Gallbladder Disease:
What is gallbladder disease?
Gallbladder disease is one of the most common surgical problems in the world today with over 500,000 gallbladder operations performed annually in the US.
The liver produces bile and sends it to other parts of the digestive system through the hepatic and common bile ducts. Most of the bile is sent to the duodenum and part of it is sent to the gallbladder. The gallbladder is an organ that lies under the liver and stores and concentrates bile. At an appropriate time controlled by a chemical released by the stomach, the gallbladder contracts and empties the bile, aiding digestion.
The gallbladder stores this small amount of bile until it is needed for digestion. Bile then moves in and out of the gallbladder through the cystic duct. When a fatty meal is eaten, bile is released from the gallbladder, which mixes with the food in the duodenum, and the pancreas adds the digestive juices. Therefore, digestion will continue in the small intestine. People can function normally without a gallbladder, although diarrhea may sometimes occur after removing the gallbladder due to excess bile salts being delivered to the intestine.
Symptoms of gallbladder disease:
Patients with gallbladder disease often experience gallbladder attacks, during which patients often complain of pain under the right rib cage radiating around to the mid-back, which can last from a few minutes up to a few hours. Nausea and vomiting may also occur. Fever associated with this pain is a sign of a more serious gallbladder problem and deserves immediate medical attention. A gallbladder attack does not always behave this way, however. Acute symptoms associated with gallbladder disease may include:
- Ulcer disease with a belt-like tightening in the abdomen
- Heart disease with chest pain
- Hiatal hernia
- Reflux esophagitis with burning in the chest and upper abdomen
Gallbladder disease can be manifest by fatty food intolerance including milk, dairy products, fried foods, and cabbage. Any symptoms of gallbladder problems should be reported to a physician as soon as possible. Attacking this problem early usually assures fewer complications.
Causes of gallbladder disease:
Most patients with gallbladder disease have no obvious underlying cause. A positive family history can be found in some patients, but it is uncommon. It is known, however, that pregnant patients are more likely to develop gallstones during pregnancy and that rapid weight loss can sometimes cause gallstones. Unfortunately, there is no known method, drug or procedure that can prevent gallbladder disease at the present time.
Most gallbladder attacks are associated with actual stones in the gallbladder. The stones are formed by an imbalance of certain chemicals in the bile. These stones can become impacted, preventing the gallbladder from emptying. The gallbladder contracts against this obstruction and causes pain. One of the most common types of gallbladder disease is called cholecystitis, which means an infection or inflammation of the gallbladder wall. This disease occurs in both an acute and a chronic variety.
- Acute cholecystitis: The acute form occurs quickly, is much more serious and usually requires an urgent operation. The gallbladder swells and decreases its blood supply. This allows the gallbladder wall to weaken and cause gangrene. Occasionally, a gallstone will erode through the wall of the gallbladder and enter the intestine, possibly causing a bowel obstruction.
- Chronic cholecystitis: The chronic variety occurs intermittently over months or years.
- Acalculous (no stone) cholecystitis: This is an infection of the gallbladder without stones. This is seen more commonly in patients in an intensive care setting or in patients who have undergone major operations.
- Poorly functioning gallbladder: Symptoms can sometimes be caused by a poorly functioning gallbladder. Unfortunately, this is difficult to diagnose, and when it is suspected, removing the gallbladder doesn't always resolve the problem.
Treatment & Prevention options:
Acute pain from gallstones and gallbladder disease is usually treated in the hospital, where diagnostic procedures are performed to rule out other conditions and complications. There are three approaches to gallstone treatment.
- Expectant management ("wait and see")
- Nonsurgical removal of the stones
- Surgical removal of the gallbladder
Related information:
- Anatomy & Functions of the gallbladder & bile ducts
- Medicine Plus
- Women’s Health – Q & A: Gallbladder disease
- Health Central – Gallbladder disease
- More patient resources
| University of Missouri Health Care | This information is not intended to replace the advice of a doctor. |
