Gallbladder Disease

Your gallbladder is a small, pear-shaped organ beneath the liver that stores bile produced by the liver and passes it along through a duct into the small intestine. The small intestine then secretes a hormone called cholecystokinin to aid in the digestion of fats.

The gallbladder can be affected by a number of diseases – ranging from a blockage of the bile duct to gallbladder cancer. Surgical removal of the gallbladder is one of the most effective methods for treating gallbladder disease.

There are several different types of gallbladder disease, each with different causes. Some of the most common include:

• Cholestasis: Any condition in which the flow of bile from the liver stops or slows, cholestasis can be caused by disorders of the liver, bile duct or pancreas.
• Cholecystitis: Inflammation of the gallbladder, which can be either short-term (acute) or long-term (chronic). An episode of cholecystitis may resolve on its own, or it may progress to a more serious condition involving bacterial infection of the inflamed gallbladder. Chronic inflammation, which can eventually cause damage to the gallbladder, is typically the result of repeat cholecystitis attacks.
• Gallbladder cancer: Although rare, gallbladder cancer may develop in people with a history of gallstones and chronic gallbladder inflammation. Gallbladder cancer is difficult to diagnose and can grow undetected without causing any specific signs or symptoms.

Gallstones

A common gallbladder disorder, gallstones are tiny masses that form from hardened bile and cholesterol or bilirubin (a yellow substance that the body creates when it replaces old red blood cells). While gallstones may go undetected for years, they can eventually cause problems.

As they grow in size, gallstones can block the exit from the gallbladder – called the cystic duct – and prevent the flow of bile from the gallbladder to the small intestine (cholestasis). When this occurs, the gallbladder will spasm and become inflamed (cholecystitis).

Gallstones can be caused by a number of factors, including having too much cholesterol or bilirubin in the bile, or not enough of a substance called bile salts. They can also be caused by any non-stone related blockage that prevents proper emptying of the gallbladder.

In some cases, little to no symptoms of certain types of gallbladder disease (such as gallstones) may occur. However, there are some common signs and symptoms of gallbladder disease to look out for, including:

• Pain or tenderness in the upper right abdomen, particularly after ingesting fatty, heavy or greasy foods
• Pain between the shoulder blades
• Indigestion after eating, especially after consuming fatty or greasy foods
• Feeling of fullness or of food not properly digesting for an extended period of time
• Nausea or vomiting
• Bloating or gas
• Chronic diarrhea
• Fever or chills (might indicate infection)
• Dizziness
• Light, chalky-colored or fatty, foul-smelling stools
• Dark urine
• Skin itching
• Jaundice

Gallbladder Disease Risk Factors

While gallbladder disease can affect anyone, certain factors may increase your risk of developing gallbladder disease, including:

• A family history of gallstones
• Advanced age (over 60 years old)
• Certain cholesterol medications
• Diabetes
• Rapid, significant weight loss
• Birth control pills or hormone replacement therapy
• Crohn’s disease and other conditions that affect nutrient absorption
• Pregnancy
• Obesity
• A high-fat, high-cholesterol and low-fiber diet

Preventing Gallbladder Disease

While certain gallbladder conditions occur suddenly and are difficult to avoid, you can lower your risk of gallstones and other complications by maintaining a healthy weight through proper diet, nutrition and exercise.

Complications of Gallbladder Disease

If gallbladder disease goes undetected or untreated, serious complications can occur, including:

• Infection within the gallbladder (acute cholecystitis): If bile builds up within your gallbladder causing inflammation (cholecystitis), the gallbladder itself may become infected.
• Passage of gallstones into main or “common” bile duct: Occasionally, gallstones may travel out of the gallbladder and become lodged in the common bile duct. If left untreated, this can lead to jaundice, persistent pain in the right upper abdomen or middle back or inflammation of the pancreas (gallstone pancreatitis).
• Death of gallbladder tissue (gangrenous cholecystitis): Untreated cholecystitis can cause tissue of the gallbladder wall to die. This is the most common complication of gallbladder disease and is often found in older people, those who wait to get treatment and those with diabetes. This complication can lead to ongoing symptoms of pain, nausea or vomiting, or fever. Although rare, if this condition is left untreated it may lead to rupture of the gallbladder, which is a life-threatening condition.

If your doctor suspects gallbladder disease, he or she will likely review your medical history, perform a physical exam and possibly order diagnostic lab and imaging tests such as an abdominal ultrasound or computerized tomography (CT) scan. Additional lab work may include a blood test to detect signs of infection or inflammation of the bile ducts, gallbladder, pancreas or liver.

If the cause of your symptoms appears to be blockage of the bile ducts, your doctor will likely order certain specialized tests to gain more precise images of the ducts, including:

• Hepatobiliary iminodiacetic acid (HIDA) scan: An imaging procedure that helps your doctor tracks the production and flow of bile from your liver to your small intestine.
• Magnetic resonance imaging (MRI)
• Endoscopic retrograde cholangiopancreatography (ERCP): A procedure involving the use of an endoscope to both detect and remove gallstones present in the main or “common” bile duct. The endoscope is inserted orally into the duodenum (first part of the small intestine), and a catheter is used to inject a contrast dye into the pancreatic or biliary ducts, which helps make the area more visible during X-ray scans.

Treatment for gallbladder disease varies based on each patient’s specific condition.

If you have gallstones that don't cause any symptoms, you likely won’t need treatment. But if you are experiencing symptoms that could be related to gallstones, you should see a physician right away. Surgery to remove your gallbladder – called a cholecystectomy – is a common treatment for this condition . Fortunately, your gallbladder is not an essential organ, and your body can digest food without it.

If your physician recommends removal of your gallbladder, there are new surgical techniques that may shorten recovery times. Most gallbladder removal surgeries are performed laparoscopically. Using this minimally invasive technique, your surgeon will make a few small incisions in your abdomen and insert a tiny camera called a laparoscope to view inside your body while removing your gallbladder.

Unlike a traditional “open” cholecystectomy (gallbladder removal), patients who undergo laparoscopic cholecystectomy are often able to leave the hospital the same day. It is the preferred procedure for both our surgeons and patients as it often results in fewer complications, smaller scars and a shorter recovery time of one to two weeks.

For a full list of the minimally invasive surgical procedures we provide, visit our Robotic and Minimally Invasive Procedures page.

Treating Gallbladder Disease in Houston

The skilled, board-certified general surgeons affiliated with Memorial Hermann routinely treat patients with mild to severe cases of gallbladder disease, performing over 600 surgeries every year.

While gallbladder disease may not initially be a life-threatening condition, you can develop serious complications if the gallbladder is not removed promptly and becomes infected. If you (or a loved one) are exhibiting symptoms of gallbladder disease, talk with your doctor.

If you are experiencing acute abdominal pain, seek immediate emergency medical attention by calling 911 or visiting a local Emergency Room.

Schedule an appointment today with a Memorial Hermann-affiliated physician using our online ScheduleNow portal or by calling (713) 222-CARE.