Gallbladder Disease

Gallbladder disease is a group of diseases that occur in the gallbladder, a small, pear-shaped organ located under the liver in the upper right side of the abdomen.

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Anatomy of the gallbladder, pancreas, and duodenum.





Anatomy of the gallbladder, pancreas, and duodenum.
Illustration by Frank Forney. © 2016 Cengage Learning®.

What Is Gallbladder Disease?

Gallbladder disease is a group of diseases that occur in the gallbladder, a small, pear-shaped organ located under the liver in the upper right side of the abdomen. The gallbladder stores bile, a secretion of the liver composed of fluid, fat, and cholesterol * . The purpose of bile is to digest fat. As the stomach and intestines digest food, bile is released from the gallbladder through a duct or passage called the common bile duct. (It is called the common bile duct because it connects both the liver and the gallbladder to the intestine.) Gallbladder disease can affect the gallbladder or the common bile duct. Diseases of the gallbladder are generally related to inflammation of the gallbladder or narrowing or obstruction of the common bile duct. Diseases include cholecystitis (kolee-sys-ti-tis) (inflammation of the gallbladder), gallstones (choledocholithiasis [kolee-doe-ko-lith-i-a-sis]), narrowing of the bile duct, biliary pain without gallstones, or, rarely, tumors of the bile duct and gallbladder.

How Common Is Gallbladder Disease?

Cholecystitis is the most common type of gallbladder disease. It can be acute and sudden or chronic and long term. Cholecystitis (chole meaning “bile,” cyst meaning “bladder,” and itis meaning “inflammation”) is inflammation of the gallbladder, usually caused by gallstones. Choledocholithiasis (kol-e-do-ko-lith-i-a-sis) is the condition of one or more gallstones in the gallbladder or bile duct.

What Are the Causes of Gallbladder Disease?

The causes of gallbladder disease include the following:

Who Is at Risk for Gallbladder Disease?

Gallbladder disease is more common in older women who are overweight or obese. A person who has diabetes is at greater risk for gallbladder disease, as is someone who eats a diet high in fat and cholesterol. Having a family history of gallstones places a person at higher risk for having gallstones. The hormone estrogen can increase cholesterol and decrease gallbladder movement; therefore, women who are pregnant, who take some types of birth control pills, or who are taking hormone replacement medication have a higher risk for developing gallstones.

What Are the Signs of Gallbladder Disease?

Signs of gallbladder disease include mild to severe pain in the stomach area at the upper right to upper middle of the abdomen that lasts from as brief as 15 minutes to as long as 24 hours. The pain may start suddenly and spread to the upper right side of the back over the right shoulder blade (scapula). The pain most commonly starts after a meal but may begin in the nighttime and be severe enough to awaken the person. The pain may make it difficult to take a normal or deep breath. The person may also have nausea, a bloated feeling, and vomiting. If the gallstone is blocking the common bile duct, the person may also experience yellowing of the skin and the whites of the eyes (called jaundice * ), dark-colored urine, light-colored bowel movement, and fever and chills. In the case of cholecystitis (inflammation of the gallbladder), fever, nausea, vomiting, and loss of appetite may occur.

How Is Gallbladder Disease Treated?

Diagnosis

To diagnose gallbladder disease, the doctor will take a complete history noting signs and symptoms consistent with gallbladder disease. The doctor will then conduct a physical examination especially noting pain in the abdomen that suggests gallbladder disease. Laboratory examination of blood samples may show infection (increase in white blood cells) or decreased liver function. X-rays of the abdomen may show the gallbladder stones, especially if they contain calcium. A special procedure called an ultrasound will be done to see if gallstones are present or if there are any other problems with the gallbladder. An ultrasound, also called a sonogram, is a diagnostic test in which sound waves passing through the body create images on a computer screen, such as images of diseased organs.

Treatment

If the gallbladder is inflamed but no stones are present, the patient will be treated with antibiotic * medication. If gallstones are present, surgery is done to remove the gallstones or to remove the gallbladder. If the patient has multiple episodes of gallbladder inflammation without the presence of gallstones, the gallbladder may be removed.

Can Gallbladder Disease Be Prevented?

Because diet seems to be associated with gallbladder disease, modifying the diet to decrease saturated fat intake and to increase foods with monosaturated fats or omega-3 fatty acids, which can be found in fish, may be helpful. Because sugar has been associated with gallbladder disease, decreasing the amount of sugar in the diet can lower the risk of gallbladder disease. Increased intake of fruits, vegetables, and nuts has been associated with decreased risk for gallbladder disease.

Because being overweight or obese is associated with gallbladder disease, increasing activity and exercise may also prevent the development of gallstones.

See also Gallstones • Jaundice • Obesity

Resources

Books and Articles

Aune, Dagfinn, Teresa Norat, and Lars J. Vatten. “Body Mass Index, Abdominal Fatness and the Risk of Gallbladder Disease.” European Journal of Epidemiology 30 (2015): 1009–19.

Loh, Wei-Liang, et al. What's Wrong With My Gallbladder?: Understanding Laparoscopic Cholecystectomy. New Jersey: World Scientific, 2016.

Murphy, P.B., et al. “The Increasing Incidence of Gallbladder Disease in Children: A 20 Year Perspective.” The Journal of Pediatric Surgery (February 2016).

Websites

Mayo Clinic. “Cholecystitis.” http://www.mayoclinic.org/diseasesconditions/cholecystitis/basics/definition/con-20034277 (accessed March 20, 2016).

National Institute of Diabetes and Digestive and Kidney Diseases. “Gallstones.” (accessed May 25, 2016).

Organizations

American Gastroenterological Association. 4930 Del Ray Ave., Bethesda, MD 20814. Telephone: 301-654-2055. Website: http://www.gastro.org (accessed May 25, 2016).

The Society for General Internal Medicine. 1500 King St., Ste. 303, Alexandria, VA 22314. Telephone: 202-887-5150. Toll-free: 800822-3060. Website: http://www.sgim.org (accessed March 21, 2016).

* cholesterol (ko-LES-ter-ol) a fatlike substance found in the blood and body tissues.

* genetic predisposition is the tendency to get a certain disease that is inherited from a person's parents.

* jaundice (JON-dis) is a yellowing of the skin, and sometimes the whites of the eyes, caused by a buildup in the body of bilirubin, a chemical produced in and released by the liver. An increase in bilirubin may indicate disease of the liver or certain blood disorders.

* antibiotic (an-tie-by-AH-tik) is a drug that kills or slows the growth of bacteria.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)