Gallbladder disease refers to a number of different diseases and disorders involving the gallbladder and bile ducts. The most common of these diseases is gallstones. Most of the time these stones pass out of the gallbladder and bile ducts without even being noticed. Only a small number of gallstone cases present with symptoms and even fewer lead to complications. However, these complications can be fatal in rare instances.
The different types of gallbladder diseases may arise for different reasons. These conditions include:
- Gallstones (cholelithiasis)
- Bile ducts stones (choledocholithiasis)
- Gallbladder inflammation (cholecystitis)
- Gallbladder disease without stones (acalculous cholecystitis)
- Bile duct disease (sclerosing cholangitis)
- Gallbladder polyps
- Gallbladder cancer (carcinoma)
Although gallstones are not usually considered to be a serious condition, gallstone disease causes approximately 10,000 deaths in the United States every year. This is largely due to delayed or poor treatment and management. There are several other less common gallbladder diseases, like gallbladder cancer, that have a high risk of death especially when diagnosed late or if the appropriate treatment is delayed.
Read more on how to know if you have gallstones.
How To Spot Gallbladder Disease
There are several signs and symptoms that may appear with most gallbladder and bile duct conditions. However, a single sign or symptom on its own may not be specific for gallbladder disease. In fact these signs and symptoms may be seen in several different types of abdominal conditions. It may also present similar to certain heart diseases.
Therefore if there is shortness of breath, dizziness and/or excessive sweating then immediate medical attention is necessary. It could be a heart attack or some other serious condition involving the vital organs. With the upper abdominal organs lying so close to the chest cavity, it is not uncommon for there to be confusion at times. Certain people are at a greater risk of developing gallbladder disease.
Gallstone disease for example is more likely to arise in overweight/obese women who are around the age of 40 years and have changes in the female hormone levels like with pregnancy, menopause or when using birth control pills and hormone replacement therapy (HRT). However, gallstones can also affect men and even arise much earlier or later in life even if the body weight is within normal limits.
Upper Right to Middle Abdominal Pain
The gallbladder is located in the upper right part of the abomen with bile ducts extending to the midline. Pain arising from the gallbladder and bile duct there present with upper righ to upper middle abdominal pain. Typically the pain arises in episodes and particularly after fatty meals and may last anywhere from 1 to 5 hours. It is described as a colicky type of pain and these episodes are therefore referred to as biliary colic.
Read more on gallbladder location.
Right Shoulder or Back Pain
Another common sign of gallstones and gallbladder inflammation in particular is pain in the right shoulder or right upper back. It may also be described as pain between the shoulder blades. It is not uncommon for this pain to be confused with cardiac (heart) pain, although the latter usually affects the left shoulder and arm. The pain typically radiates from the upper abdomen to the upper shoulder or upper back.
Tenderness of the Upper Abdomen
In addition to the pain, most people with gallstone disease will also experience abdominal tenderness. This means that pressure applied to the upper abdomen region, usually the middle or right quadrants, will worsen the pain. Sometimes the pain may so severe that standing up or sitting may cause unbearable pain as the pressure on the abdomen increases in these positions.
Nausea with or without Vomiting
Nausea is another common symptom of gallbladder disease. It tends to arise a short while after consuming a fatty meal in particular and may correlated with abdominal pain. The nausea may lead to vomiting but not in every instance. The nausea and vomiting is non-specific and can occur with a host of upper digestive conditions. Along with the pain it may also be confused with angina or a heart attack.
Yellowing of Skin and Eyes
A yellow tinge or discoloration of the skin and/or whites of the eyes is known as jaundice. This is a result of the bile flow being obstructed and compounds that are normally expelled with bile are then deposite in the skin and mucous membranes. Jaundice is not specific for gallbladder disease. It can also arise with several different liver diseases and even blood disorders. The yellowing of jaundice must be differentiated from skin yellowing due to other conditions.
Bile is stored in the gallbladder and secreted via the bile ducts into the small intestine. It helps emulsify fats so that it can be digested. However, in certain gallbladder and bile duct diseases the bile cannot be expelled. Fats remain largely undigested in the gut and are then cause the stool to become fatty or greasy in appearance and texture. The stool is also more likely to float. This type of fatty stools is known as steatorhhea.
In addition to the above signs and symptoms there may also be the following:
- Fever and chills
- Loss of appetite
- Unintentional weight loss
When to See a Doctor
It is always advisable to consult with a medical professional about symptoms like severe or persistent pain. The signs and symptoms alone are not always reliable indicators of gallbladder disease. Sometimes cardiac conditions like heart attacks can present in an atypical manner.
For example, a silent heart attack may not present with chest pain, sweating, shortness of breath and arm pain. Instead there could be mild upper abdominal pain and no other symptoms which is extremely misleading. Gallbladder disease needs to be conclusively diagnosed based on the results of certain investigations.
This may include the findings of an abdominal ultrasound, x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI), hepatobiliary iminodiacetic acid (HIDA) scan or endoscopic retrograde cholangiopancreatography (ERCP). Blood tests may also be useful to confirm jaundice, infections and so on. A doctor will determine which test is the most appropriate to confirm a condition suspected of causing the symptom.