What is the gallbladder?
The gallbladder is a small, hollow organ that is located underneath the liver, in the right upper part of the abdomen. It is a digestive organ whose main job is to store and release bile, a digestive juice made in the liver. The gallbladder fills with bile and releases it into the small intestine in response to a meal. Bile then helps to break down and absorb fat. While the gallbladder assists with digestion, it is not an “essential organ.” This means patients can have it removed and continue to live normal lives.
What is gallbladder disease?
There are various diseases that can affect the gallbladder. The most common condition is cholelithiasis, or the presence of gallstones. It is estimated that 15 percent of Americans have gallstones. These are small stones that form from the components of bile, and can be asymptomatic or symptomatic. When symptomatic, they produce pain in the right upper part of the abdomen along with nausea and occasionally vomiting. Classically, this occurs after a meal, which is when the gallbladder is “working” to release bile. The stones get stuck in the gallbladder neck, which leads to pain.
The gallbladder can become infected or inflamed, a condition known as “cholecystitis.” This can be caused by gallstones, chronic conditions of the gallbladder that lead to repeated inflammation, or in very ill individuals (for example, in the intensive care unit).
Other issues that can affect the gallbladder include gallbladder dyskinesia, which is when the movement of the gallbladder is uncoordinated. This condition gives pain similar to gallstones. Other rarer issues include problems with the muscle layer of the gallbladder, gallbladder polyps and cancer.
How is gallbladder disease diagnosed?
When a patient has signs or symptoms of gallbladder disease, physicians will typically order imaging studies. The most common initial test is an ultrasound. This is a painless procedure where an ultrasound probe is placed over the gallbladder. This test looks at the appearance of the gallbladder. Commonly seen abnormalities include gallstones and signs of cholecystitis.
The second most commonly used test is known as a HIDA scan (hepatobiliary scintigraphy). During this test, a harmless radioactive tracer is injected into the patient’s veins. The tracer then travels to the gallbladder where it is released into the small intestine just like bile. A camera evaluates how well the gallbladder takes up the tracer and releases it. A gallbladder that is not working well, or is blocked due a stone, will not release the tracer well, or at all. This signifies gallbladder disease.
How is gallbladder disease treated?
Gallbladder disease is commonly split into symptomatic and asymptomatic disease. Symptomatic disease includes issues like gallstones and cholecystitis. These conditions are treated with surgery, known as a cholecystectomy. During this surgery, the surgeon will remove the gallbladder.
Treatment of asymptomatic gallbladder disease is treated on an individual basis based on the issue. For some patients, this means surgery. For others, it means following with ultrasound. And for others, it means doing nothing, as there are not thought to be any significant future risks, and further testing is unlikely to be beneficial.
Our experienced team of physicians and advanced practice providers at Associates in Gastroenterology can help you with your concerns, questions and management of all aspects of gastrointestinal and liver disease. We would love to be your gastroenterology practice. Please schedule an appointment either by calling us (719-635-7321) or by clicking here.
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