Gallbladder diseases
Gallbladder diseases encompass a range of conditions that affect the gallbladder, a small, pear-shaped organ located under the liver. The gallbladder stores and concentrates bile, a digestive fluid produced by the liver that helps break down fats in the small intestine. Gallbladder diseases can range from mild inflammation to severe, life-threatening conditions.

Types of Gallbladder Diseases
Cholelithiasis (Gallstones)
- Description: Gallstones are solid particles that form from bile cholesterol and bilirubin in the gallbladder. They can vary in size from tiny grains to large stones.
- Types:
- Cholesterol Gallstones: Made primarily of hardened cholesterol. The most common type, often associated with obesity, high-fat diets, and certain medications.
- Pigment Gallstones: Made from excess bilirubin. Often linked to liver cirrhosis, biliary tract infections, or blood disorders like sickle cell anemia.
- Symptoms: Many people with gallstones are asymptomatic. When symptoms occur, they may include:
- Sudden, intense pain in the upper right abdomen or center of the abdomen
- Pain between the shoulder blades or in the right shoulder
- Nausea or vomiting
Cholecystitis (Inflammation of the Gallbladder)
- Description: Inflammation of the gallbladder, often due to a gallstone blocking the cystic duct.
- Types:
- Acute Cholecystitis: Sudden inflammation often due to a gallstone obstruction, leading to bile build-up, irritation, and pressure.
- Chronic Cholecystitis: Recurrent episodes of inflammation and gallstones leading to a thickened, shrunken, and scarred gallbladder.
- Symptoms:
- Severe, steady pain in the upper right abdomen
- Fever, chills
- Nausea, vomiting
- Jaundice (yellowing of the skin and eyes)
Choledocholithiasis
- Description: Gallstones that pass from the gallbladder into the bile ducts (common bile duct stones), potentially causing a blockage.
- Symptoms:
- Abdominal pain
- Jaundice
- Fever with chills (if infection develops, called ascending cholangitis)
Cholangitis
- Description: Inflammation of the bile ducts, often due to bacterial infection resulting from bile duct obstruction (e.g., gallstones, tumors, or strictures).
- Symptoms:
- Charcot’s triad: right upper quadrant pain, fever, and jaundice
- Hypotension and confusion (Reynolds pentad, when severe)
Gallbladder Polyps
- Description: Small, benign growths on the gallbladder lining. Most are non-cancerous, but larger polyps (greater than 1 cm) may have a risk of becoming cancerous.
- Symptoms: Often asymptomatic; larger polyps may cause pain similar to gallstones.
Gallbladder Cancer
- Description: A rare form of cancer that originates in the gallbladder. Risk factors include gallstones, porcelain gallbladder (calcification of the gallbladder wall), and chronic gallbladder inflammation.
- Symptoms:
- Abdominal pain, especially in the upper right quadrant
- Jaundice
- Weight loss
- Nausea and vomiting
Causes and Risk Factors
- Diet and Lifestyle: High-fat diets, obesity, rapid weight loss, and fasting can increase the risk of gallstone formation.
- Genetic Factors: Family history of gallstones or gallbladder disease.
- Gender and Age: Gallbladder diseases are more common in women, especially those over 40 years old, due to hormonal factors such as estrogen.
- Medical Conditions: Diabetes, liver disease, hemolytic anemia, and certain gastrointestinal conditions like Crohn’s disease.
Diagnosis
Diagnosis of gallbladder diseases usually involves a combination of the following:
- Physical Examination: Checking for tenderness in the abdomen, especially in the right upper quadrant.
- Blood Tests: To check for signs of infection, jaundice, or pancreatitis.
- Imaging Studies:
- Ultrasound: The most common initial imaging test to detect gallstones and gallbladder inflammation.
- CT Scan: Provides more detailed images of the gallbladder and surrounding structures.
- HIDA Scan (Hepatobiliary Iminodiacetic Acid Scan): Assesses gallbladder function and detects blockages.
- MRI/MRCP (Magnetic Resonance Cholangiopancreatography): Used to visualize the bile ducts and detect stones in the bile duct.
- Endoscopic Procedures:
- ERCP (Endoscopic Retrograde Cholangiopancreatography): Combines endoscopy and X-ray to diagnose and treat bile duct problems, including removing stones.
Treatment Options
Lifestyle and Dietary Changes
- Low-fat diet to reduce gallbladder stimulation and decrease the risk of gallstone formation.
- Weight loss and regular exercise.
Medications
- Ursodeoxycholic Acid: Used to dissolve small cholesterol gallstones and reduce gallstone formation, especially in patients who cannot undergo surgery.
Surgical Treatments
- Cholecystectomy: The surgical removal of the gallbladder.
- Laparoscopic Cholecystectomy: Minimally invasive surgery with a quicker recovery time. The most common surgical procedure for gallbladder removal.
- Open Cholecystectomy: Involves a larger incision and longer recovery, used when complications arise or if laparoscopic surgery isn’t feasible.
- ERCP: To remove stones from the bile duct, especially in cases of choledocholithiasis or cholangitis.
Non-surgical Treatments
- Shock Wave Lithotripsy: Uses shock waves to break up gallstones in certain cases, though it’s not commonly used for gallstones.
Prevention
- Healthy Diet: Low in saturated fats and high in fiber.
- Regular Exercise: Helps maintain a healthy weight.
- Avoid Rapid Weight Loss: Losing weight too quickly can increase the risk of gallstones.
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