The term gallbladder disease is used for several types of conditions that can affect your gallbladder. The gallbladder is a small pear-shaped sac located underneath your liver. Your gallbladder’s main function is to store the bile produced by your liver and pass it along through a duct that empties into the small intestine. Bile helps you digest fats in your small intestine. Inflammation causes the majority of gallbladder diseases due to irritation of the gallbladder walls, which is known as cholecystitis. This inflammation is often due to gallstones blocking the ducts leading to the small intestine and causing bile to build up. It may eventually lead to necrosis (tissue destruction) or gangrene.

Types

Gallstones, Cholecystitis, Choledocholithiasis, Acalculous gallbladder disease, Biliary dyskinesia

Pain: The most common symptom of a gallbladder problem is pain. This pain usually occurs in the mid- to upper-right section of your abdomen.

Nausea or vomiting: Nausea and vomiting are common symptoms of all types of gallbladder problems. However, only chronic gallbladder disease may cause digestive problems, such as acid reflux and gas.

Fever or chills: Chills or an unexplained fever may signal that you have an infection. If you have an infection, you need treatment before it worsens and becomes dangerous. The infection can become life-threatening if it spreads to other parts of the body.

Chronic diarrhea: Having more than four bowel movements per day for at least three months may be a sign of chronic gallbladder disease.

Jaundice: Yellow-tinted skin, or jaundice, may be a sign of a block or stone in the common bile duct. The common bile duct is the channel that leads from the gallbladder to the small intestine.

Unusual stools or urine: Lighter-colored stools and dark urine are possible signs of a common bile duct block.

Diagnosis

Detailed medical history: A list of symptoms you’re experiencing and any personal or family history of gallbladder disease are important. A general health assessment may also be performed to determine if there are any signs of a long-term gallbladder disease.

Physical exam: Your doctor may perform a special maneuver during the abdominal exam to look for what’s referred to as “Murphy’s sign.”During this maneuver, your doctor will put their hand on your abdomen over the area of the gallbladder. They’ll then ask you to take a breath while examining and feeling the area. If you feel significant pain, it suggests you may have gallbladder disease.
 

Chest and abdominal X-ray: Symptomatic cholecystitis will sometimes show stones on abdominal X-rays if the stones contain calcium. An X-ray of the chest may show pleurisy or pneumonia. However, X-rays aren’t the best test for identifying gallbladder disease. They’re often used to rule out other potential causes of pain that’s not related to gallstones, the gallbladder, or the liver.

Ultrasound: An ultrasound uses sound waves to produce images inside your body. This test is one of the main methods your doctor uses to make a diagnosis of gallbladder disease. An ultrasound can evaluate the gallbladder for the presence of gallstones, thickened walls, polyps, or masses. It can also identify any issues within your liver.

HIDA scan: A HIDA scan looks at the duct system within the gallbladder and liver. This test can evaluate the function of the gallbladder using a harmless radioactive substance. The substance is injected into a vein and then watched as it moves through the gallbladder. Another chemical may also be injected that causes the gallbladder to release bile.

Treatment

Medical treatment: The first episode of gallbladder inflammation is often treated with pain medications. Because the pain is often severe, prescription medications are needed. Your doctor may prescribe medications with codeine or hydrocodone. IV prescription anti-inflammatories may be prescribed, or stronger pain medications like morphine. Over-the-counter medications like ibuprofen (Advil) and naproxen (Aleve) may not be used as often due to the increased risk of nausea and vomiting. If you’re dehydrated, anti-inflammatory drugs may also cause severe kidney issues.

Surgery: Surgery will be recommended to remove your gallbladder if you’ve experienced multiple episodes of inflammation. Gallbladder surgery continues to be the most effective method for treating active gallbladder disease. The surgery can be done either by opening your abdomen with an incision, or laparoscopically. This involves making several poke holes through the abdominal wall and inserting a camera. Laparoscopic surgery allows for faster recovery. This method is preferred for people who don’t have complications of significant gallbladder disease.

Preventions

Refined grains (found in sugary cereals and white rice, bread, and pasta) and sugary sweets are associated with a higher risk of gallbladder disease. Whole grains like brown rice and whole wheat bread and fats from fish and olive oil are all recommended. The earlier gallbladder problems are recognized and treated, the less likely significant complications will occur. It’s important to talk to your doctor if you’re experiencing any signs or symptoms of gallbladder disease.

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With Regards
Jessica Watson
Associate Managing Editor
Clinical Gastroenterology Journal