The gallbladder is found underneath the liver and functions primarily to store bile produced by the liver. From the gallbladder, bile passes along a duct that empties into the small intestines. Bile is needed by the body to digest fats in the small intestine effectively.
Most gallbladder disorders are due to inflammatory causes. For instance, the irritation of the gallbladder walls, called the cholecystitis, is often due to gallstones problems. Inflammation of the gallbladder occurs when stones are blocking the duct that leads to the small intestines, and a build of bile happens. It may further lead to issues such as necrosis and gangrene.
Causes of Gallbladder Disease
Gallbladder disorders have various causes. The most common is gallstones. These stones are crystals that form inside the gallbladder due to excessive cholesterol or bilirubin. Gallstones cause abdominal discomfort in varying degrees. Likewise, it may also lead to severe complications, including:
- Infection of the common bile duct
- Obstruction of the central bile duct
- Inflammation of the gallbladder
- Bowel obstruction due to gallstone
- Gangrene of the gallbladder
- Gallbladder cancer
Aside from gallstones and its related complications, other types of diseases may also affect the gallbladder.
When a person’s sphincter of Oddi does not function normally, it can lead to a motility syndrome known as biliary dyskinesia. The sphincter of Oddi is a valve muscle that controls the passage of digestive juices and bile from the pancreas and the liver. It leads to the small intestine to aid in digestion. If this valve functions abnormally, there will be a backup of fluid in the duct and cause a painful obstruction.
Functional Gallbladder Disorder
This condition is diagnosed using a test called the cholecystokinin (CKK) – stimulated cholescintigraphy. A person with this disorder experiences biliary pain without gallstones or valve muscle problems in the gallbladder.
Primary Sclerosis Cholangitis (PSC)
This condition is the chronic inflammation of the gallbladder and liver. It leads to debilitating itching due to the accumulation of bile acid. The buildup of bile in the liver leads to cirrhosis, and eventually, the liver can no longer function. Most patients with this condition may end up needing a liver transplant.
Diagnosis and Treatment
Diagnosing gallbladder diseases requires several tests and procedures. Your doctor will review your medical history and conduct an abdominal examination. They will determine whether you have pain in your abdomen. Additionally, they may order one or more of the following tests and procedures.
Detailed Medical History
Your doctor will record all your symptoms and tally it against your medical history. They may come up with a general health assessment to determine if there are signs of a long-term disorder.
Your healthcare professional may perform “Murphy’s sign” during the abdominal exam. They will put their hand on your abdomen over the area of your gallbladder and ask you a take a deep breath. If you feel pain while they are prodding the area, it suggests that you may have a gallbladder problem.
Chest and abdominal X-ray
Some diseases of the gallbladder will show stones on an abdominal X-ray, mainly if the stones contain calcium. An X-ray of the chest may indicate pneumonia or pleurisy. On the other hand, this procedure is not the best for identifying gallbladder disorders. It is often used to rule out possible causes of pain that are not related to gallbladder, gallstones, or liver.
This procedure is one of the primary methods that doctors use to diagnose gallbladder diseases. An ultrasound helps evaluate the gallbladder for the presence of gallstones, masses, thickened walls, or polyps. It also helps identify problems with the liver.
This procedure will monitor the duct system connecting the gallbladder and liver. When the ultrasound result does not indicate any reason for the symptom, a HIDA scan is used to get a thorough evaluation of the duct system.
Your doctor may also require other imaging tests like MRI scans and CT scans. Blood tests may also be conducted to check white blood counts and potential abnormality in the liver function.
An Endoscopic Retrograde Cholangiopancreatography (ERCP) may also be suggested though it is a more invasive procedure. It uses a flexible camera that is inserted into the mouth past the stomach and into the small intestine. This test is useful if there is a blockage due to gallstones. During the procedure, the obstruction may effectively be removed.
Gallbladder Disease Treatment
Certain health conditions tend to increase the risk of having gallstones. Thus, lifestyle changes are encouraged to help manage gallbladder disorder in people without any symptoms. A person who is overweight or has diabetes is at a higher risk of developing gallstones. Thus, losing weight and better management of diabetes will help prevent gallbladder disorders.
On the other hand, rapid weight loss can also trigger the formation of gallstones. Consult with your doctor on the safe ways of losing weight. Increased physical activity also decreases the chances of having gallstones. You may also be advised to quit smoking and limit alcohol consumption.
The first gallbladder inflammation is often treated using pain medication. The pain is commonly intense; thus, prescription medications such as those with hydrocodone and codeine will be needed. In some cases, anti-inflammatory prescription drugs, including stronger pain medication like morphine, will also be prescribed.
Over the counter medication for pain like naproxen are not advised as they increase the risk of vomiting and nausea. Anti-inflammatory drugs may also lead to severe kidney problems if the patient is dehydrated.
Many people find it challenging to manage painful gallbladder disorder at home. You need to discuss with your doctor the best treatment plan for your case.
If you experienced multiple episodes of gallbladder inflammation, your doctor might recommend surgery for its removal. This procedure is the most effective method for treating gallbladder diseases and disorders.
The surgery may be done by making an incision in your abdomen or laparoscopically. This type of surgery allows faster recovery and is the preferred method if the patient does not have any significant complications with their gallbladder disease.
What are the Normal Conditions?
The gallbladder works as the storage of bile that is produced by the liver. It is a pear-shaped hollow structure found underneath the liver and is part of the biliary tract.
As a storage organ, the gallbladder functions as a reservoir of bile while it is not needed for digestion. It has an absorbent lining that concentrates the bile it keeps. When there is food to be digested in the small intestine, a hormone called cholecystokinin signals the gallbladder to secrete bile into the small intestines via the bile duct.
When there is an excess of cholesterol, bile salts, or bilirubin, gallstones can form. These are generally tiny, hard deposits that form inside the gallbladder when stored bile crystallizes. In most cases, a person will not feel any symptoms of gallstones until it reaches a specific size or if it obstructs the ducts. A typical procedure for treating gallstone problems and gallbladder disorder is through its surgical removal.
The Risks of Having Gallbladder Disorders
The gallbladder is just a tiny organ that functions as bile storage. It is located under the liver, and most people don’t think about it. But when certain gallbladder disorders or diseases happen, people realize that they have it. Gallbladder diseases refer to several types of conditions that affect the gallbladder. These conditions can affect anyone, but some people are more at risk than others. Here are the common risk factors that put you more at risk of having gallbladder problems.
- You are older than 60 years old
- You are a woman
- You are overweight or obese
- You have diabetes
- You have a family history of this condition
- You are taking specific medication
- You are of Mexican-American or Native American descent
Additionally, certain medical conditions and surgical procedures also increase a person’s risk of developing gallbladder disorders. It includes diabetes and metabolic syndrome, Crohn’s disease, sickle cell anemia, low melatonin, and bariatric surgery.
Some other factors that may increase the risk of gallbladder diseases include burns, childbirth, multiple transfusions, major infection or trauma, and serious illnesses like AIDS, end-stage kidney disease.
When to Seek Medical Attention
If you experience gallbladder pain, you should consult your health care professional as soon as you can, and even if the symptoms are gone. Your doctor will ensure that you will have problems that will make you at risk of a more severe complication. Similar to other types of diseases, early diagnosis will help address the problem and avoid further damage to your health.
In case you experience any of the following symptoms, call for immediate medical attention:
- Increasing pain when you take a breath
- Abdominal pain for the last five hours
- Severe, intense pain in your abdominal area
- Yellowish skin or yellow around the white part of your eyes
- Persistent vomiting
- Rapid heartbeat
- Light-colored stools
- Dark or tea-colored urine