Gallbladder disease is an umbrella term for diseases affecting the gallbladder, which is a pear shaped organ located beneath the liver. Inflammation that causes irritation to the wall of the gallbladder causes its disease to set in.
Presentation
In many instances, individuals with gallbladder diseases often experience no signs and symptoms. In case they do, the following symptoms are experienced [6]:
- Individuals with gallstones complain of pain in the upper portion of the abdomen, decreased appetite, nausea accompanied by vomiting and development of pain soon after eating.
- In condition of hydrops, there is severe sepsis along with shock like states.
- The condition of cholangitis presents with fever, development of jaundice and pain in the upper quadrant region. Sometimes, the condition can also mimic signs and symptoms of cholecystitis.
- Patients suffering from cholecystitis often complain of persistent pain in the epigastric region, fever, nausea accompanied by vomiting and anorexia.
Entire Body System
- Fever
Jaundice together with fever can be extremely serious, and you should seek urgent medical attention. Patients with acute cholecystitis will have a persistent right or upper abdominal pain, and fever. [healthxchange.sg]
Patients suffering from cholecystitis often complain of persistent pain in the epigastric region, fever, nausea accompanied by vomiting and anorexia. [symptoma.com]
If left untreated, gallstones can lead to complications such as: Cholecystitis : An infection in the gallbladder can cause pain and fever, possibly requiring surgery. [henryford.com]
[…] choledocholithiasis (gallstone in common bile duct) jaundice (if infection) fever and severe upper abdominal pain pathophysiology gallstones may be composed of a variety of compounds 70% formed from cholesterol 90% of gallstones are asymptomatic found [radiopaedia.org]
If symptoms do occur, they can include: fever jaundice itching upper abdominal discomfort. Approximately 60 to 80 percent of people with this condition also have ulcerative colitis. [healthline.com]
- Weight Loss
Secondarily, an analysis of weight loss (%EWL) and gallbladder status was performed. RESULTS: Two-hundred and two bariatric surgeries were performed. [ncbi.nlm.nih.gov]
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Paradoxically, the risk of developing gallbladder disease is increased not only by obesity, but also by rapid weight loss, often associated with weight loss surgery. [obesitynewstoday.com]
[…] of the gallbladder for all patients undergoing weight loss surgery. [obesityaction.org]
- Severe Pain
Unfortunately, the concretions humans make in their digestive system aren't valuable and can cause you severe pain instead - funny how things are different between the species. [study.com]
The gallbladder contracts vigorously against the blockage, causing severe pain in spasms, or sometimes constant pain. Biliary colic episodes usually last one to five hours, with mild pain lingering for up to 24 hours. [everydayhealth.com]
Gallstone disease is most often asymptomatic, but can cause pain in the middle and right upper abdomen. Many only have mild to moderate discomfort for an hour or so after consuming a meal high in fat. For others, this discomfort can be severe pain. [cnn.com]
If jaundice, severe pain, or pancreatitis is present, choledocholithiasis may be suspected, and ERCP and sphincterotomy are recommended before the laparoscopic operation. [emedicine.medscape.com]
- Anemia
Genetic modifiers contribute to phenotypic variability in patients with sickle cell anemia (SCA). [ncbi.nlm.nih.gov]
Cholesterol-lowering drugs, immunosuppressive drugs Antidepressants which slow down gallbladder contractions Constipation Diabetes Insulin Resistance Diseases such as chronic inflammatory bowel disease, Crohn’s disease (ulcerative colitis is controversial) Hemolytic anemias [gallbladderattack.com]
Rate ratios were adjusted for age, calendar time, sickle-cell anemia, diabetes mellitus, inflammatory bowel disease, obesity, pancreatitis, smoking, and use of statins and fibrates. [doi.org]
These black stones often form in the gallbladders of people with hemolytic anemia or cirrhosis. [diagnose-me.com]
- Fishing
You can get great fishing charters ... [tripadvisor.com]
Other healthy sources of fat include oily fish like salmon, mackerel and herring. In addition to vitamin-C deficiencies, calcium deficiency is associated with increased risk of gallbladder disease symptoms. [livestrong.com]
“Pick monounsaturated fats (like olive oil) or omega-3 fatty acids (found in fish or flaxseed oil) instead,” advises Dr Kam. “Also eat plenty of fruits and vegetables.” [healthxchange.com.sg]
Omega-3 oil, found in fish, may block cholesterol formation in bile. People with a tendency toward gallstones can take a higher dose than normal: four to six 1,000-milligram capsules of fish oil a day. [drhoffman.com]
Always discuss alternative medical treatments with your doctor before trying them. 9 Add omega-3s to your diet by either taking a supplement or eating fish that are loaded with omega-3 fatty acids, like salmon, tuna and trout. [wikihow.com]
Gastrointestinal
- Nausea
Nausea and vomiting are also common. Typically, patients with acute gallstone pancreatitis will present with sudden severe upper abdominal pain, often associated with back pain. [healthxchange.sg]
In general, these issues, particularly nausea and vomiting, should lessen within the first three months of taking the drug. [drugwatch.com]
Acute cholecystitis can also cause: fever nausea vomiting jaundice Chronic cholecystitis After several attacks of acute cholecystitis, the gallbladder can shrink and lose its ability to store and release bile. [healthline.com]
Nausea and vomiting may occur. [medstarwashington.org]
- Abdominal Pain
Abstract Imaging of the gallbladder has a key role in the examination of patients with abdominal pain-especially pain localized to the right upper quadrant. [ncbi.nlm.nih.gov]
Symptoms of gallbladder disease include: Abdominal pain after meals Fever Jaundice (yellowing of the skin and whites of the eyes) Right upper quadrant abdominal pain Diagnosis of Gallbladder Disease If your child experiences symptoms of gallbladder disease [rileychildrens.org]
Typically, patients with acute gallstone pancreatitis will present with sudden severe upper abdominal pain, often associated with back pain. The pain is usually severe enough to bring the patient to the emergency room. [healthxchange.sg]
- Diarrhea
For the diarrhea I took Pepto Bismol pills. They were easy to keep in my purse and I could take as many as I needed to get the diarrhea to stop. [healingwell.com]
After gallbladder surgery by either method, it’s not uncommon for people to experience some diarrhea. According to the Mayo Clinic, up to 3 out of 10 people can have diarrhea after gallbladder surgery. [healthline.com]
This is a summary article ; read more in our article on gallstones. anatomy gallbladder biliary tree anatomy epidemiology 20-40 years female > male overweight presentation chronic gallbladder disease bloating, gas and abdominal discomfort after meals diarrhea [radiopaedia.org]
That's because they are so interwoven with other digestive symptoms such as indigestion, gas, bloating, constipation, diarrhea and nausea and general digestive discomfort. Constipation and weight gain can also be signs of gallbladder problems. [gallbladderattack.com]
- Severe Abdominal Pain
Abdominal pain (biliary colic) Gallstones can cause sudden, severe abdominal pain that usually lasts 1 to 5 hours, although it can sometimes last just a few minutes. [nhs.uk]
abdominal pain (right upper quadrant epigastric pain). [froedtert.com]
This results in inflammation of the pancreas that can be quite severe. Gallstone pancreatitis can be a life-threatening disease and evaluation by a physician urgently is needed if someone with gallstones suddenly develops severe abdominal pain. [patients.gi.org]
The development of pus leads to severe abdominal pain. If the condition isn’t diagnosed and treated, it can become life-threatening as the infection spreads to other parts of the body. [healthline.com]
- Clay-Colored Stool
Common symptoms of gallstones include: Nausea, vomiting A bloated feeling in the gut Excess belching, flatulence Clay colored stool Pain that may occur with gallstones: Pain in the upper right portion of the abdomen, beneath the breastbone, between the [healdove.com]
Other symptoms of gallbladder disease that may occur: Pain that spreads to the back or below the right shoulder blade Abdominal fullness Clay-colored stools Fatigue Enlarged liver Enlarged spleen Repeat episodes of cholangitis (an infection of the common [liversupport.com]
[…] of the skin or whites of the eyes Clay-colored stools The symptoms of gallstones may look like other health problems. [cedars-sinai.edu]
Liver, Gall & Pancreas
- Biliary Colic
While cholecystectomy for FGBD appears safe, the outcomes are comparable to cholecystectomy for biliary colic and thus are not without risk. Copyright © 2016 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]
Recurrent biliary colic equals chronic cholecystitis. [rcemlearning.co.uk]
When gallstones cause episodes of biliary colic, it's known as uncomplicated gallstone disease. [nhs.uk]
Psychiatrical
- Suggestibility
By a combination of the two techniques the correct diagnosis was arrived at in each of the 99 patients studied, suggesting that the methods may have complementary roles. [ncbi.nlm.nih.gov]
A dose-effect relationship was indicated, suggesting that modern low-dose oral contraceptives are safer than older formulas, but an effect cannot be excluded. CONCLUSIONS. [doi.org]
Urogenital
- Dark Urine
Symptoms include a yellow discolouration of the skin and whites of eyes, itchy skin, pale bowel motions and dark urine. Jaundice together with fever can be extremely serious, and you should seek urgent medical attention. [healthxchange.sg]
Common symptoms of a gallstone include: Long-term abdominal pain Nausea Vomiting Fever Yellowing of the skin Dark urine Light-colored stool Complications of gallstones If you have any of these symptoms, it is important to see your physician. [henryford.com]
Signs of infection include jaundice, light colored stools, fever, chills and/or dark urine. Seek medical help right away if you have these symptoms. [healdove.com]
If gallstones have moved into the main bile duct to the intestine (the common bile duct) then infection is even more serious and may result in jaundice, dark urine and pale motions in addition to the symptoms of cholecystitis. [netdoctor.co.uk]
Workup
In order to diagnose gallbladder disease, a preliminary examination through abdominal examination should be conducted. This would give information about the exact location of pain in the abdomen along with presence of tenderness if any. Following this, various other diagnostic procedures would also be required, which would include [7]:
- Medical history: A detailed medical history of the patient is gathered in order to obtain a family medical profile. Heredity is one of the major factors for gallbladder disease which would serve as an important clue in the diagnosis.
- Physical examination: A physical examination of the abdomen is necessary including Murphy’s signs. Such a type of method would shows signs of palpable gallbladder which would suggest gallbladder disease.
- Imaging studies: Chest and abdomen X-ray would be done to diagnose pneumonia and cholecystitis. Ultrasonography is also indicated to detect presence of gallstones, thickening of the walls and other problems with the gallbladder [8].
Serum
- Hypercholesterolemia
Chenodiol is associated with dose-dependent diarrhea as well as with hepatotoxicity, hypercholesterolemia, and leukopenia, all of which limit its use. 14 Nutrition and lifestyle changes may be beneficial for the prevention and treatment of cholelithiasis [uspharmacist.com]
Polymorphisms in ABCG5/G8 transporters linked to hypercholesterolemia and gallstone disease. Nutr Rev. 2008; 66 :343–348. [ PubMed ] 61. Stinton LM, Myers RP, Shaffer EA. Epidemiology of gallstones. [ncbi.nlm.nih.gov]
Treatment
In gallbladder diseases, wherein there is no presence of stones, but signs of inflammation are evident, antibiotics form the basis of treatment regime. However, when there are recurrent bouts and no signs of improvement are present then surgery is recommended [9].
In many instances it has been seen, that surgical removal of the gallbladder is the best option. Surgical procedures are carried out using 2 methods: either opening up the abdomen or laprocospically. Method involving the latter procedures enables faster recovery and leaves minimal scars as only 3 holes are made to conduct the method. This is the preferred method, when there are no urgent complications that need immediate attention [10].
Prognosis
Prognosis of the condition is favorable with prompt treatment regime. Gallstones can occasionally cause pain if they temporary block the passage of the bile duct. When there is permanent blockage, the condition can turn life threatening indicating immediate removal of the organ [5].
Etiology
Development of gallstones is one of the major types of gallbladder disease, having a high incidence rate. Gallstones form when substances in the bile form hard particles which can be the size of a grain up to that of a golf ball. Women after pregnancy are at an increased risk of developing gallstones. Women who have undergone hormone replacement therapy are also in the risk category. In addition to these, other risk factors that significantly contribute towards gallbladder disease include faulty dietary habits, heredity, obesity and slow intestinal transit [2].
Epidemiology
Gallbladder disease has become a relatively common phenomenon, affecting about 20 million Americans. The incidence of cholelithiasis is estimated to be about 0.15% to 0.22% amongst the pediatric population [3].
Gallbladder cancer is a rare occurrence in the developed countries. In US, an estimated 5000 cases occur each year. Amongst the developing countries, the incidence of gallbladder cancer is higher in South American Indian and North Indian population.
Pathophysiology
Anatomically, the gallbladder is a pear shaped organ located beneath the liver. Its major function is to store bile juice, which is essential for digestion of fats in the small intestine. The gallbladder releases the bile through the bile duct. This is a tube like structure that connects the gallbladder and liver to the small intestine.
Gallbladder disease may set in, when there is some kind of physical obstruction that takes place preventing the flow of bile through the duct. As a result of this phenomenon, there is inflammation accompanied by irritation in the wall of the gallbladder. Problems related to the gallbladder get corrected once the organ is removed [4].
Prevention
Diet plays a major role in prevention of gallbladder disease. Individuals who adhere to a balanced diet rich in omega 3 fatty acids, fruits, vegetables and nuts are at a lowered risk of developing gallbladder disease. Foods rich in fat and simple sugars significantly increase the risk of the disease.
Summary
Diseases of the gallbladder are common worldwide. A type of condition, wherein the gallbladder undergoes inflammation is termed as cholecystitis. It occurs when there is development of gallstones that significantly obstruct the bile ducts. This can eventually lead to occurrence of gangrene or necrosis. In addition to cholecystitis, other gallbladder diseases include primary sclerosing cholangitis (PSC), cancer of the gallbladder, biliary enteric fistulas and gallbladder polyps [1].
Patient Information
- Definition: Gallbladder disease is a condition that affects the functioning of the gallbladder. The primary function of the gallbladder is to store bile that is primarily produced in the liver and used for digestion of fats.
- Cause: Development of gallstones blocks the bile duct, obstructing its way and paving way for onset of gallbladder disease. Women are at an increased risk of contracting this disease condition than males. Faulty dietary habits and being overweight and obese predisposes an individual to develop gallbladder disease.
- Symptoms: Several types of gallbladder disease often share similar signs and symptoms. Individuals with cholestatis, suffer from jaundice, dark colored urine, splenomegaly and hepatomegaly. In case of cholelithiasis, individuals suffer from abdominal pain along with pain in the epigastric region. In conditions of cholecystitis, there is fever, followed by pain in upper quadrant region and development of jaundice.
- Diagnosis: Preliminary physical examination of the abdomen forms the basis of the diagnostic procedure. In addition, a detailed medical history would be carried out to elicit information of family history of the disease. In addition, X-ray of the abdomen and chest would also be required to detect any underlying disease condition. Ultrasonography is also indicated in diagnosis of gallbladder disease.
- Treatment: Antibiotics form the preliminary treatment regime if there are signs of inflammation and no evidence of gallstones is present. When antibiotics do not work, then surgery is the last resort.
References
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- Williams CI, Shaffer EA. Gallstone disease: current therapeutic practice. Curr Treat Options Gastroenterol. Mar 2008;11(2):71-7.
- Holcomb GW. Gallbladder disease. In: O'Neill JA, Grosfeld JL, Fonkalsrud EW, Coran AG, Caldmone AA, eds. Principles of Pediatric Surgery. Vol 1. 2nd ed. St. Louis, MO: Mosby; 2003:67: 645-651.
- Kalloo AN, Kantsevoy SV. Gallstones and biliary disease. Prim Care 2001; 28:591.
- Sarmiento RV. Emphysematous cholecystitis. Report of four cases and review of the literature. Arch Surg 1966; 93:1009.
- Stringer MD. Informed consent and choice in cholecystectomy. Pediatr Surg Int. Oct 2004;20(10):741-3.
- Kalimi R, Gecelter GR, Caplin D, et al. Diagnosis of acute cholecystitis: sensitivity of sonography, cholescintigraphy, and combined sonography-cholescintigraphy. J Am Coll Surg 2001; 193:609.
- Barakos JA, Ralls PW, Lapin SA, et al. Cholelithiasis: evaluation with CT. Radiology 1987; 162:415.
- Sicklick JK, Camp MS, Lillemoe KD, et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy: perioperative results in 200 patients. Ann Surg. May 2005;241(5):786-92; discussion 793-5.
- Siddiqui S, Newbrough S, Alterman D, Anderson A, Kennedy A Jr. Efficacy of laparoscopic cholecystectomy in the pediatric population. J Pediatr Surg. Jan 2008;43(1):109-13; discussion 113