Gallbladder - Symptoms, Diagnoses & Treatment

Gallbladder Anatomy and Location:

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.

What Does the Gallbladder Do?

It is the organ where bile gets 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 you eat 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.

Gallbladder Conditions

The common conditions that affect the gallbladder are:

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.

Choledocholithiasis (Common Bile Duct Stones)

Stones in the small tubes that transport bile from the gallbladder to the duodenum (common bile duct) is 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 transportation of bile.

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 gets accumulated in the gallbladder, which irritates its walls and causes swelling and infection. This inflammation can develop suddenly (acute cholecystitis) or over a period of 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.

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.

Gallbladder Polyps

Benign growths that form on the lining of the gallbladder are called gallbladder polyps. It normally does not cause any complications or pain.

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.

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.

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.

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.

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 gallbladder removed immediately. The risk factors include diabetes, obesity, and weak immune system.

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.

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.

• Fever.

• 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-ray 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 - Your 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 Are the Risk Factors for Developing Gallbladder Problem?

The factors that increase your risk are:

• Obesity.

• Females over 40 years.

• Pregnancy.

• Consuming a diet rich in refined carbohydrates and saturated fats.

• Sedentary lifestyle.

• Taking medicines that contain Estrogen.

• Diabetes.

• Metabolic syndrome.

Diet for Gallbladder Problem:

• Foods to avoid:

  • Trans and saturated fats.

  • Processed food.

  • Too much of 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.