The gallbladder is a relatively small organ located in a concavity of the liver. Its primary function is to store bile which it releases as needed during digestion.
Like other organs, the gallbladder is prone to dysfunction and may result in gallbladder disease. Gallbladder disease affects far more women than men. Its symptoms may range from mild discomfort to unbearable pain and are usually more pronounced after ingesting food. In extreme cases the affected person can experience jaundice, fever and nausea. Gallbladder disease usually occurs as a result of gallstones which are solid stones of varying size developed in the gall bladder from bile salts, cholesterol and calcium. Gallstones can affect anyone but is far less likely to occur in younger people. There are certain risk factors for developing gallstones. These include: a family history of gall stones; having high blood cholesterol levels; being obese; being affected by chronic intestinal diseases and taking oestrogen based pills, for example: contraceptives and HRT (Hormonal Replacement Therapy).
Gallbladder Pain Symptoms
There are two main types of gallbladder disease:
- Cholecystitis (caused by inflammation of the gallbladder)
- Choledocholithiasis (caused by the presence of gallstones in the common bile duct).
In many cases gallstones will be asymptomatic. It is estimated that approximately 90% of people inflicted with gallstones will display no symptoms. The probability of experiencing associated pain from the presence of gallstones is about 2% in the initial 10 years of gallstone formation. In general, 10 years signifies the period in which symptoms are likely to develop. After 10 years the likelihood of acquiring corresponding symptoms reduces to a large extent. There is literally no known reason why the symptoms tend to lessen after 10 years however some medical doctors have theorized it may be as a result of newly formed stones being more apt to cause symptoms than older, larger stones.
Biliary colic is considered the most prevalent symptom of gallbladder disease and is often manifested as periodical pain that is felt in the middle or right section of the upper abdomen. The symptoms may vary in different sufferers of the disease but will likely exhibit any of the following characteristics:
- The main symptom is customarily described as a piercing pain in the upper right abdomen just below the rib cage. It can be extremely severe to the point where it also occurs in the upper back area. It is not unusual for a person to also notice pain beneath the breast bone when struck by this condition.
- The pain will be persistent even after taking over-the-counter pain reducers, after changing position and or passing gas.
- These bouts of pain ordinarily begin at a specific time of day, but are less likely to occur more than or as much as once per week.
- The condition clears or corrects itself after the passage of many hours. If it is still causing pain after a twenty four hour period it is likely that it may be acute cholecystitis or a far worse condition.
- It may also cause some nausea and or vomiting.
- The symptoms can occur once again after they have ceased, but in some cases it may take years to have a repeat episode.
Other digestive disorders can have a similar effect that may lead to the belief that a person is experiencing symptoms of gall bladder disease. Symptoms such as: feeling overly full after eating; bloating of the abdomen; heartburn; regurgitation or reflux (acid flowing back into the oesophagus (food pipe)) or belching are not generally considered symptoms of gallbladder disease. These symptoms are usually as a result of peptic ulcers, indigestion of unknown origin or acid reflux disease.
There is also the possibility that signs of gas, nausea and abdominal discomfort may be indicative of Chronic Cholecystitis. This condition will include gallstones and mild inflammation that may also lead to scarring and stiffness of the gallbladder. However, often the symptoms of this condition are accompanied by diarrhoea with up to ten bowel movements daily.
Acute cholecystitis (Gallbladder Inflammation)
Up to 3% of people experiencing the symptoms of gallbladder disease will also experience accompanying inflammation. This happens as a result of blockage to the duct by gallstones or sludge. The symptoms resemble those of biliary colic but are often unrelenting and cause greater pain. These are the usual signs associated with acute cholecystitis:
- Extreme pain in the upper right abdomen that is unending and that lasts for several days. The pain is generally exacerbated upon inhalation.
- Nausea and vomiting often accompany these sudden attacks.
- The pain may also migrate to the back or be present in the shoulder blades. It is sometimes felt beneath the breast bone or on the left side of the body.
- Approximately one third of sufferers will be subjected to fever and chills.
It is very important for anyone who is afflicted with the severity of an acute attack to seek immediate medical attention. Gangrene and perforation of the gallbladder may occur if it is not dealt with promptly. An estimated 20% of persons with the condition will acquire an infection. For diabetics the overall risk of complication is much higher.
Blockage in the gallbladder caused by gallstones
If gallstones become lodged in the common bile duct forming a blockage, it will generate symptoms that are almost identical to those that occur when stones are present in the gallbladder. Additionally it may also cause the following symptoms:
- Jaundice, which will be made apparent by: the yellowing of the eyes and skin, itchiness, pale coloured bowel movements and discoloured or dark urine. However having symptoms of jaundice can be caused by other ailments including hepatitis, alcoholic liver disease and hepatotoxicity.
- There may be an increase in heart rate and sudden drop in blood pressure
- Nausea, vomiting and pain in the upper right abdominal will most likely be evident.
- Fever and chills may also manifest themselves. When combined with the above symptoms these may indicate an infection within the bile duct or more specifically cholangitis.
It is therefore important to seek medical intervention at the onset of these symptoms. Because of the likelihood of infection, emergency medical treatment may also be necessary.
In milder cases of gallbladder disease it may be possible to alleviate the pain with pain killers and a hot water bottle placed on the abdomen to sooth it. However once the symptoms of the disease are present no matter how mild it is, it is vital to get the advice of a medical practitioner to prevent unnecessary complications. Because the disease may resemble other conditions, certain tests may be performed to eliminate any other causes. Once gallbladder disease has been diagnosed it may require a change in diet, cholecystectomy (surgery to remove the gallbladder) or through dissolution therapy (dissolving the gallstones). The prognosis for this condition if treated is usually very good.