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Gallbladder Disease
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Gallbladder disease usually means you have cholecystitis, or an inflammation and infection of the gallbladder. It can also mean that you have gallstones in your bladder or blockage of the biliary duct, which sends bile down to the duodenum from the liver and gallbladder. Gallbladder disease can be tricky to spot and can mimic other diseases, such as stomach complaints and heart disease. Doctors must always be aware of the possibility of gallbladder disease whenever a person complains of pain in the chest or abdomen or has nausea and vomiting along with the pain.
The gallbladder is a small sac located beneath the liver. It takes bile made in the liver and stores it for when you have a big meal. Bile made by the liver and stored in the bladder is useful in fat digestion. The bile duct takes the bile from both the liver and gallbladder and sends it to the duodenum, where fats are digested.
There are technically several different kinds of gallbladder disease. Perhaps the most common is called acute cholecystitis. This is inflammation of the gallbladder that is often accompanied by infection and gallstones. Gallstones can be present without any gallbladder inflammation and there is a condition called acalculous gallbladder disease, which means the gallbladder doesn't empty very well even in the absence of gallstones. Serious infections and abscesses or gangrene can occur in the gallbladder. There can be polyps within the gallbladder that affect the function of the gallbladder. Tumors of the gallbladder and bile ducts can also occur and are considered very serious.
There is a condition called acute cholecystitis, which is the sudden onset of pain in the abdomen caused by gallstones in 90 percent of cases. It can less commonly be caused by other illnesses and tumors of the gallbladder. Bile becomes trapped in the gallbladder, which irritates the lining of the gallbladder and can lead to infection by bacteria and perforation of the gallbladder. The condition is more common in women than in men and usually affects women of middle age. The highest rate is in Native Americans.
The main symptoms of acute cholecystitis include abdominal pain that may be dull, sharp and cramping. It also may be a pain that comes and goes and spreads to the back or to the right shoulder blade. It often occurs within minutes of having a meal. Related symptoms include fullness in the abdomen, nausea, vomiting, clay colored stools, fever or jaundice (yellowing of the skin and eyes). When the doctor examines the abdomen, he or she might find right upper quadrant tenderness, other abdominal tenderness and abnormalities of the blood tests. These can include abnormalities of the serum lipase, amylase, bilirubin, CBC (complete blood count), or liver function tests.
There are other non-blood tests that can be done, including an abdominal ultrasound, a CT scan of the abdomen, plain X ray of the abdomen, a gallbladder radionuclide scan and an oral cholecystogram.
Anytime you experience severe abdominal pain, you should seek the attention of a doctor. Often IV fluids and pain medication can be given, along with antibiotics.
Cholecystitis has the potential to resolve on its own; however, many patients need to have their gallbladder removed in a surgery called cholecystectomy. This can be done through an open procedure or through a laparoscopic procedure. Sometimes antibiotics are given first in order to settle down the gallbladder, followed by a cholecystectomy to prevent the condition from returning. A low fat diet is recommended whenever the patient has gallbladder problems because these will irritate the bladder and won't get digested well anyway. Emergency surgery is recommended anytime there is gangrene of the gallbladder suspected, inflammation of the pancreas or inflammation of the common bile duct. Sometimes a drain is placed into the gallbladder to drain it out and allow it to settle down before surgery. Surgery usually takes care of the problem completely, although some people need IV antibiotics for a period of time after surgery is over with.
Complications of cholecystitis include pus in the gallbladder that needs draining, gangrene of the gallbladder, pancreatitis, injury to the bile ducts during the surgical procedure or peritonitis, which is inflammation of the lining of the abdomen.