General Gallbladder Conditions

The gallbladder is a lemon-sized sac tucked under your liver. It stores bile secreted by the liver, which then flows into the small intestine for fat digestion. If something slows down the stream of bile or blocks it, your health can be jeopardized.

The following are gallbladder conditions that need medical attention, along with their symptoms and treatment options.

1. Gallstones (Cholelithiasis)

Gallstones are solid chunks of cholesterol and bilirubin (a bile salt) that form in the gallbladder. They can be of various sizes, from a single, large stone to hundreds of small ones. Small stones are the most harmful because they can get lodged in the bile duct.

Large gallstones tend to stay put. As a result, they’re nicknamed “silent gallstones” because they cause no discomfort and are often detected only when an imaging procedure is done for an unrelated health issue.

When a bile duct is blocked it can cause an attack characterized by:

• Intense pain in the upper abdomen.
• Pain in the right shoulder.
• Pain between the shoulder blades.
• Jaundice (yellow eyes or skin).
• Fever.
• Chills.
• Clay-colored feces.

There are many treatments for gallstones:

• Gallbladder Removal (Cholecystectomy) – The good news is that you can live a perfectly healthy life minus a gallbladder. Your liver will still make bile, but it will be routed directly into your small intestine.
• Extracorporeal Shockwave Lithotripsy (ESWL) – This technique uses shock waves to break up the stones into tiny pieces that can easily pass through the bile duct.
• Oral Dissolution Treatment – Medications made from bile acid are taken by mouth to dissolve the gallstones.

2. Acute Cholecystitis

Acute cholecystitis happens suddenly and triggers intense, steady upper abdominal pain. Several of these attacks can make the gallbladder shrink and become unable to keep and release bile. As a result, it can lead to chronic cholecystitis, a condition that continues over time.

The symptoms of acute cholecystitis include:

• Sudden, sharp pain in the upper right or upper middle of your abdomen.
• Pain that radiates to your back or under your right shoulder blade.
• Pain that lasts about half an hour.
• A bulging stomach.
• Fever.
• Clay-colored bowel movements.
• Jaundice.

There are various options for treating acute cholecystitis:

• Removal of the gallbladder.
• Antibiotics.
• Gallbladder drainage.
• Intravenous fluids.

3. Chronic Cholecystitis

Chronic cholecystitis is an inflammation and swelling of the gallbladder. Attacks of acute cholecystitis cause this. Most of these attacks are generated by gallstones which block the bile duct and cause bile to back up into the organ. The condition is called chronic because repeat attacks are likely to happen over time.

As these attacks continue, the gallbladder walls thicken and scar while the organ shrinks. This makes it more and more difficult for the gallbladder to store and release bile.

The symptoms of cholecystitis include:

• Abdominal tenderness.
• Pain that lasts about 30 minutes.
• Sharp pain in the upper right or middle of your stomach.
• Pain that radiates to your back or beneath your right shoulder blade.
• Nausea and vomiting.
• Jaundice.

Hospitalization is necessary while treating gallbladder conditions such as acute cholecystitis, and this medical care includes:

• Fasting – This rests on the inflamed organ.
• Antibiotics.
• Draining the gallbladder.
• IV fluids for dehydration.
• Pain medication.
• Endoscopic Retrograde Cholangiopancreatography – a procedure where stones and excess bile that block the bile duct are removed.

Although symptoms usually resolve in several days, they often recur. Most people who suffer from chronic cholecystitis will eventually need to have their gallbladder removed.

4. Biliary Colic

Biliary colic occurs when one or more gallstones block the gallbladder’s common bile duct or its cystic duct. As a result, the ducts strenuously contract (spasm) to dislodge the stone, resulting in severe pain. These episodes typically occur for one or two hours and may not recur for years.

Biliary colic is usually triggered by the consumption of a large, fatty meal.

Usually, the only symptom is sudden pain that radiates from the upper abdomen to the right shoulder or back. The worst pain happens about an hour after the initial symptoms. The pain generally resolves after approximately one to five hours.

Surgery is usually necessary for relief from biliary colic by removing the gallbladder. This can be done one of two ways:

• Laparoscopic Surgery – Also called keyhole surgery, this procedure involves making several small incisions in your abdomen to remove your gallbladder.
• Laparoscopic surgery requires general anesthesia.
• Open Surgery – One large incision is made in your abdomen to remove your gallbladder during open surgery. This procedure is also performed with general anesthesia.

5. Acalculous Gallbladder Disease

Acalculous gallbladder disease is an uncommon condition in which inflammation of the gallbladder occurs without gallstones. It causes thickening and swelling of the gallbladder, which hampers the ability to empty it.

Acalculous gallbladder disease usually happens to people who have other afflictions, primarily sepsis, a severe infection of the entire body. It can also affect those who are experiencing:

• Shock from being seriously ill.
• Multiple-system trauma (trauma that affects many body parts).Burns.
• Cardiac arrest.
• Diabetes.
• Drastic weight loss.

The symptoms of this conditions include:

• Upper abdominal pain.
• Shortness of breath.
• Fever.
• Nausea.
• Diarrhea.
• Chills.

Hospitalization is necessary to control the inflammation caused by acalculous gallbladder conditions, and treatments include:

• Bile drainage.
• Pain medications.
• Intravenous antibiotics.
• Removal of the gallbladder.

6. Choledocholithiasis

Choledocholithiasis refers to gallstones that form in the common bile duct rather than in the gallbladder. A stone trapped in the bile duct can infect the bile. When this happens, bacteria may spread to the liver and cause a deadly infection.

It can also cause biliary cirrhosis (inflammation and collapse of the bile ducts) and pancreatitis (inflammation of the pancreas).

What are some of the symptoms of choledocholithiasis?

• Right-side abdominal pain.
• Jaundice.
• Dark urine.
• Clay-colored feces.
• Fever.
• Nausea and vomiting.

Two treatments are generally used to counteract choledocholithiasis:

• Surgery to remove the gallbladder and gallstones.
• ERCP (Endoscopic Retrograde Cholangiopancreatography – a technique that uses X-ray to view the bile and pancreatic ducts) with a sphincterotomy.

This procedure involves surgically cutting the common bile duct muscle to help stones travel through or be removed.

The gallbladder can seem to be a mysterious organ. Its form and function may be less familiar to you than your kidneys or intestines. Because of this, flare-ups can be frightening and confusing.

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Contact us today. The team of professionals at GastroMD looks forward to working with you. We are one of the leading gastroenterology practices in the Tampa Bay area. We perform a host of diagnostic procedures using state-of-the-art equipment in a friendly, comfortable, and inviting atmosphere where patient care is always a top priority.