When IBS and Gallbladder Problems Happen at the Same Time

Although irritable bowel syndrome is primarily a disorder of the large intestine, having IBS obviously provides no guarantee that the rest of your digestive system works perfectly. One very important organ in the process of digestion is the gallbladder; problems with this organ may overlap your IBS symptoms.

Your gallbladder is a small, sac-like organ located on the right side of your upper abdomen, tucked under your liver. The gallbladder's main job is to store bile, which is necessary to digest the foods we eat. Bile is first produced by the liver and then stored in the gallbladder. When we eat foods that have fat in them, the gallbladder secretes bile into the small intestine. There the bile breaks down fat, allowing it to be absorbed into our bloodstream.

Although some gallbladder problems including gallstones may develop without any noticeable signs, the following symptoms may be indicative of gallbladder disease:

• Bloating after meals, particular meals with a high-fat content
• Chronic diarrhea
• Indigestion
• Nausea after meals
• Pain in the middle or right side of your abdomen

Some gallbladder conditions announce their presence through what is commonly referred to as a gallbladder attack, clinically known as biliary colic. Such an attack may occur within a few hours of eating a large or fatty meal. You may experience pain in your upper right abdomen and this pain may also radiate to the upper back, between your shoulder blades, under your right shoulder, or behind your breastbone. Some gallbladder attacks result in nausea and vomiting. Usually, these attacks only last for an hour or so. Such an attack should be reported to your doctor, even if symptoms subside.

If you experience the following symptoms, seek immediate medical attention:

• Clay-colored stools
• Fever and chills alongside nausea and vomiting
• Signs of jaundice
• Severe and persistent pain in your upper right abdomen

After you have told your doctor that you are experiencing unusual digestive symptoms, your doctor will perform a physical examination and recommend blood tests. Further testing may include:

• An ultrasound that can identify the location and size of gallstones
• X-ray pictures from a computerized tomography scan that may indicate the presence of gallstones, as well as show any inflammation or injury to the gallbladder and the bile ducts
• A cholescintigraphy (HIDA scan) that involves the injection of a radioactive substance to aid evaluation of how your gallbladder is functioning and to assess for the presence of gallbladder infection and blockage in the bile ducts
• An endoscopic retrograde cholangiopancreatography—using an endoscope, any stones in the bile duct can be identified and removed through this invasive procedure

Some small gallstones can be removed non-surgically through the use of ERCP. There are other ways of non-surgically dissolving gallstones, but these approaches are only used in rare circumstances.

The most common way to treat gallbladder problems is to remove the gallbladder, a procedure known as a cholecystectomy. The procedure is most often performed laparoscopically, which means that the gallbladder is removed through the use of only very small incisions.

Unlike some other health problems, there does not seem to be any evidence that IBS patients are more likely to suffer from gallbladder disease than other people.

One interesting avenue of research explores whether gallbladder motility may contribute to IBS symptoms. Studies on the subject are few and have yielded very mixed results. For example, one study found no difference in rates of gallbladder contractions between IBS patients and healthy control subjects. Another study found faster rates than would be expected in patients who suffer from constipation-predominant IBS (IBS-C) and slower rates than would be expected in those who suffer from diarrhea-predominant IBS (IBS-D). An additional study found no difference between IBS patients and healthy controls in terms of gallbladder contraction rates two hours after eating but found a significant difference three hours after eating. 

At present, the clinical research about the interrelationship between IBS and gallbladder problems remains inconclusive.

Because IBS is a functional disorder, many people with IBS lack full confidence in their diagnosis, asking whether other digestive disorders may be present. Because some people with IBS experience nausea and because abdominal pain can radiate, it's reasonable to wonder whether you may also have gallbladder problems.

The best place to address such a concern is through a conversation with your doctor, who can explore your symptoms and order appropriate diagnostic tests.