An Overview of Gallbladder Disease

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Gallbladder disease refers to medical conditions (for example, gallstones or cholecystitis) that affect your gallbladder—a pear-shaped organ located beneath your liver that stores bile (a dark yellow fluid that helps digest fats in your gut).

Diseases that affect the biliary ducts, like primary sclerosing cholangitis, or the sphincter of Oddi, like biliary dyskinesia, are also usually lumped under the term "gallbladder diseases."

By reading about the symptoms and causes of gallbladder problems, as well as how these problems are diagnosed and treated, you will hopefully feel ready to tackle any challenges along the way of your gallbladder health journey.

Symptoms

The most common symptom of gallbladder disease is biliary colic, which is an intense, dull pain in the upper ride side of the abdomen that results from a gallstone becoming lodged in the bile duct. Biliary colic is often triggered (but not always) by eating a fatty meal, and is episodic, meaning the pain comes and goes.

Besides a gallstone attack, other types of gallbladder disease (for example, cholecystitis, biliary dyskinesia, and advanced gallbladder cancer) may cause upper ride sided abdominal pain, although there are often other symptoms present. For instance, the biliary-like pain of cholecystitis is usually associated with fever and an elevated white blood cell count.

Besides abdominal pain, other potential symptoms of gallbladder disease include:

  • Jaundice
  • Nausea and/or vomiting
  • Fatigue
  • Fever
  • Pruritus
  • Bloating
Symptoms of Gallbladder Disease

Causes

The most common cause of gallbladder disease is gallstones, which are crystals that form inside the gallbladder as a result of too much cholesterol (cholesterol gallstones) or bilirubin (pigment gallstones). Besides the potential to cause abdominal discomfort, complications may occur as a result of gallstones. Some of these complications include:

  • Inflammation of the gallbladder (cholecystitis)
  • Obstruction of the main bile duct (choledocholithiasis)
  • Infection of the common bile duct (ascending cholangitis)
  • Gangrene of the gallbladder (gangrenous cholecystitis)
  • Bowel obstruction from a gallstone (gallstone ileus)
  • Gallbladder cancer

Besides gallstones and related complications, there are other diseases that affect the gallbladder.

Biliary Dyskinesia

This is a motility syndrome that results from an abnormally functioning sphincter of Oddi. Your sphincter of Oddi is a muscular valve that controls the flow of digestive juices and biles from the liver and pancreas to the small intestines. If the sphincter of Oddi is not working properly, there is a backup of fluid in the ducts, causing an intensely painful obstruction. 

Functional Gallbladder Disorder

This condition causes biliary pain in the absence of gallstones or a sphincter of Oddi problem. A test called a cholecystokinin (CCK)-stimulated cholescintigraphy is needed to confirm the diagnosis.

Primary Sclerosis Cholangitis

Primary sclerosing cholangitis (PSC) is a chronic inflammatory disease of the gallbladder and liver that may cause debilitating itching from bile acid accumulation. As the bile accumulates in the liver, cirrhosis develops, and eventually the liver loses its ability to function. Many people with PSC ultimately need a liver transplant.

Gallbladder Disease Causes and Risk Factors

Diagnosis

The diagnosis of gallbladder disease entails several key steps:

Medical History

During a medical history, your doctor will evaluate your personal and family history of gallbladder disease. He will also ask you questions about your symptoms, like whether you are experiencing upper right sided abdominal pain and if so, whether it is associated with eating a fatty meal.

Physical Examination

In addition to a medical history, your doctor will check your vitals and perform a physical examination to look for signs of gallbladder disease like fever or jaundice, among others. Lastly, your doctor will likely perform a maneuver called the "Murphy's sign," which entails the doctor pressing on your gallbladder to see if any pain is elicited.

Labs

Your doctor may order blood tests, like a complete blood count and liver function tests, if he suspects a gallbladder problem. With gallstone-related complications, like inflammation or infection, a person usually has an elevated white blood cell count and may have elevated liver enzymes or bilirubin level.

Imaging

While a medical history and labs can help piece together a diagnosis of gallbladder disease, imaging is needed to confirm the diagnosis. The primary test used to visualize the gallbladder is an ultrasound. That said, depending on the type of gallbladder disease suspected, a variety of other imaging tests may be utilized. These include:

  • Hepatobiliary Iminodiacetic Acid (HIDA) scan
  • Computed Tomography (CT) scan
  • Magnetic Resonance Cholangiopancreatography (MRCP)
  • Endoscopic Retrograde Cholangiopancreatography (ERCP)
How Gallbladder Disease Is Diagnosed

Treatment

Treating gallbladder disease depends on the type of disease present. For the treatment of gallstones (the most common manifestation of gallbladder disease), there are generally three treatment options:

  • "Watch and wait"
  • Surgery to remove the gallbladder (often performed laparoscopically)
  • Medication (a bile acid pill that breaks up gallstones)

The treatment of diseases related to the biliary ducts may require a procedure called an ERCP. During an ERCP, a gastroenterologist uses an endoscope to look for blockages in the biliary ducts. Then with instruments inserted through the endoscope, he can relieve any obstruction (for example, by removing a stone or placing a stent).

How Gallbladder Disease Is Treated

A Word From Verywell

Living with gallbladder disease may be an overwhelming process, especially if it has taken some time for doctors to clinch your diagnosis. By gaining knowledge, though, you are already taking an active step in managing your gallbladder health.

Be sure to see your doctor if you are experiencing symptoms of a potential gallbladder problem. In the end, prompt treatment of your gallbladder disease is the best way to prevent complications and get you back to feeling and living well.

An Overview of Gallbladder Disease
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Article Sources
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