To understand the gallbladder you first need to know about the liver, which is a large organ in the upper right side of your abdomen located mostly under your lower right ribs.  The liver has many functions.  Think of it as a large filter for your blood.  It also plays a role in the metabolism or change of sugars into fats and fats into sugars in your body.  It produces some of the necessary components that help your blood to clot and it also makes bile, or gall, which is used to digest the fat portion of your food after you eat.

 The liver makes this bile 24 hours a day, but you only need it after you eat, so there has to be a place to store it.  That is what the gallbladder is, a small sac hanging under the liver which stores the gall or bile until it is needed.

 When you eat, the gallbladder gets a message to squeeze, and send some of the bile into your intestines to digest the fat part of the food.

 The medical word for the bile system is “chole”.  The medical word used for a bladder, which is a fluid containing sac, is “cyst”.

 When the gallbladder is working normally you have no symptoms.  The system can have things wrong with it that makes it cause pain, or other symptoms.  Stones can grow in the gallbladder, and then when it squeeezes it can hurt.  The medical term for stones is “lithiasis”.  There is a duct (the medical word for duct in the gallbladder system is “docho”) that drains the gallbladder when it squeezes.  If a stone gets in the way of the duct and plugs it, back pressure can build up and cause pain,  If the back pressure gets high enough or is present long enough, the bile can back up through the liver, into the blood, and make you turn yellow (jaundiced).

 If the gallbladder gets irritated it can become sore and painful, just like if you had an irritated sore spot some place on your skin.  The medical word for this inflammation is “itis”.

 Sometimes the gallbladder gets so that it just can’t squeeze adequately to push enough bile out and you can also get painful symptoms from this.

 If you have gallstones it is called Cholelithiasis.

 If you have gallstones in the gallbladder and in the duct it is called Choledocholithiasis.

 If the gallbladder is irritated and inflamed it is called cholecystitis.

 Some of the symptoms of gallbladder disease are as follows:

1. Pain over the area of the gallbladder, particularly a short time after eating.  The pain can radiate toward your right shoulder and right shoulder blade, and the area over the gallbladder can be tender to touch.  
2. You can have increased passing of gas by mouth and by rectum.
3. You can have nausea, diarrhea, and sometimes vomiting.
4. You might develop a fever.
5. You may become jaundiced.
6. You could have significant pain in your middle abdomen and middle back areas.

 Tests that can be done for gallbladder disease include a physical exam and a history taking.  Blood and urine tests may be done, and imaging exams like an ultrasound or a CT scan of the area are often very helpful.  If it is suspected that the gallbladder output is diminished a test called a HIDA Scan would be appropriate.

 Common risks for gallbladder disease include:

1. Obesity
2. Age 30-40 and above
3. Increased “gas”
4. Female
5. Female with many children
6. Family history of Gallbladder Disease

 If you have a “bad” gallbladder you may be put on pain meds, sometimes antibiotics, told to follow a low fat diet , and eventually surgery will be needed.  There are emergent situations when surgery would be the appropriate 1st treatment.

Written by: Michael Beasley M.D.