Gallstone disease

The gallbladder is an organ that sits beneath the liver on the right side of your abdomen and stores the bile that the liver produces. This bile aids in the breakdown of fat. Despite how helpful it is, we all don't give the gallbladder much thought until we run into trouble. Your persistent pain or digestive issues may be related to your gallbladder. Now let's look at the most common ways gallbladder becomes a problem.

Understanding Gallstones and the ways they can cause problems

Gallstones are hard deposits that can form in your gallbladder. The stones can be as big as a golf ball or as small as a grain of sand. These stones can cause pain and other problems while they travel through and get stuck in various places along their journey.

Biliary Colic is classically described as severe and sharp abdominal pain in the upper right side of the abdomen. It may also spread to the back or right shoulder blade. It is commonly felt after having dinner or any other heavy meal and can last for several minutes or up to a few hours. This is the most common symptom of gallstones when they temporarily block the gallbladder outlet (cystic duct). A lot of people might not feel the pain attacks to be that severe and attempt to regulate their diet to try and avoid the symptoms.

Cholecystitis occurs when the cystic duct gets completely blocked by the stones. Obstruction leads to stagnation of the bile, which in turn leads to infection, inflammation and sometimes perforation.

Cholangitis occurs when the bile duct gets blocked by the stones, leading to backup of bile into the entire liver and into the bloodstream. This will lead to jaundice and can cause fever and chills from a severe infection.

Pancreatitis occurs when a stone temporarily blocks the pancreatic duct where it joins the bile duct as they both empty into the first portion of the intestine (duodenum). Up to 70% of all cases of pancreatitis are thought to be from gallstone disease. This can show up as upper abdominal pain radiating to the back and some of the severe attacks can be life threatening.

Atypical symptoms like nausea, vomiting and abdominal bloating though common, when not accompanied by pain, mandate evaluation for other reasons before blaming them on gallbladder disease.

Risk Factors & Prevention

Gallstone disease can run in families, but a healthy diet and exercise to maintain a healthy body weight can prevent gallstones. On the other hand, rapid weight loss over a short period of time can also lead to gallstone formation.

Laparoscopic Cholecystectomy

A thorough evaluation, including physical examination, blood tests, and imaging studies like ultrasound or CT scans can be done to determine the cause of your symptoms.

The most effective way of treating gallstone disease is to have the gall bladder removed through small incisions (laparoscopic cholecystectomy). Other treatments like medications and stone removal have been tried in the past and were found to be ineffective.

Most people who have had pain from gallstones only notice that the pain is all gone after the operation. They can eat a full range of foods like everyone else.

This is best planned soon after the diagnosis as even mild symptoms might be followed by a severe attack at any time. Repeated episodes of obstruction and inflammation may lead to scarring and make the operation more challenging and riskier.

Gallbladder polyps seen on ultrasound are the other common reason for gallbladder removal – symptoms, size or growth on follow up might prompt the recommendation for surgery, mainly to prevent cancer. Gallbladder cancer, though rare, is often diagnosed late, hard to cure, and is more common in India compared to rest of the world. It is often seen in older people who have had long standing untreated gallstone disease.

Early diagnosis and a safe operation are key to good outcomes in gallbladder disease.