An Overview of Gallbladder Disease

Gallbladder disease refers to any condition that affects the gallbladder, a pear-shaped organ located just beneath the liver. The gallbladder serves as a sort of silo for bile, a fluid produced by the liver for digesting fat. When digestion is taking place, the gallbladder releases bile through a duct that connects it and the liver to the small intestine.

The most likely reason you might encounter issues with your gallbladder is if something—in most cases, a gallstone—blocks the flow of bile. But, you also can develop any of a number of gallbladder diseases, including biliary dyskinesia, sclerosing cholangitis, and acalculous gallbladder disease. Gallbladder cancer is rare, but can occur.

Symptoms

Although there are several distinct types of gallbladder disease, they all bring about similar symptoms. Note that in the case of gallstones, symptoms can be so extremely painful they're described as an attack, and yet more than 80 percent of people with gallstones never experience a symptom. Such symptoms may include:

  • Abdominal pain, especially in upper right side of the abdomen
  • Jaundice (yellowing of the whites of the eyes and skin)
  • Nausea and vomiting
  • Fever, which isn't likely with a gallstone attack but may occur when there's inflammation or an infection of the biliary tract

    Less often, gallbladder disease can be linked to a host of other symptoms, some of which may be symptoms of a second, unrelated condition such as gastroesophageal reflux disease (GERD). Examples include chest pain, burping, bloating, and regurgitating fluids. Pruritis (itching) is another unusual symptom associated with gallbladder disease that likely results from the accumulation of bile.

    Complications

    Gallbladder disease can lead to long-term health problems, some of which may need to be treated with a cholecystectomy—removal of the gallbladder. Serious complications of gallbladder disease include:

    • Acute cholangitis: A bacterial infection of the biliary tract
    • Pancreatitis: Inflammation of the pancreas that arises when digestive enzymes become blocked in the pancreatic duct
    • Gangrenous cholecystitis: A medical emergency that can lead to other complications, including a perforation or a fistula (passage) in the wall of the gallbladder
    • Emphysematous cholecystitis: An acute infection of the gallbladder wall

    Given abdominal pain might indicate gallbladder disease, it's a good idea to visit your doctor for any unusual stomach discomfort. If you develop abdominal pain that's severe, persistent, and accompanied by other symptoms, such as nausea and vomiting, fever, clay-colored stools, tea-colored urine, and/or jaundice, get emergency help at a hospital.

    Causes and Risk Factors

    The most common type of gallbladder disease is the formation of gallstones, which are basically crystallized cholesterol or bilirubin (a pigment produced by the liver). Women are more likely to develop gallstones than men are, particularly during pregnancy.

    People over 40 also are more at risk of gallstones than younger folks.

    Other risk factors for gallstones include:

    • Obesity
    • Eating a diet high in cholesterol, refined carbohydrates, and saturated fats (cheese, butter, red meat)
    • Getting too little physical activity
    • Rapid weight loss
    • An underlying disease, such as diabetes, metabolic syndrome, or cirrhosis of the liver
    • Certain medications, particularly those that contain estrogen (birth control pills, hormone replacement therapy)

    Besides gallstones, there are a number of less-common causes associated with gallbladder disease. These include:

    • Cholecystitis: Inflammation of the gallbladder that can occur because of a gallstone blockage or, less often, poor blood flow or stasis
    • Biliary dyskinesia: Obstruction fo the bile ducts
    • Functional gallbladder disorder: Gallstone-like pain in the absence of actual gallstones
    • Primary sclerosing cholangitis: Inflammation of the bile ducts 

    Gallbladder cancer is another potential cause of gallbladder disease, but it's very rare.

    Diagnosis

    Since there are different types of gallbladder disease, it sometimes takes an array of tests for a doctor to zero in on what might be causing the abdominal pain and other symptoms that point to a problem with this organ.

    To diagnose gallbladder disease, a doctor will first want to know where the pain is located, if it's happened before, and if it's related to eating. This will be followed by a physical exam.

    If gallbladder disease is suspected, the doctor may order blood tests or imaging. This could be ultrasound or computerized tomography (CT), or a special test called a HIDA scan in which a radioactive tracer injected into a vein makes it possible to see how bile moves through the bile duct system. Another imaging test, endoscopic retrograde cholangiopancreatography (ERCP), is sometimes used to both diagnose a gallstone and remove it. 

    It's important when determining what is causing severe abdominal pain to rule out conditions and diseases that don't involve the gallbladder but can be associated with similar symptoms. For instance, certain symptoms of hepatitis—jaundice, clay-colored stools, and dark urine—also can indicate gallbladder disease. 

    Treatment

    Gallstones are the most common manifestation of gallbladder disease. When they don't cause symptoms, the most common treatment is no treatment at all. When gallstones do cause pain, however, the treatment is usually either medication to break them up or surgery to remove the entire gallbladder—a procedure called a cholecystectomy.

    Treatment for other types of gallbladder disease typically involves a combination of medications to treat the pain and surgery, or even another procedure targeted to the specific problem, such as percutaneous removal of stones or ERCP.

    There's been some research to suggest that certain alternative therapies might be helpful in managing gallbladder disease, too, including certain herbs, such as milk thistle and turmeric, and eating a diet high in vitamina B, iron, and antioxidants. Acupuncture may also help with some of the pain associated with gallbladder disease. 

    Prevention

    There also are things you can do to lower the risk of gallbladder disease, such as maintaining a healthy weight, getting daily physical activity, not smoking, and seeing your doctor for regular medical checkups—all sensible measure to take to stay healthy in general.  

    A Word From Verywell

    For such a small organ, the gallbladder can wreak a lot of health havoc. In fact, you don't really need it. If for some reason you become one of the 600,000 people who have their gallbladders removed each year, it's unlikely you'll notice yours is gone, according to the Cleveland Clinic. Your liver will continue to produce the bile that's necessary for digesting the fats you eat.

    Right after surgery, however, your body will need to adjust to the absence of your gallbladder. To help smooth the transition for your digestive system, stick to a low-fat diet, slowly introduce foods that cause gas like whole grains, nuts, seeds, and broccoli, and notice if a certain food causes discomfort so that you can let your doctor know. 

    Sources:

    Cleveland Clinic. "5 Ways to Avoid Discomfort After Your Gallbladder Removal." July 29, 2015.

    Lee JY, Keane MG, Pereira S. Diagnosis and Treatment of Gallstone Disease. Practitioner. June 2015;259(1783):15-9, 2.

    Medline Plus. "Gallbladder Disease." Feb 20, 2018.