The gallbladder is a 4-inch-long pear-shaped organ located under the liver in the upper right region of the abdomen. It stores a compound produced by the liver to digest fat, and helps the body absorb fat-soluble vitamins and nutrients, called bile.
When there is a problem with your gallbladder, it can be quite painful and require immediate action. When the gallbladder stops functioning properly or the bile ducts are blocked, it can cause a lot of pain.
Common Gallbladder Problems
Some common gallbladder problems include:
Gallstones, or cholelithiasis
Gallstones are solid masses of cholesterol or pigment of different sizes. Gallstones occur when high levels of fat and bile cause crystals to form. These crystals may combine over time and expand into stones.
The size of stones can vary. It can be as small as a grain of sand or as large as a golf ball. They may or may not cause symptoms.
Common bile duct stones, or choledocholithiasis
Bile is transported from the gallbladder via small tubes and deposited in the common bile duct. From there, it is moved to the small intestine. Sometimes, gallstones can lodge or form in the common bile duct. These stones normally begin their life in the gallbladder and travel to the common bile duct. This is referred to as a secondary stone or a secondary common bile duct stone.
If the stone forms within the duct itself, it is called a primary stone, or primary common bile duct stone. These are less common but are likely to cause an infection than secondary stones.
Gallbladder cancer is very rare, affecting less than 4,000 Americans yearly; but if it does occur, it can spread to other parts of the body. Risk factors include gallstones, porcelain gallbladder, obesity, female gender, and older age.
Inflamed gallbladder, cholecystitis
When bile can’t leave the gallbladder, acute or sudden cholecystitis occurs. This commonly occurs when a gallstone blocks the tube that bile uses to travel in and out of the gallbladder. Chronic cholecystitis occurs if there are recurrent acute attacks.
When the bile duct is congested, bile accumulates. The excess bile irritates the gallbladder, causing swelling and infection. After a while, the gallbladder is damaged, and it can no longer function fully.
If left untreated, gallstones can lead to a perforated gallbladder where a hole in the wall of the organ can develop. Perforation also occurs as a complication of acute cholecystitis. This opening in the gallbladder’s wall can allow leakage of infection into other parts of the body causing a severe, widespread infection.
Common bile duct infection
If the common bile duct becomes blocked, it can lead to an infection. Early detection can be treated. However, if it is missed, it can spread and develop into a severe, fatal infection.
Dysfunctional gallbladder or chronic gallbladder disease
Repeated episodes of gallstone attacks or cholecystitis may damage the gallbladder permanently. This can lead to a stiff, scarred gallbladder. Symptoms can be hard to identify in this case. They include abdominal fullness, indigestion, and increased gas and diarrhea.
Gallstone ileus is infrequent but can be deadly. It occurs when a gallstone travels to the intestine causing obstruction. Often, emergency surgery is required to clear the blockage.
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A patient with gallstones may also develop pus in the gallbladder; this is called empyema. The condition can cause severe pain in the abdomen. It is a fatal condition if left untreated for long. Individuals with diabetes, reduced immune system, and obesity have an increased risk of developing this complication.
Porcelain (calcified) gallbladder
Porcelain gallbladder is a condition where the muscular walls of the gallbladder develop an accumulation of calcium. This causes them to become stiff, limiting the gallbladder’s function and increasing the risk of gallbladder cancer.
Polyps are a type of growth that is benign noncancerous. Smaller gallbladder polyps often do not cause any problems and rarely produce any symptoms. Larger polyps may need to be removed.
Symptoms of gallbladder problems include:
- Pain in the mid- or upper-right section of the abdomen: Most of the time, gallbladder pain comes and goes. However, pain from gallbladder problems ranges from mild and irregular to very severe, frequent pain. Gallbladder pain often causes pain in the chest and back.
- Nausea or vomiting:Any gallbladder problem may cause nausea or vomiting. Long-term gallbladder diseases and disorders may lead to long-standing digestive problems that cause frequent nausea.
- Fever or shaking chill: This signals an infection in the body. Alongside other gallbladder symptoms, fever and chills may signify a gallbladder problem or infection.
- Changes in bowel movements:Gallbladder problems often cause changes in bowel habits. Frequent, unexplained diarrhea can signal a chronic gallbladder disease. Light-colored or chalky stools may point to a problem with the bile ducts.
- Changes in urine:Patients suffering from gallbladder issues may notice darker than normal urine. Dark urine may indicate a bile duct block.
- JaundiceYellowing of the skin occurs when liver bile does not successfully reach the intestines. This normally happens due to a problem with the liver or due to a blockage in the bile ducts caused by gallstones.
When to see a doctor
Anyone with gallbladder symptoms should seek medical attention. Mild, intermittent pain that goes away on its own does not need immediate attention. However, patients with this type of pain should make an appointment with their doctor to be examined further.
If the symptoms are more severe and include the following, a patient should be seen immediately:
- Upper-right quadrant pain that does not go away within 5 hours
- Fever, nausea, or vomiting
- Changes in bowel movement and urine
This combination of symptoms can indicate a serious infection that needs instant treatment.
It was assumed that a low-fat diet could help treat gallstones or at least prevent their growth. However, this approach to treatment has been discredited by new evidence that suggests losing too much weight too rapidly might even lead to gallstones becoming larger than shrinking.
A balanced diet that includes a variety of foods will not cure gallstones, but it can preserve overall health and health keep any pain caused by gallstones under control.
The National Institute of Diabetes and Digestive and Kidney Diseases recommends:
- eating high-fiber foods, such as peas, beans, fruits, whole grains, and vegetables
- reducing consumption of carbohydrate and sugar
- consuming healthy fats, such as those found in fish oil and olive oil
If a doctor suspects a patient has a gallbladder problem, they will likely order the following:
- Imaging tests of the gallbladder:Ultrasound and CT scans are commonly used to image the gallbladder. These will then be checked for gallstones.
- Tests to examine bile ducts:These tests use dye to show if a gallstone is causing a blockage in the bile ducts. Tests to check the bile ducts for stones include MRI, hepatobiliary iminodiacetic acid (HIDA) scans, and an endoscopic retrograde cholangiopancreatography (ERCP).
- Blood tests: Doctors can use blood tests to reveal signs of infection, inflammation of the bile ducts, pancreatitis, or other complications caused by gallstones.
Gallstones and cholecystitis are treatable conditions. Gallstones that cause symptoms or infections of the gallbladder do need treatment. Treatment options include: medications to break up gallstones, antibiotics to treat infections, and surgically removing the gallbladder.
According to the University of California San Francisco (UCSF), gallbladder removal surgery is one of the most commonly performed surgeries.
Laparoscopic gallbladder removal is the most common procedure, where a surgeon inserts a thin tube with a tiny video camera attached into a small incision in the abdomen. The camera transmits images from inside the body to a video monitor.
While watching the enlarged images on the monitor, the surgeon carefully removes the gallbladder through one of the small cuts. These surgeries are often outpatient procedures, meaning that the patient can often go home the same day.
While gallbladder problems can’t be completely prevented, patients can take steps to decrease the risks of developing gallstones or other infections. To reduce risk of gallbladder disease, you must avoid:
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) state that the following people have an increased risk of gallstones:
- people with a family history of gallstones
- people over 40
- native and Mexican Americans
- individuals with obesity