What You Should Know About Gallbladder Disease

The gallbladder is one of the organs that make up the digestive system. Its primary role is to store bile, a substance the body needs to break down fats. Gallbladder disease most often involves problems with bile flow, usually due to gallstones. Treatment varies depending on the cause and severity of illness but typically involves gallstone or gallbladder removal.

What is the gallbladder?

The gallbladder is a small, pear-shaped organ and part of the digestive system (also called the gastrointestinal system). Located underneath the liver on the upper right side of the abdomen, it’s generally about 3 to 4 inches (7 to 10 centimeters) long and has three main parts:

  • Fundus: This part of the gallbladder has no opening and borders the liver.
  • Body: This is the most extensive section of the gallbladder.
  • Neck: This is the narrowest part of the gallbladder. It empties into a small tube called the cystic duct, one of the body’s bile ducts. The cystic duct helps form the pathway from the liver to the gallbladder and the gallbladder to the small intestine.

While people can survive without a gallbladder, it plays a valuable role in human health.

What does the gallbladder do?

The gallbladder’s main role in the digestive system is to store bile between meals until the body needs it. Bile is a digestive fluid that the liver produces and sends to the gallbladder. It has several ingredients, including cholesterol, fats, and water, but it mainly consists of bile salts. Bile also contains bilirubin, a waste product formed by the breakdown of red blood cells.

Bile has two primary functions in the body:

  1. To help digest and absorb fats from food
  2. To remove waste products from the body, including bilirubin and excess cholesterol

When the food a person eats enters the small intestine, it causes the gallbladder to contract (squeeze). The gallbladder then releases bile into the small intestine. Here, bile salts help break down fats and fat-soluble vitamins in the food and make them easier for the intestine to absorb. After a few hours, the gallbladder begins to relax and store bile again.

What causes gallbladder disease?

Gallbladder disease typically occurs when there’s a problem with the flow of bile through the gallbladder or bile ducts. The most common source is a blockage of the gallbladder or bile ducts, typically due to gallstones. In general, causes of gallbladder disease include:

Gallstones: One of the most common causes of gallbladder disease, gallstones form when substances in the bile clump together and become solid. Stones can be as small as a grain of salt or as large as a golf ball. In most cases, gallstones don’t cause symptoms. However, if a stone blocks a bile duct, it can cause severe pain (biliary colic), fever, nausea, vomiting, and yellowing of the skin or whites of the eyes (jaundice).

Cholecystitis (inflammation of the gallbladder): If bile builds up in the gallbladder, it can lead to inflammation or cholecystitis. This condition typically causes severe pain in the upper right side of the abdomen, fever, nausea, and vomiting. The most common cause of cholecystitis is gallstones, though it can rarely occur without gallstones.

Tumors: Rarely, cancerous or noncancerous tumors can also prevent normal bile flow. These can occur in the gallbladder or the ducts that carry bile from the gallbladder.

Narrowing of the bile ducts: This can occur due to bile duct disorders, infections, or pancreatitis (inflammation of the pancreas) and cause symptoms similar to gallstones.

Infestation by intestinal parasites: Infestation of the digestive system by parasites such as tapeworms or roundworms can produce swelling that affects bile flow.

How is gallbladder disease treated?

Treatment for gallbladder disease depends on what’s causing it and how severe it is. If there are gallstones but no symptoms are present, treatment usually isn’t necessary. If gallstones block the bile ducts, surgically removing them can relieve pain and prevent complications.

If gallbladder inflammation (cholecystitis) is present, it usually requires a hospital stay to receive IV antibiotic medications and help control pain. It may also require surgery.

Surgery to remove the gallbladder is called a cholecystectomy. This procedure is usually necessary when a person has several gallstones or multiple episodes of gallbladder inflammation. It’s generally also needed when the gallbladder stops working normally because the risk for infection or gallstones is high when bile is inactive in the gallbladder.

There are two types of cholecystectomy:

  1. Laparoscopic cholecystectomy: This procedure is more common and involves making a few small incisions and using a special medical device to remove the gallbladder. It’s generally done outpatient, which means people can go home the same day.
  2. Open cholecystectomy: This is done in severe cases or if problems occur during the laparoscopic surgery. It involves making a larger incision in the upper right abdomen. It’s done in the hospital and may require staying in the hospital for up to one week.

In some cases, nonsurgical treatments are an option for gallstones. For example, if a person has gallstones that mainly consist of cholesterol, a single, small gallstone, or medical conditions that prevent surgery. Medications that dissolve gallstones or a noninvasive procedure that uses shock waves to break them into smaller pieces may be an alternative in these situations.

Conclusion

The gallbladder is an organ of the digestive system that stores bile until the body needs it to break down and absorb food. Gallbladder disease can affect the gallbladder, bile ducts, or both.

Contact your healthcare provider if you’re experiencing possible gallbladder disease symptoms. You may still need treatment if your symptoms go away and come back again, and your provider may need to refer you to a specialist such as a gastroenterologist or a surgeon.

Key takeaways

Although the gallbladder is useful, helping the body digest and get energy from food, it’s not necessary to live.

Gallbladder disease may occur due to a wide range of problems, such as gallstones, inflammation (cholecystitis), and, rarely, tumors.

Many treatment options are available to help people feel better, from symptomatic relief to gallbladder removal.

Resources:

Institute for Quality and Efficiency in Health Care. How Does the Gallbladder Work?

Merck Manual. Gallbladder and Biliary Tract.

Merck Manual. Gallbladder and Bile Duct Disorders.

National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for Gallstones.

UptoDate. Patient Education: Gallstones (Beyond the Basics).

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