Gallbladder diseases: cause and treatment

The bile is concentrated and stored in the gallbladder, a pear-shaped organ located just below the liver. Bile is produced in the liver and plays a role in fat metabolism. The bile is stored in the gallbladder and excreted during digestion into the duodenum, the part of the small intestine that directly connects to the stomach. Gallstones are the most common gallbladder disease.

Gallbladder: gallstones

They usually occur when excessive amounts of cholesterol in the bile clump together into a solid mass. People with hemolytic anemia (anemia), where red blood cells are broken down at an accelerated rate, can develop gallstones made of bilirubin, a bile pigment. The amount and size can vary from a large stone to a lot of grit. Gallstones are more common in women than in men. Usually there are no symptoms and no treatment is required.

Inflamed gallbladder

However, sometimes acute symptoms occur because a bile duct is blocked or the gallbladder becomes inflamed (cholecystitis). A blocked bile duct can also easily become infected. Sometimes an inflamed gallbladder fills with pus, requiring immediate intervention.

Gallbladder cancer

Tumors rarely occur in the gallbladder, but for unknown reasons gallstones increase the risk of gallbladder cancer. Few people with gallstones also develop gallbladder cancer, but people with gallbladder cancer usually also have gallstones. Gallbladder cancer is usually discovered at age 70 or older, and in 75 percent of cases it is not treatable by surgery. The prognosis is therefore poor.
Treatment for most gallbladder diseases involves surgical removal of the gallbladder. Gallstones can be dissolved with chemicals or ultrasound waves, but they usually return if the gallbladder is not removed. Digestion is not disturbed by removal of the gallbladder. The bile then flows straight from the liver into the small intestine.

Symptoms of gallbladder disease

  • Sometimes nausea and vomiting with attacks of pain.
  • Fever and chills (in case of gallbladder inflammation).
  • Full feeling and swollen stomach.
  • Severe belching, heartburn and gas formation.
  • Weight loss (for cancer).
  • Jaundice.

Moderate to severe pain in the upper right abdomen, sometimes spreading to the chest, right shoulder and back. Pain from gallstones may come and go for periods of thirty minutes to four hours. With gallbladder inflammation, the pain gradually increases and worsens with deep breathing. Gallbladder cancer causes persistent pain for a long time.

Causes of gallbladder disorders

The cause of gallstones is unknown, but cholesterol stones are related to an abnormal composition of the bile. However, age, obesity, a high-calorie diet, rapid weight loss, Crohn’s disease, liver cirrhosis, blood diseases or intestinal surgery can increase the risk. In women, frequent pregnancies, birth control pills or estrogen treatment can promote the formation of gallstones.
Blockage of a bile duct (by a gallstone), injury or a bacterial infection (by blockage of a bile duct) can cause gallbladder inflammation or an abscess. Gallstones increase the risk of gallbladder cancer. Finally, it can be noted that hereditary factors can play a role in the formation of gallbladder diseases.

Prevention

There is not so much specific advice for prevention, but what can reduce the risk is to keep your weight at a healthy level. It is also recommended to consult a doctor if you want to lose weight quickly.

Treatment of gallbladder disease

There are a number of treatments for gallbladder disease:
First, the gallbladder is usually removed via conventional abdominal surgery. However, nowadays gallbladder removal via laparoscopy is preferred. A laparoscope is inserted into the abdominal cavity through a small incision and the gallbladder is removed. With this technique, the postoperative pain is much less and the recovery time is shorter.
Certain medicines are prescribed for the pain before the operation. In addition, an IV for nutrition and fluids is started and sometimes antibiotics are administered to prevent or treat additional bacterial infections (as prophylaxis).
Secondly, in patients with gallbladder inflammation who are too weak for surgery, an opening is made in the gallbladder. This allows a tube to be inserted to drain the gallbladder. The gallbladder can still be removed later.
Medicines to be taken orally that dissolve the cholesterol stones in a few months or years are sometimes prescribed . However, this (expensive) treatment only helps with small stones that consist only of cholesterol and only helps in half of the cases.
Using a long, thin needle, a solution (MTBE) can be introduced directly into the gallbladder through a catheter, causing the cholesterol stones to dissolve within a few days. But they often come back. The gallstones can also be crushed with sound waves.
One of the worst gallbladder diseases, gallbladder cancer can be treated with radiation and chemotherapy.

To the doctor

If you suffer from severe abdominal pain, it is advisable to visit a doctor. In the event of an emergency, call the ambulance immediately. This applies to pain in the abdomen and nausea, shortness of breath and sweating, because these symptoms can also indicate a heart attack.

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