Nearly 1 million new cases of gallbladder and gallstone disease are diagnosed every year in the U.S. Yet most of us don’t even know why the little pear-shaped organ is there.
Most people don’t give a thought to their gallbladder until it “attacks” them. A typical gallbladder attack might come shortly after a fatty meal, and often during the night. It usually announces itself with a steady pain in the upper right abdomen, a pain that increases rapidly and can last from 30 minutes to several hours.
The gallbladder is a small, pear-shaped sac located right below your liver in the right upper abdomen. It’s the storage center for a liquid called bile, which is made in the liver, and helps the body digest fats. After a meal, the gallbladder contracts and pushes the bile into a tube—called the common bile duct—that carries it to the small intestine to do its work. Bile is made up of water, cholesterol, fats, bile salts, proteins, and bilirubin—a waste product. If the liquid bile contains too much cholesterol, bile salts, or bilirubin, it can harden into pieces of stone-like material, gallstones. If a gallstone— which can be small as a grain of sand or as large as a golf ball—lodges in any of the ducts to and from the gallbladder, and blocks the normal flow of bile, you may experience an attack.
Aside from the initial pain, bile that’s trapped in these ducts can cause inflammation in the gallbladder, the ducts and, more rarely, in the liver and pancreas. If the blockage remains for a significant time, infection and serious damage to the organs can occur.
Responding to an attack
If you think you might have had a gallbladder attack—marked by abdominal pain, and sometimes pain in the back between the shoulder blades or under the right shoulder—you should make an appointment to see your physician. However, if the pain lasts more than 5 hours and you experience nausea and vomiting, fever or chills, or notice a yellowish color to your skin or the whites of your eyes—you should see a doctor immediately.
Gallstone symptoms may be similar to those of a heart attack, appendicitis, ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis, and hepatitis, so an accurate diagnosis is important.
If, after discussing your symptoms and taking your medical history, gallstones are suspected, the specialists at Premier Medical’s GI division will do an ultrasound exam. This is the most sensitive and specific test for gallstones. Other tests, like the CT scan and HIDA scan can be used to reveal possible complications or diagnose abnormal contraction of the gallbladder.
One of the most important procedures we do is called ERCP (endoscopic retrograde cholanglopancreatography). Using an endoscope, we can locate and remove stones that are lodged in the bile ducts. An EUS (endoscopic ultrasound) may also be used to better visualize the bile ducts and pancreas.
If you have frequent gallbladder attacks, you may be advised to have your gallbladder removed, one of the most common surgeries performed in the U.S. Luckily, the gallbladder is a non-essential organ, and you’ll do fine without it and very fine without the pain of gallstones.