The Gallbladder is a small pear shaped organ of about 8cm. in size that lies under the liver and holds bile, removes water, and reduces the pH to less than 7, making it slightly acidic. It’s main purpose is to aid with the digestion of fats.
Gallbladder diseases are fairly common and quite often painful conditions that in many cases require surgery and can be life threatening. However since bile is actually produced by the liver, the gallbladder is not essential for survival and removal of the organ need not necessarily have a major adverse effect on your life.
Causes of Gallbladder disease:
Gallbladder problems are usually caused by gallstones (cholelithiasis). A gallstone is made up of deposits of cholesterol and calcium bilirubate which result in inflammation. Stones can occur when the Gallbladder has been fairly inactive for a period as in the presence of; pregnancy, celiac disease, diabetes, cirrhosis, pancreatitis, obesity, as a complication of surgery or through the use of hormonal contraceptives.
Other Gallbladder conditions include; Choledochollithiasis or bile duct stones, Cholangitis which is an infection of the bile duct, Cholecystitis which is an inflammation usually caused by impacted gallstones and Cholesterolosis which presents as polyps or crystal deposits.
Signs and Symptoms of Gallbladder Disease:
Symptoms are not always present, but a classic attack presents as acute upper abdominal pain either constant or intermittent, that may radiate to the back, shoulders or the front of the chest. Attacks often come after fatty meals or at night while asleep and can be so severe that the sufferer will go to the hospital for relief.
Other symptoms include; indigestion, constipation, belching, flatulence, nausea, vomiting, chills, bad breath, discoloured stools, fever, abdominal distension and jaundice.
Diagnosis of Gallbladder Disease:
Gallbladder disease can mimic certain other disease such as heart attacks, pancreatitis, angina, peptic ulcers, esophagitis, cancer or even pneumonia so a correct diagnosis is essential. X-Rays, CT scans, ultrasound, oral cholecystography and Echography are used to detect gallstones. Bilirubin and alkaline phosphatase levels support the diagnosis. White blood cell levels may be somewhat elevated, and serum amylase levels are used to differentiate gallbladder disease from pancreatitis.
Treatment of Gallbladder Disease:
Surgical removal of the gallbladder in the form of, either open cholecystectomy or laparoscopic cholecystectomy is usually the treatment of choice although if there are only a few stones, electrohydraulic shock wave lithotripsy in conjunction with the administration of ursodeoxycholic acid to help dissolve the stones may be attempted to fragment the stones so they can pass through.
Fluoroscopically guided endoscopy where a basket is used to trap the stone and remove it through a catheter can also be attempted if required. In patients who are poor surgical risks Chenodeoxycholic acid to dissolve stones is an alternative.
A diet consisting of several small, low-carbohydrate, high protein, low fat, non-spicy meals a day is recommended. Vitamin K supplementation is advised.
Prognosis is usually good but it is common to experience some post-operative symptoms such as pain, nausea, diarrhea, bloating and heartburn. Pain relievers such as Aspirin, Codeine, Cell signaling products and Powerstrips may be necessary.