The gallbladder is a small organ which sits beneath the liver. This contains bile, and during digestion releases it into the small intestine.
Bile is a secretion made from the liver and is yellowish. It helps the body break down fat and clean out waste.
Gallbladder can be affected by a number of issues.
This article looks at gallstones, cholecystitis, gallbladder disease and other forms. It explains how these issues can be understood, and what therapies are available.
Types
Some common health problems that can affect the gallbladder include:
Gallstones
Gallstones are the type of gallbladder disease which occurs most often. These little stones, which develop in the gallbladder, contain cholesterol and solidified bile.
In the United States, about 20 million men between the ages of 20 and 74 have gallstones. Fourteen million of those are women.
There are often no signs, but gallstones within the gallbladder may get stuck in an opening or duct.
This can lead to a sudden pain in the abdomen just below the right ribs, especially between the rib cage and the belly button. The pain can extends to the shoulder blade or hand.
Other symptoms include:
- abdominal pain that lasts several hours
- nausea, vomiting, and loss of appetite
- a fever and chills
- a yellow tinge to the skin and the whites of the eyes
- dark-colored urine and pale stools
- itchy skin
- heavy sweating
A individual might also experience contractions as the gallbladder attempts to remove a gallstone.
Using the toilet doesn’t relieve discomfort by vomiting and passing gas.
Eating foods that contain a lot of fat can cause the pain— what doctors call biliary colic — but without a clear trigger it can happen.
A person experiencing this pain should see a doctor, as it can result in complications.
Cholecystitis
A more serious blockage of the gallstone inside a bile duct may cause gallbladder swelling. This condition is called cholecystitis.
If a person is not receiving treatment, there can be serious complications.
Cholecystitis can be chronic, or acute.
Acute cholecystitis
A person first experiences sudden, intense pain. The pain may last 6–12 hours or longer.
There may also be:
- nausea and vomiting
- a fever
- slight yellowing of the skin
- swelling in the abdomen
People who have this type of cholecystitis may get very sick. If the inflammation is serious, the gallbladder can rupture.
Chronic cholecystitis
Chronic cholecystitis is the result of inflammation of the gallbladder over a long period. It occurs when the gallbladder is not fully flushed out.
The underlying cause may involve:
- gallstones blocking a duct
- high concentrations of bile salt and calcium
- the gallbladder being unable to empty properly
- sickle cell anemia
Symptoms involve frequent bouts of intense inflammation and pain in the upper body. The pain will be less intense than the one of acute cholecystitis, and a person will not normally have a fever.
Cholecystitis can be responsible for a number of serious complications. Including:
Gallbladder infection: If cholecystitis results from a buildup of bile, the bile may become infected.
Death of gallbladder tissue: Without treatment, cholecystitis can cause gallbladder tissue to die, and gangrene can develop. Dead tissue can also cause the gallbladder to tear or burst.
Torn gallbladder: A tear in the gallbladder can result from swelling or infection.
Both forms of cholecystitis can have life-threatening consequences. It is important to seek medical aid if a person shows symptoms.
Diagnosis
A doctor will ask the person about their symptoms, and will conduct a physical exam.
Also, an ultrasound can detect:
- gallstones
- fluid around the gallbladder
- thickening of gallbladder walls
If symptoms persist, blood tests can provide more information.
If they are unsure of the diagnosis, a doctor can suggest more imaging tests— like a CT or MRI scan.
Treatment
A person suffering from either form of cholecystitis will need hospital treatment.
The aim is to:
- control the symptoms
- reduce inflammation in the gallbladder
Depending on how severe the symptoms are, the first steps may be:
- fasting, to ease stress on the inflamed gallbladder
- supplying intravenous fluids to prevent dehydration
A doctor may also prescribe:
- antibiotics to fight infection
- pain relief medication
Symptoms usually improve within a couple of days.
Surgery
A person may need surgery, in some cases.
A cholecystectomy is a name for removing a gallbladder. Usually, it is a laparoscopic, or keyhole, operation.
Surgeons take that as a routine procedure. In the U.S., approximately 500,000 people have it every year, and many go home the same day. It takes around a week to recover.
In a person with chronic cholecystitis after an episode subsides the surgeon will usually remove the gallbladder.
A person may need an operation within 48 hours, if:
- they have acute cholecystitis and surgery does not pose a risk
- they are older or have diabetes
- a doctor suspects a complication, such as an abscess or gangrene
- the person has cholecystitis with gallstones
If the operation is dangerous due to other health problems, such as heart, lung, or kidney disorders, the doctor may postpone the procedure until treatment or management of the other problems.
The diet before and after surgery
A doctor will recommend taking a low-fat diet several weeks in advance of surgery.
Then most people don’t need to adopt a special diet. Usually they should start eating within a few hours of surgery, as well.
It is better, however, to:
- begin with small meals
- avoid caffeinated drinks
- avoid fatty or spicy foods
- increase the fiber intake gradually
These steps can help reduce the side effects of surgery, which include:
- indigestion
- bloating
- flatulence
- diarrhea
In general, a balanced diet is important for staying healthy. This should include:
- plenty of fresh fruits and vegetables
- high-fiber options, such as wholemeal bread and pasta
- foods that are low in fat, salt, and sugar
Living without a gallbladder
The gallbladder stores bile, but it’s not an important organ and without it, a person can live a regular life.
Bile will still find its way through ducts in the liver to the small intestines.
Prevention
Preventing the development of gallstones reduces the chance of cholecystitis.
A person can help prevent gallstones by eating a healthy diet and getting enough exercise, and thus maintaining a healthy weight.
It is important to avoid rapid weight loss and maintain a high fiber diet, full of fresh fruits and vegetables, and low fat diet.
Other problems affecting the bile ducts
Some of these issues include:
Primary biliary cirrhosis
It includes inflammation of the liver’s bile ducts, and through scarring.
Primary biliary cirrhosis starts with inflammation, which prevents bile supply from the liver. The bile gets trapped in liver cells and results in inflammation.
Recurring inflammation can, over time, lead to liver scarring, cirrhosis and liver failure.
Primary sclerosing cholangitis
In this state, inflammation leads to scarring which results in narrowing and blocking of the affected bile ducts.
Primary cholangitis with sclerosis (PSC) may also eventually lead to cirrhosis. The body can not remove the bile salts when this happens which help it absorb fats.
PSC is similar to primary biliary cirrhosis except that it involves external and internal bile ducts. The cause is unknown but it is likely the result of an attack on the body by the immune system.
Tumors of the bile duct and gallbladder
Cancer of the bile duct or gallbladder is rare. Risk factors include older age and having PSC.
Pancreatitis and pancreatic tumors
Pancreatitis is inflammation of the pancreas.
It can result from:
- gallstones
- certain viral infections
- digestive enzymes
- alcohol
- some drugs
Pancreatic tumors can block the ducts through which bile leaves the liver.
Other problems affecting the gallbladder
The following can harm the gallbladder:
Crohn’s and other intestinal diseases: These can change the way that the body absorbs nutrients.
Diabetes: This can increase the risk of gallstones.
Overweight or obesity: This can place a strain on the body and increase the cholesterol in the bile, increasing the development of gallstones.
For this reason, however, anyone who thinks of losing weight should first speak to a doctor, because rapid weight loss can also cause gallstones.
