Gallbladder

An Overview

The gallbladder is a small pouch that sits just under the liver. The gallbladder stores bile produced by the liver. After meals, the gallbladder is empty and flat, like a deflated balloon. Before a meal, the gallbladder may be full of bile and about the size of a small pear. In a healthy gallbladder, this process happens painlessly. However, when blockage occurs in the gallbladder, or it stops functioning correctly, considerable pain and discomfort can occur. The main purpose of the gallbladder is to store bile, also called gall, needed for the digestion of fats in food. Produced by the liver, bile flows through small vessels into the larger hepatic ducts and ultimately through the cystic duct (parts of the biliary tree) into the gallbladder, where it is stored.

In this article, we look at the function of the gallbladder, some common gallbladder problems and their symptoms, treatment options, and the long-term outlook. In response to signals, the gallbladder squeezes stored bile into the small intestine through a series of tubes called ducts. Bile helps digest fats, but the gallbladder itself is not essential. Removing the gallbladder in an otherwise healthy individual typically causes no observable problems with health or digestion yet there may be a small risk of diarrhea and fat malabsorption.

• Gallstones (cholelithiasis):  For unclear reasons, substances in bile can crystallize in the gallbladder, forming gallstones. Common and usually harmless, gallstones can sometimes cause pain, nausea, or inflammation.
• Cholecystitis: Infection of the gallbladder, often due to a gallstone in the gallbladder. Cholecystitis causes severe pain and fever, and can require surgery when infection continues or recurs.
• Gallbladder cancer: Although rare, cancer can affect the gallbladder. It is difficult to diagnose and usually found at late stages when symptoms appear. Symptoms may resemble those of gallstones.
• Gallstone pancreatitis: An impacted gallstone blocks the ducts that drain the pancreas. Inflammation of the pancreas results, a serious condition.

The stages of gallbladder cancer are:

Stage I.• At this stage, gallbladder cancer is confined to the inner layers of the gallbladder.

Stage II.• This stage of gallbladder cancer has grown to invade the outer layer of the gallbladder and may extend beyond the gallbladder.

Stage III•. At this stage, gallbladder cancer has grown to invade one or more nearby organs, such as the liver, small intestine or stomach. The gallbladder cancer may have spread to nearby lymph nodes.

Stage IV.• The latest stage of gallbladder cancer includes large tumors that involve multiple nearby organs and tumors of any size that have spread to distant areas of the body.

Symptoms for Gallbladder

• Pain in the mid- or upper-right section of the abdomen: Most of the time, gallbladder pain comes and goes. However, pain from gallbladder problems ranges from mild and irregular to very severe, frequent pain. Gallbladder pain often causes pain in the chest and back.

• Nausea or vomiting: Any gallbladder problem may cause nausea or vomiting. Long-term gallbladder diseases and disorders may lead to long-standing digestive problems that cause frequent nausea.

• Fever or shaking chill: This signals an infection in the body. Alongside other gallbladder symptoms, fever and chills may point to a gallbladder problem or infection.

• Changes in bowel movements: Gallbladder problems often cause changes in bowel habits. Frequent, unexplained diarrhea can signal a chronic gallbladder disease. Light-colored or chalky stools may point to a problem with the bile ducts.

• Changes in urine: Patients suffering from gallbladder issues may notice darker than normal urine. Dark urine may indicate a bile duct block.

• Jaundice Yellowing of the skin occurs when liver bile does not successfully reach the intestines. This normally happens due to a problem with the liver or due to a blockage in the bile ducts caused by gallstones.

Diagnosis

If a doctor suspects a patient has a gallbladder problem, they will likely order the following:

• Imaging tests of the gallbladder: Ultrasound and CT scans are commonly used to image the gallbladder. These will then be checked for gallstones.
• Tests to examine bile ducts: These tests use dye to show if a gallstone is causing a blockage in the bile ducts. Tests to check the bile ducts for stones include MRI, hepatobiliary iminodiacetic acid (HIDA) scans, and an endoscopic retrograde cholangiopancreatography (ERCP).
• Blood tests: Doctors can use blood tests to reveal signs of infection, inflammation of the bile ducts, pancreatitis, or other complications caused by gallstones.

Treatment

• Gallstones and cholecystitis are treatable conditions.
• Gallstones that do not cause symptoms will not need immediate treatment other than an alert for potential future gallbladder problems.
• However, gallstones that cause symptoms or infections of the gallbladder do need treatment.
• Treatment options include surgically removing the gallbladder, medications to break up gallstones and antibiotics to treat infections.

Chemotherapy. Chemotherapy is a drug treatment that uses chemicals to kill cancer cells.

Radiation therapy. Radiation uses high-powered beams of energy, such as X-rays, to kill cancer cells.

Clinical trials. Clinical trials use experimental or new medications to treat gallbladder cancer. Talk to your doctor to see whether you’re eligible to participate in a clinical trial.

Endoscopic ultrasound: A tiny ultrasound probe on the end of a flexible tube is inserted through the mouth to the intestines. Endoscopic ultrasound can help detect choledocholithiasis and gallstone pancreatitis.

Abdominal X-ray: Although they may be used to look for other problems in the abdomen, X-rays generally cannot diagnose gallbladder disease. However, X-rays may be able to detect gallstones.

Prevention

• There is no sure way to prevent gall bladder cancers. We cannot modify risk factors such as age, gender, race, ethnicity and congenital abnormalities. But we can always take precautions to reduce the risk. Obesity is one of the important risk factor. It is always recommended to maintain healthy weight and lead an active life.
• Healthy diet with cereals, whole grains instead of refined, at least two and half cups of fruits and vegetables daily, limiting intake of processed food and red meat have been shown to lower the risk of many cancers including GBC.
• women
• people over 40
• people with a family history of gallstones
• native and Mexican Americans
• individuals with obesity
• Gallbladder problems are generally easy to resolve. Long-term complications are unlikely after removing the gallbladder or treating the infection. Those without a gallbladder can lead a normal, healthy life after recovery. Gall bladder is helpful organ but not an essential organ, one can live without it. Many people who have got their gall bladder removed lead normal life after surgery.

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