERD, approximately 6% of males and 9% of females have gallstones. This may suggest there is some link between these conditions.

However, gallstones are not uncommon, and scientists believe that rates are increasing due to obesity. Obesity is also a risk factor for GERD, as excess weight puts pressure on the esophagus, so both conditions may be more likely in those with higher body weights.

Another potential reason for the higher rates of gallstones in those with GERD is medication. A small study from 2006 suggests that proton pump inhibitors (PPIs), a common GERD medication, may reduce gallbladder function and increase gallstone formation.

However, this was a small study of only 19 people. A more recent literature review could not find enough high quality evidence to say if PPIs impact gallbladder function. The authors highlight a need for more rigorous scientific investigation.

Can gallbladder problems cause GERD?

There is not much evidence that gallbladder disease causes GERD. However, gallbladder removal is a risk factor for bile reflux, according to a 2021 study.

The gallbladder stores bile. Without it, bile may travel up into the stomach. This can cause symptoms that are very similar to GERD.

The table below compares symptoms of gallbladder disease and GERD.

GERDGallbladder disease
Most common symptomsheartburn
acid reflux
regurgitation of sour liquid
upper right abdominal pain that may radiate into the back and right shoulder
Other symptomsdifficulty swallowing
pain in upper abdomen
nausea
nausea or vomiting
shortness of breath when inhaling due to pain
When the symptoms occurusually occur after eating and worsen when lying downoften begin following a meal or at night
How long symptoms lastsymptoms may last for several hours after eating or until food is digestedpain may last from 15 minutes to a few hours.

Doctors typically use a person’s symptoms and an ultrasound scan to diagnose gallstones and gallbladder disease. The doctor may also order blood tests that may show increased white blood cells and elevated inflammatory markers.

In addition, they may perform a test for Murphy’s sign, which involves applying pressure below the ribs on the right side and asking the person to inhale. The inhalation brings the gallbladder close to the doctor’s fingers. If the gallbladder is inflamed, this will cause pain and an inability to inhale further.

There are no gold standard tests to diagnose GERD. Instead, doctors use the individual’s symptoms and may trial GERD medications to see if they help.

However, if someone presents with alarming symptoms, including anemia, weight loss, swallowing difficulties, or vomiting blood, doctors evaluate them with an esophagogastroduodenoscopy (EGD). This procedure allows the doctor to examine the esophagus, stomach, and duodenum.

Doctors distinguish between gallbladder disease and GERD based on the individual’s symptoms, physical examination, and imaging tests.

There is little evidence to suggest that gallbladder removal helps with GERD symptoms.

Acid reflux happens when the lower esophageal sphincter does not close as it should, allowing digestive juices to rise into the esophagus.

Some health conditions can cause acid reflux. These include hiatal hernia, when the upper part of the stomach bulges through the diaphragm into the chest cavity. This means the lower esophageal sphincter cannot function as it should.

Hiatal hernia is a common condition affecting 55–60% of individuals over the age of 50 and is a leading cause of GERD.

Other factors that can contribute to GERD include things that put pressure on the esophagus or affect how it works. These include:

If a person believes they have GERD or gallbladder disease, they should speak with their doctor as soon as possible. Only a doctor can make a firm diagnosis.

Anyone who has severe or worrying symptoms should dial 911 or the number of the nearest emergency department. Symptoms that require prompt attention include severe pain or vomiting blood.

Some questions to ask a doctor could include:

  • Are my symptoms the result of gallbladder disease or GERD?
  • What tests do I need to confirm the diagnosis?
  • What is the best treatment for me?
  • Are there any lifestyle changes I should make?
  • How long will it take for my symptoms to improve?
  • Are there any complications I should be aware of?
  • What happens if I do not treat my condition?

If the symptoms may be due to medication side effects, or a person is concerned their PPIs may raise the risk of gallstones, they should discuss this with a doctor. Do not change the drug or dosage without consulting a medical professional.

Gallbladder disease and GERD are two different conditions that may cause similar symptoms. There may also be some links between the two.

For example, some studies suggest PPIs may play a role in gallstone formation. However, scientists highlight that there is a lack of high quality evidence to support this.

Additionally, people who undergo gallbladder removal may develop bile reflux, which can feel similar to GERD. If a person has any concerns they might have GERD, bile reflux, or gallbladder disease, they should speak with a doctor promptly.