The gallbladder is a storage organ that lies under the liver and in close proximity to the pancreas. It receives bile produced by the liver and stores it until it is ready to be released. Bile contains the wastes and byproducts from the liver and is expelled into the small intestine.
It also helps to emulsify fats in food within the small intestine thereby assisting with chemical digestion. Although the gallbladder is not essential for survival, problems with the gallbladder can cause several symptoms, result in disturbances with digestion in particular and sometimes even lead to life-threatening complications.
What are Gallbladder Problems?
Gallbladder problems arise for many differet reasons and are of various types. It can affect gallbladder functioning in various ways and lead to a host of different signs and symptoms. Some problems like the formation of stones in the gallbladder (gallstones) and inflammation of the gallbladder are common in the general population, and especially among adults. Other conditions like gallbladder cancer are less common but potentially life-threatening.
Intolerance to Fats
When the gallbladder is diseased, its ability to hold and release bile may also be affected. This can affect the digestion of fats since bile breaks down fats into smaller globules (emulsification). This allows fat-digesting enzymes to more effectively break down fat in foods. Bile secretion increases when fats are detected in food. Therefore symptoms of the different gallbladder problems may worsen with the consumption of fatty meals.
Signs and Symptoms
The signs and symptoms of different types of gallbladder problems may vary to some extent. However, most of these problems have at least some symptoms in common. The following signs and symptoms are mainly seen with conditions like gallstones and gallbladder inflammation, which are two of the more common gallbladder problems. These signs and symptoms include:
- Pain in the upper abdomen, towards the middle of the upper abdomen extending slightly to the right. This is where the gallbladder is located. The pain may be of sudden onset in conditions like gallstones and tend to rapidly worsen over a short period of time. It is often triggered or worsened by consuming fatty meals.
- Referred pain may be felt in distant sites, such as the back or right shoulder between the shoulder blades. Sometimes gallbladder pain may also be mistaken for lower chest pain due to the proximity. In acute conditions there may also be significant tenderness of the abdominal wall over the gallbladder.
- Nausea and vomiting are other common non-specific symptoms of gallbladder diseases. It tend to occur or worsen a short while after eating. Fatty meals in particular tend to be triggers.
- Fever may be present in conditions like cholecystitis.
Other non-specific signs and symptoms such as loss of appetite and unintentional weight loss may also occur with certain gallbladder conditions, namely gallbladder cancer.
Read more on signs of gallbladder disease.
Types and Causes
There are several types of gallbladder problems which may be due to different causes. Some of these types of gallladder problems is discussed in further details below.
Gallstones are where hard masses (‘stones’) develop from the constituents of the bile within the gallbladder. These stones may pass out unnoticed or become lodged with a duct to cause an obstruction. Most gallstones are cholesterol stones. It may arise when the levels of cholesterol within the bile are very high. Similarly high levels of bilirubin, a common component of bile, may also cause gallstones as well as any gallbladder obstruction.
Cholecystitis is inflammation of the gallbladder. Most of the time this inflammation occurs due to gallstones which lead to a build up of bile within the gallbladder. Any other blockage in the bile ducts can also lead to cholecystitis, including tumors. The inflamed gallbladder can progress to several complications such as infection, rupture of the gallbladder or even death of gallbladder tissue.
Gallbladder polyps are growths that protrude into the gallbladder lumen. It include cholesterol polyps, inflammatory polyps and adenomatous polyps. These types of tumors are common and most are benign. However, some have the potential to become malignant (cancerous), particularly adenomatous polyps. There are other beningn tumors that can also occur in the gallbladder, such as fibromas, granular cell tumors, hemangiomata, leiomyomas and lipomas.
Gallbladder cancer is one of the more serious and potentially life-threatening conditions of the gallbladder. Also known as gallbladder carcinoma, it usually arises with chronic inflammation of the gallbladder. Overall gallbladder cancer is not common. The more common types of gallbladder cancer is adenocarcinoma. It is malignancy that arises from the glandular cells in the inner lining of the gallbladder.
A gallbladder mucocele, also known as hydrops, is where the gallbladder becomes distended due to the accumulation of mucus or watery fluid. This is not the same as an empyema where the gallbladder becomes filled with pus. Most of the time a mucocele occurs due to a gallstone or tumor that blocks the gallbladder duct. Parasites, infections like typhoid, external compression on the gallbladder and certain genetic conditions may also be responsible.
A gallbladder volvulus is a twisting of the gallbladder which results in the blood supply to the gallbladder being compromised. The twisting can also result in injury of the common bile duct and even gangrene if there is a complete blockage of the blood supply. Gallbladder volvulus tends to be more common among the elderly and appears to be associated with the shrinking of tissue and loss of fat with advancing age.
Read more on twisted gallbladder.
Gallbladder empyema is where the gallbladder becomes filled with pus usually due to a bacterial infection of the gallbladder. The pus accumulates in an infected gallbladder if there is an obstruction which prevents the pus from draining. This is usually due to an obstruction caused by gallstones. If left untreated, an empyema can result in complications like sepsis which may be life-threatening.
A porcelain gallbladder is where there is extensive calcification of the gallbladder wall. This is therefore also referred to as a calcified gallbladder. It is not a common condition and almost all instances of porcelain gallbladder is linked to gallstones. Most of the time there are no symptoms due to a porcelain gallbladder. However, intervention is still necessary since there is a high risk of cancer associated with the calcification of the gallbladder.