What Is Gallbladder?
The gallbladder is a small pear-shaped organ situated in the upper-right segment of the abdomen under the liver. It is a hollow organ that measures roughly 4 inches. It is the organ where bile is stored. Bile is a yellowish-brown or green digestive fluid produced by the liver and is released into the duodenum (first part of the small intestine) by the gallbladder when one eats something.
Bile moves from the liver to the gallbladder through the common hepatic duct and is released into the duodenum through the common bile duct. Normally, this process happens without any pain or discomfort. But if there are blockages in any of these ducts or if the gallbladder does not function properly, it results in severe abdominal pain and discomfort.
What Are the Conditions Affecting Gallbladder?
The common conditions that affect the gallbladder are:
1. Cholelithiasis (Gallstones):
Gallstones are deposits of cholesterol or digestive fluids that are formed in the gallbladder. They can be of different sizes, which can vary from a grain of sand to a golf ball. It results from the crystallization of excess fat and bile. Over time, these crystals combine and form stones. Depending on the size and number of stones, it may or may not cause symptoms.
2. Choledocholithiasis (Common Bile Duct Stones):
Stones in the small tubes that transport bile from the gallbladder to the duodenum (common bile duct) are called choledocholithiasis. There are two types of these stones:
-
Primary Common Bile Duct Stone - These stones are formed inside the common bile duct itself.
-
Secondary Common Bile Duct Stone - These stones are formed in the gallbladder and get stuck in the bile duct during the transportation of bile.
3. Cholecystitis (Inflammation of the Gallbladder):
The gallbladder usually gets inflamed when a gallstone gets stuck in its opening, which blocks the flow of bile. Bile accumulates in the gallbladder, which irritates its walls and causes swelling and infection. This inflammation can develop suddenly (acute cholecystitis) or over some time (chronic cholecystitis) due to recurrent acute attacks. If the obstruction is not removed and prompt treatment is not done, it can affect the proper functioning of the gallbladder.
4. Porcelain Gallbladder:
Porcelain gallbladder is a condition that results from a buildup of calcium in the muscular walls of the gallbladder. This makes the organ bluish and brittle and limits its function.
5. Gallbladder Polyps:
Benign growths that form on the gallbladder lining are called gallbladder polyps. It normally does not cause any complications or pain.
6. Perforated Gallbladder:
When acute cholecystitis caused by gallstones is left untreated, the collected bile can perforate the wall of the gallbladder. This perforation results in the leaking of infection and bile into the body cavity, which can cause sepsis.
7. Infection of the Common Bile Duct:
Any blockage in the common bile duct can result in infection. If detected early, it can be successfully treated. But in the later stages, it can result in the spreading of infection, which becomes difficult to treat and can be life-threatening.
8. Dysfunctional Gallbladder:
Dysfunctional gallbladder, otherwise called chronic gallbladder disease, results from repeated gallbladder infection or gallstones. The organ does not function properly as it becomes scarred and rigid.
9. Gallstone Ileus:
Gallstone ileus is a rare and life-threatening condition that results from obstruction of the small intestine by a gallstone. Emergency surgery is needed to remove the stone from the intestine.
10. Gallbladder Empyema:
Gallbladder empyema or abscess is the formation of pus in the gallbladder. It can be fatal if the pus is not aspirated and the gallbladder is removed immediately. The risk factors include diabetes, obesity, and a weak immune system.
11. Gallbladder Cancer:
This is a very rare condition. The prognosis is good if this cancer is detected at an early stage. But most gallbladder cancers go undetected until they spread to other parts, making it difficult to treat. The factors that increase the risk of this type of cancer are gallstones, porcelain gallbladder, being female, obesity, and old age.
12. Cholangiopathy:
Any bile duct illness is referred to as cholangiopathy. It usually begins as bile duct inflammation, caused by a transient infection, obstruction, or an inflammatory disease that progresses over time, like primary biliary cholangitis.
13. Gangrene:
Gallbladder gangrene is a consequence associated with persistent cholecystitis. Chronic inflammation causing the gallbladder to enlarge and dilate over time may ultimately result in tissue death. An infection could spread throughout the abdominal cavity as a result of a gallbladder wall perforation. This is among the factors that make cholecystitis a dangerous condition.
Who Is Affected by Gallbladder Disease?
When individuals have gallstones, they are likely to suffer from gallbladder disease. Among the risk factors are:
-
A diet high in cholesterol. The most prevalent kind of gallstones are cholesterol ones, which are formed from excess cholesterol in the gallbladder.
-
Obesity and overweight.
-
Older than sixty years. People over 60 are more likely to get gallstones, most likely because they have had longer for excess bile products to build up.
-
Gallstones are more than twice as common in women as in men. Excess estrogen raises cholesterol and delays the gallbladder's emptying, particularly during pregnancy.
-
Gallbladder illness in the family history.
-
Diabetes.
-
Gallstones are common in people with Crohn's disease because of a decreased capacity to absorb bile salts, which aid in the breakdown of cholesterol inside the gallbladder.
-
Liver cirrhosis may slow down the passage of bile from the liver to the gall bladder.
-
Cholesterol-lowering medicines reduce blood cholesterol and increase the deposition of cholesterol in the gall bladder.
-
Individuals with sickle cell disease may have an accumulation of bilirubin in the gallbladder.
What Are the Symptoms of Gallbladder Problems?
The symptoms caused by gallbladder problems are:
-
Severe and frequent pain in the upper right side of the abdomen.
-
Nausea.
-
Vomiting.
-
Chills.
-
Diarrhea.
-
Chalky and light-colored stools.
-
Dark urine.
-
Yellowish discoloration of skin and sclera (jaundice).
How Is Gallbladder Problem Diagnosed?
The tests that are done to diagnose gallbladder problems are:
-
Ultrasound of the Abdomen - High-frequency sound waves is used to obtain images of the gallbladder.
-
HIDA Scan - It is otherwise called cholescintigraphy or hepatobiliary scintigraphy. Here, radioactive dye is injected intravenously, which dyes the bile. It is used to check if there is any blockage in the flow of bile from the liver to the gallbladder.
-
Endoscopic Retrograde Cholangiopancreatography (ERCP) - A tube is inserted from the mouth to the small intestine through the stomach, and a dye is injected into the bile system ducts to see if they are patent.
-
Magnetic Resonance Cholangiopancreatography (MRCP) - It is used to obtain high-resolution images of the bile ducts, pancreas, and gallbladder.
-
Endoscopic Ultrasound - It is used to diagnose choledocholithiasis and gallstone pancreatitis.
-
X-Rays of the Abdomen - Gallstones might show up on X-rays.
What Are the Treatment Options for Gallbladder Problems?
Depending on the condition, the treatment options include:
-
Cholecystectomy - It is the surgical removal of the gallbladder, through laparoscopy (several small incisions) or laparotomy (open surgery).
-
Medicines - The doctor might prescribe antibiotics if there is any infection.
-
Extracorporeal Shock-Wave Lithotripsy - Here, high-energy shock waves are used to break gallstones.
-
Chemotherapy and Radiotherapy - For gallbladder cancer, chemotherapy and radiation therapy might be helpful.
-
Ursodeoxycholic Acid - Small cholesterol gallstones can be dissolved using Ursodeoxycholic acid.
What Is the Diet for Gallbladder Problems?
-
Foods to Avoid:
-
Trans and saturated fats.
-
Processed food.
-
Too much refined carbohydrates.
-
Sweets.
-
-
Foods to Include:
-
Fruits and vegetables.
-
Calcium-rich foods like green leafy vegetables and milk.
-
Foods containing vitamin C.
-
Protein.
-
Nuts.
-
Fish.
-
Most of the diseases affecting the gallbladder can be treated easily. For any questions or doubts, consult a medical gastroenterologist now.
Conclusion:
Minimally invasive surgery is an easy way to treat the majority of gallbladder problems. Even in cases where symptoms are not severe, it is crucial to treat them with caution. More frequently, gallbladder diseases end in gallbladder removal and it may be necessary for patients to abstain from fatty meals initially as the body gets used to not having a gallbladder. After a few months, the majority of individuals can return to a regular but nutritious diet.
