Gallbladder

What is a Gallbladder?

Located below the liver and just above the right section of the abdomen, Gallbladder is a pear-shaped organ. It measures around 4-inches and is responsible to store bile that is a combination of fat, fluids, and cholesterol. The function of bile is to break down the fat from the food inside the intestine. Gallbladder further delivers the bile to the small intestine allowing the fat-soluble vitamins as well as nutrients to be absorbed quite easily in the bloodstream.

Gallbladder Location

Gallbladder Location: 3d rendered illustration of the gallbladder

The symptoms of different gallbladder problems are likely to come and go but there are chances of developing a gallbladder problem if a person had it previously. It is possible to treat the problems associated with gallbladder, but if left untreated, it may prove to be fatal.

What are the possible Gallbladder problems?

Common Gallbladder conditions that can be considered a possible gallbladder problem are:

• Bile Duct Infection: This happens when there is an obstruction within the bile duct. If detected at the earlier stages, it can easily be treated. However, it may prove fatal if proper treatment is not provided as the infection starts spreading to other parts of the body.
• Choledocholithiasis: Typically a gallstone that had developed inside the gallbladder and passed to the bile duct inside the small intestine. It is also known as secondary stone or secondary common bile duct stone. However, although rare, there are situations wherein the stone develops inside the bile duct itself and is termed as primary stones.
• Cancer: A rare situation, gallbladder cancer can spread to other body parts rapidly if it goes untreated.
• Disease Without Stones: A gallbladder disease without stones is also known as acalculous gallbladder disease. Symptoms are usually same as the ones during gallstones but it occurs without a stone.
• Empyema: Occurs due to abscess of the Gallbladder. In this condition, Pus that is a combination of bacteria, dead tissues and blood cells, usually form inside the gallbladder. This development usually leads to severe abdominal pain and if it goes undiagnosed, it might turn into a life threatening disease by spreading the infection across the body.
• Ileus: It is also a rare condition where the gallstone travels inside the intestine and blocks it. It can be severe and mostly occurs to people above the age of 65 years.
• Inflamation: Also referred to as Cholecystitis, it may be either Acute or Chronic inflammation that occurs after several acute cholecystitis attacks. It damages the liver to a great extent and might even make it incapable of performing its functions easily.
• Gallstones: Small yet hard deposits that form inside the gallbladder. In many cases, it goes undetected for years causing infection, inflammation and pain inside the gallbladder. Acute cholecystitis is usually caused due to gallstones which typically measures from a few millimetres to several centimeters. While a person may develop a single or multiple gallstones at a time, with time they grow in size and block the channels leading out through the gallbladder. A gallstone usually forms from cholesterol inside the bile but may also be formed due to calcium bilirubinate which is commonly known as pigment stone.

• Perforated Gallbladder: A long term neglect or if untreated for a long time, a gallstone can turn into a life threatening problem. It may even prove dangerous and develop abdominal infection.
• Polyps: Typically a growth inside the gallbladder, it is noncancerous in nature. It may not be essential to remove polyps if they are small in size, but in case they are large in size, they have to be removed surgically.
• Porcelain Gallbladders: With time, calcium deposits inside the gallbladder can stiffen the muscular walls and make them very rigid. Termed as Porcelain gallbladder, the condition has high risks of causing gallbladder cancer.

Gallbladder Symptoms &  Problems

Almost all the problems associated with gallbladder have common symptoms. Some of the gall bladder symptoms are:

• Gallbladder Pain: It is the most common symptom occurring in the mid to upper right section of the abdomen. Depending on the damage, the pain may be mild to severe. In a few cases, the pain spreads across other parts of the body like chest or the back.
• Acid Reflux, Vomiting or Nausea: Another common symptom associated with different gallbladder problem, it is a chronic disease causing several digestive problems.
• Fever: Having fever due to unexplainable reasons might be a signal about a gallbladder infection. If left untreated, it can be life-threatening and spread to other areas inside the body.
• Chronic Diarrhea: A common sign that a person has chronic gallbladder disease is a situation where an individual has constantly been having 4 bowel movements per day for about 3 months.
• Jaundice: Presence of a common bile duct stone or blockage is usually a yellow-tinted skin.
• Unusual Urination or stool: Dark urination or light colored stools show signs of common bile duct block.

Diagnosis of Gallbladder Problems

In order to diagnose a gallbladder problem, a doctor would recommend any of the following tests:

• HIDA scan: Also known as cholescintigraphy, it is a nuclear medicine test conducted using a radioactive dye that is injected intravenously. This scan reveals the condition cholecystitis when it fails to make it from the liver to the gallbladder.
• ERCP: As per this test the doctor inserts a flexible tube through the mouth leading to the stomach and entering the small intestine. Endoscopic retrograde cholangiopancreatography or ERCP helps the doctor to see using the tube to inject dye inside the bile system ducts. A doctor may use tiny surgical tools for treating the gallstone condition.
• Endoscopic Ultrasound: A small ultrasound probe using a flexible tube gets inserted inside the intestine through the mouth. It facilitates in detecting choledocholithiasis or gallstone pancreatitis.
• Abdominal X-Rays: Although these x-rays are used for diagnosing other abdominal problems, it can also help in detecting gallstones.
• MRCP: Magnetic Resonance Cholangiopancreatogaphy is an MRI scan that offers high resolution images of pancreas, gallbladder, and bile ducts. These images help in guiding further treatments or tests.
• Abdominal ultrasound: It is a Non-Invasive test that examines high-frequency sound waves produced within the belly due to skin bounces.

Treating Gallbladder Problems

The scale of damage and the kinds of symptoms determine the type of treatment that a doctor adopts to treat a gallbladder problem. Some of the common treatments are:

• Cholecystectomy: Typically a Gallbladder surgery, it involves removal of the gallbladder. It is done by laparoscopy or laparotomy.
• Antibiotics: Although antibiotics will not be able to cure cholecystitis, it would definitely help in preventing the infection to spread.
• Chemotherapy & Radiation Therapy: This is usually a follow up after a surgery is performed for gallbladder cancer.
• Ursodeoxycholic Acid: An oral medicine that is usually recommended to people having problems from gallstones but surgery cannot be performed on them. The acid gets dissolved in small cholesterol gallstones and help in reducing the symptoms. Chenodiol is also another similar oral solution.
• Extracorporeal shock-wave lithotripsy: Particularly good for treating small gallstones, high-energy shockwaves are projected from a machine via abdominal walls.
• Contact Solvent Dissolution: A rarely used technique it involves insertion of a needle through the skin and into the gallbladder. The needle injects chemicals that are meant to be dissolved within the gallstones.