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Gallbladder Disease
Gallbladder disease is a term for several types of conditions that can affect your
gallbladder, a small pear shaped sac located under the liver. Your gallbladder’s
main function is to store the bile produced in your liver and pass it along to the
small intestine.
The majority of gallbladder diseases are caused by inflammation due to
irritation to the gallbladder wall (cholecystitis). This occurs when gallstones
obstruct the ducts leading to the small intestine and may eventually lead to
necrosis or gangrene. Other diseases of the gallbladder include biliary enteric
fistulas, sclerosing cholangitis, gallbladder polyps, and gallbladder cancer.
Part 2 of 6: Types
What are the Types of
Gallbladder Disease?
Gallstones
Gallstones are the most pressing of all gallbladder diseases. They develop when
substances in the bile (such as cholesterol, bile salts, and calcium) form hard
particles that block the passageway to the gallbladder.
In addition, stones tend to form when the gallbladder doesn’t empty completely
or often enough. They vary in size from as small as a grain of sand to as large
as a golf ball.
Numerous factors contribute to your risk of gallstones. These include:
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being overweight or obese
eating a high-fat or high-cholesterol diet
having diabetes
being age 60 or older
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taking medications that contain estrogen
having a family history of gallstones
being a women
Cholecystitis
Cholecystitis is the most common type of gallbladder disease. It presents itself
as either an acute or chronic inflammation.
Acute Cholecystitis
Acute cholecystitis is generally caused by gallstones, but may also be the result
of tumors or various other illnesses. It may present with pain in the upper right
side or upper middle part of the abdomen. The pain can come right after a meal
and range from sharp pangs to dull aches that may often radiate to the right
shoulder. Fever nausea, vomiting, jaundice, and different colored stools are also
a result of acute cholecystitis.
Chronic Cholecystitis
After several attacks of acute cholecystitis, the gallbladder will shrink and lose
its function of storing and releasing bile. Abdominal pain, nausea, and vomiting
may follow.
Choledocholithiasis
Gallstones may become lodged in the neck of the gallbladder or in the bile
ducts. When the gallbladder is plugged in this way, bile cannot exit. This may
lead to the gallbladder becoming inflamed or distended. The plugged bile ducts
will further prevent bile from traveling from the liver to the intestines.
Choledocholithiasis produces extreme pain in the middle upper abdomen,
fever, chills, nausea, and vomiting.
Acalculous Gallbladder Disease
Acalculous gallbladder disease (biliary dyskinesia) occurs without the presence
of gallstones. It can be chronic or acute and may result from the gallbladder
muscles or valve not working properly. Symptoms include abdominal pain on
the right side of the body, radiating to the shoulder. Eating high fat foods often
triggers this. Related symptoms may include nausea, vomiting, bloating, and
loose stools.
Sclerosing Cholangitis
Sclerosing cholangitis is the inflammation, scarring, and damage to the bile
ducts. It’s unknown what causes the disease. Symptoms may include an
enlarged liver or spleen along with a decrease in appetite and weight loss.
Gallbladder Cancer
Cancer of the gallbladder is a relatively rare disease. If not treated, however, it
can spread from the inner walls of the gallbladder, to the outer layers, and then
to the other organs and ducts. Symptoms may be similar to those of acute
cholecystitis.
Gallbladder Polyps
Gallbladder polyps are lesions or growths that occur on the gallbladder. They
are usually harmless and the symptoms are often non-existent.
Gangrene of the Gallbladder
Gangrene develops when the gallbladder stops functioning because of
inadequate blood flow. This may occur due to infections, injury, diabetes,
surgery, or diseases related to blood circulation. Symptoms may include pain in
the gallbladder region, fever, nausea, gas, disorientation, and low blood
pressure.
Abscess of the Gallbladder
Abscess of the gallbladder results when an area of the body becomes inflamed
with pus. Pus is the accumulation of white blood cells, dead tissue, and
bacteria. It may present with upper right-sided pain in the abdomen.
Part 3 of 6: Diagnosis
How Is Gallbladder Disease
Diagnosed?
To diagnose gallbladder disease, a comprehensive abdominal exam should be
completed. This will include checking for pain in the abdomen, and one or
more of the following tests and procedures may be used.
Detailed Patient History
A list of symptoms being experienced and any personal or family history of
gallbladder disease are important. A general health assessment may also be
performed to determine if any other signs of a long-term gallbladder disease are
present.
Physical Exam
A doctor may attempt to elicit Murphy’s sign during an abdominal
examination. This maneuver permits the gallbladder to be palpated (felt) and
may suggest gallbladder disease.
Chest and Abdomen X-Ray
Symptomatic cholecystitis will show stones on 20 percent of abdominal X-rays
if they contain calcium. An X-ray of the chest may show pleurisy or
pneumonia. A normal X-ray should not deter from further investigation.
Ultrasonography
This is the main method of diagnosis and usually reveals the presence of
gallstones, thickened walls, or any other problems within the gallbladder.
Ultrasonography produces pictures with an instrument with sound waves.
Other Investigations
Blood tests are done to check for increased white blood cells and liver function.
Part 4 of 6: Treatment
How is Gallbladder Disease
Treated?
Medical
For gallbladder inflammation where stones are not present, the first episode is
often treated with antibiotics. If the patient returns with multiple episodes,
surgery is recommended
Surgery
Sometimes surgery to remove the gallbladder is your best option. It can be done
either by opening the abdomen, or laproscopically, which involves making
three holes and inserting a camera. The type of surgery allows for easier and
faster recovery with virtually no scar. If there are no urgent complications, most
surgeons prefer this method.
Part 5 of 6: Complications
Potential Long-Term
Complications of Gallbladder
Disease
The gallbladder may at some point form an abnormal passageway (fistula) to
help process the liver’s bile. This is the most severe problem associated with
gallbladder disease. Complications include obstruction of the intestine,
inflammation, perforation (a hole in the gallbladder), bacterial contamination,
and malignant transformation.
Part 6 of 6: Prevention
Can Gallbladder Disease be
Prevented?
Diet may play a role in gallstones. According to the Medical Center at the
University of Maryland, studies have found a lower risk of gallstones in people
who consume foods with monosaturated fats or omega 3 fatty acids (found in
fish oil). Fruits and vegetables, nuts, alcohol, and coffee appear to be associated
with a lower risk of gallstones. Sugar consumption, however, is associated with
a higher risk of gallbladder disease.